This US study aimed to compare prediabetes and diabetes prevalence across ethnicity-adjusted BMI categories among middle-aged (age 45–64 years) Chinese, Filipino, South Asian and White adults. Data on 373 098 adults (76% White, 9% Chinese, 10% Filipino, 5% South Asian) were analysed.
Even using ethnicity-adjusted BMI categories for healthy weight, overweight and obesity, the prevalence of prediabetes and diabetes was significantly higher in Asian than White adults. Notably, among Asian adults in the healthy BMI range, up to 33% of men and 25% of women had prediabetes, and more than 25% of Filipino and South Asian men had diabetes. Among those with a healthy BMI, compared with White participants, age-adjusted prevalence ratios were as follows:
- South Asian men/women: 1.8/2.8 for prediabetes and 5.9/8.0 for diabetes.
- Filipino men/women: 1.8/2.6 for prediabetes and 5.0/7.5 for diabetes.
- Chinese men/women: 2.1/2.9 for prediabetes and 2.1/3.4 for diabetes.
These findings underscore the variation at which the different Asian subgroups develop diabetes despite a similar burden of prediabetes, with South Asian and Filipino ethnicities at greater risk of progression from prediabetes to diabetes.
The authors highlight the importance of screening for diabetes and prediabetes in people of Asian ethnicities and suggest that screening should be expanded to include people with a healthy (ethnicity-adjusted) BMI in those of higher-risk Asian ethnicity.
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024