Study to Identify How to Prevent, Treat Diabetes in Asians

Although more than 23 million adults and children in the United States have diabetes, little is known about the chronic disease in Asian Americans – one of the largest ethnic groups in the Bay Area. PAMF’s Research Institute is committed to changing this and has received a $2.5 million grant from the National Institutes of Health (NIH) to conduct a five-year study on diabetes and its risk factors among the six largest Asian ethnic groups in California – Asian Indians, Chinese, Filipino, Japanese, Korean and Vietnamese.

Investigators at the Research Institute hope the study will lead to better prevention, treatment and management of diabetes in Asians.

"By the end of the study, we hope to gain a much better understanding of what puts certain Asian ethnic minorities at greater risk for diabetes, one of the most costly and prevalent chronic health conditions," said Latha Palaniappan, M.D., M.S., the study’s principal investigator.

Diabetes, a chronic disease characterized by high blood sugar levels, occurs at significantly higher rates among blacks and Hispanics than among whites. Asians consist of more than 30 ethnic groups from more than 20 countries of origin. In previous diabetes studies and reports, however, they have always been grouped together, meaning very little is known about the prevalence and risk factors of diabetes in specific Asian ethnic groups.

"In some of our preliminary studies, we’ve seen that certain Asian ethnic groups, such as Asian Indians and Filipinos, are at much higher risk for diabetes than others," said Dr. Palaniappan. "These findings reinforce the need to study Asian subgroups separately instead of grouping these diverse populations together."

Dr. Palaniappan said she also hopes the study will have an international impact because it will examine how different racial and ethnic groups metabolize insulin and glucose, which could help improve the diagnosis of and treatment for diabetes in Asians.

The study, which is formally named the Pan Asian Cohort Study (PACS), will examine existing clinical records of more than 60,000 Asians in California for diabetes risk, the largest group of Asian-Americans ever assembled for a study. The study will include examination of the medical records, excluding any personal identifiers, of PAMF patients.

"We want to assure patients that we will only have access to information in their health record that enables us to conduct this important study," said Dr. Palaniappan. "We are very careful to follow all Health Insurance Portability and Accountability Act (HIPAA) regulations and patient confidentiality guidelines."

PAMF’s electronic health record (EHR) system, in place for nearly a decade, allows researchers to better understand variations in treatment for diabetes, identify best practices and recommend ways to improve care both inside and outside of the organization. In addition to reviewing existing medical records as part of the study, researchers will use the EHR system to select and follow a group of patients over more than a decade to further study diabetes risk factors that may be unique to Asian Americans.

In addition, PACS will study how obesity should be defined for Asians, because it is the most important risk factor for developing type II diabetes. In 2004, the World Health Organization (WHO) recommended lower body mass index (BMI) cutoff points to define people of Asian descent worldwide who are overweight and obese. The PACS study results could indicate that the recommendations should be different for Asians living in the United States.

"Traditionally, Asian-American minorities have received less medical research attention than other racial/ethnic minorities, and studies focused on Asian Americans have received less than 1 percent of federal research funds," said Dr. Palaniappan.

"Asian Americans make up more than 25 percent of the Bay Area’s population alone, and this NIH grant allows us to conduct what we believe is a truly groundbreaking study."

For more information about the study and preliminary findings, visit www.pamf.org/pacs.