Diabetes Canada
- Several studies including the Study of Health Assessment and Risk in Ethnic Groups (SHARE) have repeatedly demonstrated higher prevalence of diabetes among South Asians in Canada than Canadians of Europid or Chinese Origin.1, 2 This pattern is consistent with that of South Asians around the world.
- Several studies have corroborated that for a given body mass index (BMI), elevated levels of glucose-and lipid-related factors were more likely to be present in South Asians.2
- When comparing the risks for diabetes and dyslipidemia, the BMI cut points for South Asians corresponding to the obesity BMI cut point of 30.0 kg/m2 for Caucasians is only 21.0 kg/m2.2, 3 This finding implies that South Asians have more abdominal adiposity than Caucasians for a given BMI, and partially explains why they are more prone to obesity and related complications.4
- In the DREAM Trial South Asians with prediabetes had double the risk of death or diabetes than Europids and lesser benefit from rosiglitazone.5
- South Asian patients with acute coronary syndrome (ACS) have increased prevalence of diabetes than Europid patients. They also had increased one-year mortality compared with Europid patients.6
- Asian criteria for obesity and abdominal obesity must be urgently incorporated for the prevention and control of these conditions in South Asians. 4 This would be most effective— but also most daunting—and may require programs and policies that are culturally specific and sensitive to South Asians.
- With respect to South Asians affected by diabetes, high-quality educational initiatives and intervention Programs specifically designed for this high-risk population are lacking but desperately needed. Physical activity is low and deserves special attention in this population.7
- There is an urgent call to action: to bring together all stakeholders, including healthcare professionals from all disciplines, policymakers, general public, along with private sector representatives, to address the emerging public health issues among South Asians worldwide.8
Sources
1. Chiu JF, Bell AD, Herman RJ, et al. Cardiovascular risk profiles and outcomes of Chinese living inside and outside China. Eur J Cardiovasc Prev Rehabil. Apr 27 2010.
2. Anand SS, Yusuf S, Vuksan V, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000;356(9226):279-284.
3. Razak F, Anand S, Vuksan V, et al. Ethnic differences in the relationships between obesity and glucose-metabolic abnormalities: a cross-sectional population-based study. Int J Obes Relat Metab Disord. Jun 2005;29(6):656-667.
4. Gholap N, Davies M, Patel K, Sattar N, Khunti K. Type 2 diabetes and cardiovascular disease in South Asians. Prim Care Diabetes. Sep 23 2010.
5. Boyko EJ, Gerstein HC, Mohan V, et al. Effects of ethnicity on diabetes incidence and prevention: results of the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) trial. Diabet Med. Nov 2010;27(11):1226-1232.
6. Raghavan R, Rahme E, Nedjar H, Huynh T. Long-term prognosis of south Asians following acute coronary syndromes. Can J Cardiol. Jul 2008;24(7):585-587.
7. Khan SN, Grace SL, Oh P, et al. A comparison of physical activity environments between South Asians and white Caucasians with coronary heart disease. Ethn Dis. Autumn 2010;20(4):390-395.
8. Lau DCW. Excess Prevalence and Mortality Rates of Diabetes and Cardiovascular Disease Among South Asians:A Call to Action. Canadian Journal of Diabetes. 2010(June 20):102-104.