Asian Americans newly diagnosed for type 2 diabetes

Introduction
Diabetes mellitus represents a chronic ailment impacting the way the human body converts food consumed into energy. The major portion of consumed food breaks down into glucose and gets discharged into the bloodstream. The human pancreas secretes the hormone, insulin, that helps employ cell blood sugar as energy. Three forms of diabetes have been identified, namely, gestational, type 1, and type 2 diabetes. In the latter, the patient’s body is ineffective in utilizing insulin, thus incapable of maintaining normal blood sugar levels. Ninety percent of diabetes patients suffer from this form of the disease. Its onset may be postponed or even altogether avoided if one adopts a healthful lifestyle (for instance, routine physical exercise, eating nutritious foods, and weight loss) (Centers for Disease Control and Prevention (CDC), 2017).
Population
Diabetes mellitus type 2 (T2D) has been found to be highly prevalent among Hispanic Americans, Native Americans, and non-Hispanic Black Americans. But the nation’s swiftest growing ethnic/racial minority – Asian Americans – are also being diagnosed with the disease at a disturbing rate. This sub-population’s supposed low disease burden, self-sufficiency and education are impeding healthcare services directed at it. This myth has largely been kept alive due to the absence of dependable data which typically grouped all Asian Americans as a single, homogenous category, instead of a heterogeneous one. The problem proves especially significant when studying T2D prevalence in this subgroup. In the year 2014, for instance, the CDC reported a nine percent age-adjusted T2D prevalence for the Asian-American population, overall. The above rate is higher as compared to that for White non-Hispanic Americans (7.6 percent), though lower as compared to the Native-American (15.9 percent), non-Hispanic Black-American (13.2 percent), and Hispanic American (12.8 percent) populations, thus portraying Asian Americans as a “moderate risk” population. A study of disaggregated information for Asian-American ethnic subgroups reveals differences in disease burdens (Nguyen et al., 215).
Intervention
One major issue linked to diabetes among Asian-Americans is population awareness. A decade earlier, this group exhibited rather low diabetes prevalence. However, currently, educating the subpopulation on this ailment’s seriousness is imperative. Unlike other ethnic groups, Body Mass Index (BMI) isn’t always applicable to disease risk for this group, thus posing another challenge. Most diabetes therapies support lifestyle modifications with researchers revealing ample exercise and proper diet aids diabetes management and prevention, and postpones onset. The standard low-fat, high-complex carb, and high-fiber Asian diet, besides physical activity, may facilitate T2D prevention and management.
Comparison
Group education and self-management initiatives are recommended for Asian-Americans diabetics, having proven positive patient results. However, scant evidence exists of these interventions’ efficacy in case of other minority ethnic groups. Cultural tailoring represents an idea which employs a grasp of the impact of cultural traits on health behavior for formulating an effective initiative. Nam et al.’s RCT (randomized controlled trial) meta-analysis revealed culturally-adapted diabetes education improved glycemic control more than ordinary care for diabetics from ethnic minority populations. Very few research scholars have looked into culturally-adapted diabetes education and self-management initiatives’ efficacy in case of Chinese diabetics (Sun et al., 2012).
Diabetes’ effect goes beyond mere physical wellbeing. It also adversely influences a patient’s quality of life (QOL), social and familial relations, and routine lifestyle (exercise, meal planning, stress management, etc.). Diabetes management and patient living experiences are influenced by familial dynamics, acculturation, and cultural traditions and views. Academicians from China determined numerous culturally-informed diabetes and diabetes management related ideas apparent only in Chinese patients. An interview of Chinese migrant diabetics and their significant other revealed links between diabetes and Chinese cultural beliefs regarding cold-hot balance, as well as the problem associated with diet modifications owing to Chinese views on food and the pivotal role it plays in societal relations and QOL. Further, Chinese diabetes management necessitates accommodations by every member of the patient’s family. Existing studies indicate Chinese migrant patient orientation towards successful diabetes management might necessitate culturally-suitable modifications of conventional initiatives (Sun et al., 2012).
Reduction of A1C levels
A1C (glycated hemoglobin, HbA1c, hemoglobin A1C, or glycosylated hemoglobin) levels represent the proportion of red blood cells with sugar molecules fastened to them. The following healthy lifestyle modifications may decrease A1C levels and improve everyday blood glucose management:
1. A minimum half-hour of exercise (not necessarily formal), 5 days weekly. This may be any relaxing activity like playing sport, biking indoors or outdoors, pet-walking, etc.
2. Balanced meals with the right portion sizes (non-starchy vegetables may be freely consumed, but complex carbs (potatoes, bread, etc.), fruits, fatty foods and lean proteins ought to be carefully consumed). Processed foods, sugary fruit juices and sodas ought to be avoided.
3. Abiding by a schedule. Extreme sugar level fluctuations owing to skipping meals, overeating, eating too frequently, etc., must be avoided.
4. Abiding by one’s individualized diabetes treatment regime for effective diabetes management.
5. Routine blood sugar tests, independently. Maintaining a test result journal may inform one of the impact of particular activities on blood glucose, help avoid foods that sharply increase blood glucose, and formulate the right eating schedule (Theobald, 2014).
Time
Retrospective analyses support evidence indicating rapid growth of T2D patients’ referral rates and decreased mortality rates for multifactorial reasons. Besides gender, blood pressure, and smoking activity, A1C results three months subsequent to first diagnosis is predictive of patient mortality as well. Thus, rigorous, timely intervention is recommended for new onset T2D patients (Kerr et al., 2011).








References
Centers for Disease Control and Prevention. (2017, June 01). Diabetes Home. Retrieved August 05, 2017, from https://www.cdc.gov/diabetes/basics/diabetes.html
The CDC helps improve Americans’ health security. In the role of America’s health protection organization, it saves the lives of citizens and shields them from health hazards. For achieving its mission, it engages in critical scientific research, offering relevant health data to safeguard the US from lethal, costly health hazards, besides responding in a timely manner should these surface. In the above paper, CDC scholars offer improved insights into diabetes and its many forms.
Kerr, D., Partridge, H., Knott, J., & Thomas, P. W. (2011). HbA1c 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes. Diabetic Medicine, 28(12), 1520-1524.
Kerr and colleagues employ information gleaned from patients’ HbA1c3 surveys for ascertaining five-year mortality after T2D diagnosis, within a big local new-onset patient group enrolled in one community-based diabetes educational initiative some weeks after diagnosis. Referrals for T2D patients were reviewed, for five years (between 1999 and 2003), and the causes underlying mortality rates until end-2007 were ascertained through regression analysis.
King, G. L., Dr. (2014, May 05). Stopping Diabetes in the Asian American Community. Retrieved August 05, 2017, from http://diabetesstopshere.org/2014/05/01/stopping-diabetes-in-the-asian-american-community/
American Diabetes Association’s researcher, King, employed information from surveys conducted at Joslin Diabetes Center for accounting for the individual impact of diabetes on himself, family members, and the overall Asian-American subgroup. Furthermore, causes underlying high diabetes prevalence among Asian Americans are described, together with the researcher’s motivation to research diabetes in the Asian-American population subgroup. The key diabetes management and prevention challenges in the community are addressed in the paper, and ideal solutions to those challenges recommended.
Nguyen, T. H., Nguyen, T.-N., Fischer, T., Ha, W., & Tran, T. V. (2015). Type 2 diabetes among Asian Americans: Prevalence and prevention. World Journal of Diabetes, 6(4), 543–547. http://doi.org/10.4239/wjd.v6.i4.543
World Journal of Diabetes vol. 6 authors concentrate, in this article, on the current issue of high T2D prevalence among the Hispanic American, Native American, and non-Hispanic Black populations. But considerable emphasis has been given to diabetes incidence in the Asian-American population. The paper banks on previous studies for analyzing growing diabetes cases in this population and the factors influencing this growth.
Sun, A. C., Tsoh, J. Y., Saw, A., Chan, J. L., & Cheng, J. W. (2012). Effectiveness of a Culturally Tailored Diabetes Self-Management Program for Chinese Americans. The Diabetes Educator, 38(5), 685–694. http://doi.org/10.1177/0145721712450922
This paper aimed at assessing the effectiveness and viability of a support-group-type diabetes education and self-management initiative directed at Chinese American diabetics. The research work’s rationale was: formulating culturally-suited diabetes management and education interventions in order to respond effectively to the increased cases of diabetes in the Chinese American minority group. Study authors posited that subjects would, by the end of intervention, display: greater knowledge on superior diabetes practices and apply them appropriately, improved social support, and improved HbA1c results. Research goals were as follows: A minimum of half the study subjects would exhibit appreciably improved diabetes knowledge as well as appreciably better practice activities; a minimum of half the respondents would self-report increased emotional support, and no less than thirty percent would exhibit significantly improved A1C levels.
Theobald, M. (2014, September 16). 5 Ways to Lower Your A1C. Retrieved August 05, 2017, from https://www.everydayhealth.com/hs/type-2-diabetes-live-better-guide/lower-your-a1c/
In this paper, the author outlines the significance of carrying out blood glucose tests at home – a valuable tool in everyday diabetes management – while cautioning that this practice only offers a glimpse at the body’s momentary state and not what is occurring within it over a longer period of time. The occasional HbA1C test administered by physicians for measuring average blood glucose over a period of 3 months has been explained, which offers a more precise idea of a patient’s long-term T2D management plan’s efficacy.