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Epidemiology/health services research
The changing landscape of diabetes prevalence among first-generation Asian immigrants in California from 2003 to 2013
  1. Wenjun Fan1,
  2. Debora H Lee1,
  3. John Billimek2,
  4. Sarah Choi3,
  5. Ping H Wang1
  1. 1Department of Medicine, UC Irvine Diabetes Center, School of Medicine, University of California, Irvine, California, USA
  2. 2Health Policy Research Institute, School of Nursing, University of California, Irvine, California, USA
  3. 3UCLA, School of Nursing, Los Angeles, California, USA
  1. Correspondence to Dr Ping H Wang; phwang{at}uci.edu

Abstract

Objective The prevalence of diabetes mellitus (DM) is increasing rapidly, particularly in Asia. Asian immigrants in Western countries are a fast-growing population who carry both intrinsic risks due to their genetic background and extrinsic risks associated with Western lifestyles. However, recent trends in diabetes prevalence and associated risk factors among Asian immigrants in the USA are not well understood.

Research design and methods We examined adults aged 18 and older from the recent California Health Interview Survey data sets from 2003 to 2013 to determine prevalence of known DM among first-generation Asian immigrants and whites. The impact of various DM risk factors in Asian immigrants relative to whites was analyzed and multivariable regression models were constructed to obtain adjusted DM risk in Asian immigrants versus in whites.

Results Across the study span, we identified 2007 first-generation Asian immigrants and 14 668 whites as having known DM or prediabetes mellitus (pre-DM). From 2003 to 2013, the prevalence of DM and pre-DM combined rose from 6.8% to 12.4% in Asian immigrants and 5.5% to 6.9% in whites. Much of the increase could be attributed to pre-DM, which rose from 0.7% to 3.2% in Asian immigrants during the study period. The impacts of age and body mass index on DM risk were consistently greater in Asian immigrants than in whites. Non-DM Asian immigrants were found less likely to engage in physical activity than were non-DM whites. After adjustment of various associated factors, Asian immigrants were more likely than whites to have DM and this relative risk for DM gradually increased across the study period.

Conclusions A rising prevalence of known DM and particularly pre-DM among Asian immigrants in California was observed during the previous decade. To reduce the burden of diabetes and its complications, future strategies should consider specific risk factors for this ethnic group, including encouraging physical activity.

  • Pre-Diabetes
  • Survey Analysis
  • Immigration
  • Minority

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000327

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    Footnotes

    • Contributors WF and PHW conceived and designed the study. WF, DHL, JB and SC contributed to statistical modeling and data analysis. WF, DHL, and PHW drafted the manuscript. All authors made critical review and revisions of manuscript. PHW is the guarantor of this work and, as such, had full access to all the data and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    • Funding This study was supported by UC Irvine Diabetes Center and the Ko Family Foundation.

    • Competing interests None declared.

    • Ethics approval UC Irvine Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The California Health Interview Survey is conducted biennially by the UCLA Center for Health Policy Research. Researchers can access the publicly available CHIS data files, and customize and run their own data searches using the Public Use Data Files.