Written by Rena Mei
The American Diabetes Association (ADA) recently announced their recommendation to screen Asian Americans for type 2 diabetes starting at a lower weight. We talked to our section chief of internal medicine, Dr. Ady Oster, to see what this means for our providers. It turns out to have little effect on our services.
While this change is new at the national level, it is not news to health institutions around the world. “The World Health Organization has had this recommendation for over 10 years,” says Dr. Oster. “The Health Center’s BMI charts in the rooms all have 23 as the healthy cutoff for Asians. But it’s good that the United States is catching up with what is known and done globally.”
People who are overweight have a higher risk of developing diabetes. For Asian Americans, the cutoff for being “overweight”—and therefore being at risk for diabetes—may be lower. Body Mass Index (BMI) measures a person’s weight class based on their height. The ADA’s new guideline states that Asian Americans with a Body Mass Index (BMI) of 23 or higher should get screened for diabetes. The former recommended cutoff was a BMI of 25, which is the current recommendation for the general population. This change indicates that Asian Americans, compared to the general population, are at greater risk for diabetes without having to put on as much weight.
Asian Americans are nearly twice as likely to develop diabetes as the general U.S. population. To address this need, the Health Center has a dedicated Diabetes Care Team in available for diabetes patients to manage their condition. The physician-led team tracks all diabetes patients and provides extra support and follow-up for those who need it. For example, care managers provide individual counseling over the phone, and health educators run regular diabetes workshops and support groups. Our staff is available to teach patients to eat healthy, exercise regularly, and check their blood glucose levels to prevent or manage their diabetes.
“The care here is not going to change, but the new ADA cutoff is going to improve the elsewhere where Asian patients may be a minority,” says Dr. Oster. Asians tend not to be as heavy as non-Asians and can be easily overlooked as not being at risk for diabetes. The new ADA guideline may therefore lead to more appropriate screenings of Asian American patients for diabetes.
On a broader level, this change marks an important step towards gaining recognition about Asian American health in the context of the larger U.S. population.
Rena Mei is a health educator at the Charles B. Wang Community Health Center. She has a bachelor’s degree in Human Evolutionary Biology and Chemistry from Harvard University.