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DIABETES IN THE ASIAN AMERICAN POPULATION
Presented by Janice S. Wong R.N CDE -2007


As an RN/CDE, I have worked as a staff nurse, a charge nurse, a supervisor, a assistant manager, and a manger, working on Med Surgical Units and in a Mental Health Unit.

I have been a R.N for over 42 years and am a Certified Diabetes Educator at Washington Hospital/Nursing Education in Fremont CA, and this has been the most rewarding in my long career, as I am also a diabetic and have been one for over 34 years. I have seen the spread of Diabetes in the Asian American community , and see the need for education for all of us, on how to live with Diabetes.

Diabetes is a chronic disease that is unfortunately growing very rapidly in the Asian American population. Why you ask? Well it has many reasons….but it has mainly to do with diet and exercise…although genetics plays a big part in making the Asian American susceptible to diabetes. There is so far no cure, but it can be controlled.

What is diabetes? It is a group of diseases that is characterized by raised levels of blood glucose resulting from defects in insulin production or insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.(3)

There are three different types of diabetes - there are more sub groups that I will not discuss since the treatment is the same and might cause confusion. As a result, I want highlight Diabetes Type 2 as this is the most common to us Asian Americans.

 
Type 1
Diabetes
It is an auto-immune disease. It develops when the body’s immune system destroys pancreatic beta cells. The insulin producing cells in the pancreas, that regulates blood glucose. People with Type 1 are usually children or young adults, however it can happen at any age. Type 1 need insulin injections to stay alive. It accounts for 5% to 10% of all diagnosed cases of diabetes. Risk factors may be autoimmune, genetic, or environmental. There is no known way of preventing Type 1 Diabetes.
Pre-Diabetes
It is a stage that people go through before developing Type 2 Diabetes. During this time your Blood Sugars may be slightly elevated , but not High enough to be diagnosed with diabetes…If you can get control of your blood Glucose levels during this stage, you can delay or prevent Type 2 diabetes from ever developing.
Type 2
Diabetes
It is caused by both a genetic tendency and external factors - i.e. an unhealthy diet…obesity (abdominal)…lack of physical activity… women having a high birth weight baby (over 9 pounds)…Men with waistlines greater than 40 inches…Women with waistlines greater than 35 inches…and people who are not obese by the standard criteria, but are obese at the abdomen..or have high levels of visceral fat and advancing age. Belonging to Ethnic groups with a high tendency to develop Type 2 Diabetes ...Hispanic/ Latino American…Afro-American…Native-American…and Asian-Americans, and Pacific Islanders . Type 2 diabetes make insulin but cannot utilize it well (insulin resistance)
Gestational Diabetes It develops in women during pregnancy…have a family tendency for diabetes and because of the Hormonal changes during pregnancy may require insulin…..and also the hormones secreted tend to make the insulin less effective. In most cases when the pregnancy ends so does gestational diabetes…but the mother is at risk to develop diabetes Type 2 in the future.

Most Asians who develop diabetes in the United States defy the typical profile of a diabetic and most are not obese. Although statistics are scarce, Dr William Hsu Co-Director of Joslin’s Asian American Diabetes Initiative, in 2006 estimated that 10% of the Asian adult population were diabetic. That is in comparison with 7% of the total population estimated to have either type of diabetes according to the Centers for Disease Control and Prevention.(1)

The Chinese-speaking immigrants who were surveyed . . . were found to have less knowledge of how to manage their diabetes . . compared with Asian American immigrants who preferred to speak English.
Click HERE for more info.

Asians seem to suffer the same problems of obesity without needing to gain as much weight as those in other ethnic groups. When Asians gain weight, they often store fat mainly in the abdomen (visceral). Like other immigrants, Asians who arrive in America often begin eating more and getting less exercise than they did in their native countries. Most start to gain weight and so do their children. They also fall victim to advertising, that junk food is good food…fast food will help feed the family and is cheap, and oversized. High calorie American style foods are rapidly replacing traditional foods on their tables. (3) Studies showed that 14% of Asian children in New York are obese, more than twice the rate among their parents. (2)

In China the number of obese people has tripled since 1992 to 90 million, as Western food has become popular and prosperity has made it possible to eat more. The World Health Organization has warned that Asia faces a “tsunami” of Diabetes within the coming decade, and have condemed the Chinese Government for its slow response to their Diabetes Crisis. (2) In Japan, the Health Message coming over the TV to their country men is to not eat the Western Diet….cut down on the rice…park your car…ride your bike and walk more.

Many Asians have replaced traditional food with processed food, and even Asian companies are selling processed foods that are not nutritionally different from American processed foods, high in calories, starch and fat. The food industry has honed their products to the children, and Asian children are also persuaded to eat these foods, and so they do…and so do we the Asian adults, and where is this leading us (Asians) to…..weight gain….and diabetes.

The AADI was established in 2000 by Joslin Research Director George L. King, M.D., and friends of Joslin Diabetes Center, in recognition of the growing challenge of diabetes in Asian Americans. Diabetes disproportionately affects Asian Americans who are two times more likely to develop the disease than Caucasians.

Our Goals

  • To study diabetes in the Asian American population and disseminate Joslin's research findings to healthcare providers and Asian American communities.
  • To increase diabetes awareness through innovative and culturally appropriate educational materials.
  • To design and implement clinical treatment programs for Asian Americans.
  • We, Asian Americans, are a busy group - hard working, some smoking, some drinking a little alcohol, but not many of us paying attention to what we eat, when we eat, and exercise… using the remote control is not exercise, neither is cruising the internet. One day you noticed you have been really tired, no energy. After eating a meal, you just have to take a nap…and thirsty always needing to drink soda, juice, water, and like a child having to get up to use the toilet several times during the night. Soon you notice that no matter how much sleep you get….it is not enough…your spouse or significant other complains about how you doze off and are no fun anymore. You are exhibiting the classic symptoms of diabetes. Tiredness, lethargy, thirst, increased urination, and if not corrected soon , you may have some weight loss…and maybe a trip to the hospital because you are dehydrated and weak.

    Now that you have been diagnosed with diabetes, how do you feel? Scared, upset, can’t be me, (denial) depressed…probably some or all of these feelings. I felt the same way when I was diagnosed with diabetes 34 years ago. I went into denial for about 2 weeks. No one in my family had diabetes…or so I thought.

    My father was from Tokyo, my mother was born in America, of Japanese immigrants. Hard working, but like many Asians never went to a Doctor unless we had to. So everyone was surprised that I had diabetes…no one spoke of it, nothing to be proud of. I was an R.N so I must know a lot….they thought….not true…but I did learn a lot from that day on. A few years later , my younger sister became a diabetic, next my grandmother, my mother, and now my 2 brothers. When they say you have such a sweet family, it is the truth.



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