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ADA drops BMI cut point recommendation for type 2 diabetes screening in Asian Americans
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Aligning its guidelines with evidence that Asian Americans develop type 2 diabetes at lower BMI levels than the general population, the American Diabetes Association has lowered its screening cut point recommendation, according to a position statement published in Diabetes Care.
The statement drafted by William C. Hsu, MD, director of the Asian Clinic of the Asian American Diabetes Initiative at Joslin Diabetes Center, Harvard Medical School, Boston, and colleagues recommends clinicians consider testing for diabetes in all Asian American adults who present with a BMI ≥23 kg/m2.
William C. Hsu
“Clinicians have known this intuitively for quite some time,” Hsu said in a press release. “They can see that Asian Americans are being diagnosed with diabetes when they do not appear to be overweight or obese according to general standards.
“But if you use the previous Association standard for diabetes screening of being age 45 or older with a BMI of 25 kg/m2 or above, you will miss many Asian Americans who are at risk,” he said.
The recommendation comes after a comprehensive review and analysis. Asian Americans have twice the prevalence of type 2 diabetes compared with whites despite having lower rates of obesity under current federal BMI standards, according to the release; the position statement does not redefine overweight or obesity for Asian Americans.
The statement highlights that the Asian American population, the largest growing ethnic group in the United States, is projected to more than double by 2060, reaching 34.4 million; its share of the US population would surge from 5.1% to 8.2% in the same period.
People with origins from the Far East (China, Japan, Korea and Mongolia), Southeast Asia (Cambodia, Malaysia, the Philippine Islands, Thailand, Vietnam, Indonesia, Singapore, Laos, etc.) or the Indian subcontinent (India, Pakistan, Bangladesh, Bhutan, Sri Lanka and Nepal) come under this population category.
“Asian Americans are a heterogeneous group and have historically been underrepresented in studies, so it is important to keep in mind that this is just the beginning,” Jane Chiang, MD, senior vice president for Medical Affairs and Community Information, American Diabetes Association, said in the release. “Clearly, we need more research to better understand why these distinctions exist.”
Disclosure: The researchers report no relevant financial disclosures.
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