Asians Americans and Diabetes

The scourge of type II diabetes is impossible to miss when looking at the societies of countries like the United States. More commonly known as adult-onset diabetes, the disorder is commonly manifested upon adulthood (if not sooner) when the body of the patient is unable to regulate insulin and blood sugar like could and should normally be happening within said patient. Asian-Americans are commonly immune from the normal trends and patterns of type II diabetes. However, there are some Asian-Americans that absolutely deal with the disorder and they are very much at a disadvantage given their start minority status in the United States in general and within most corners and cities within the same. Sure, there are cities like New York and San Francisco. There are some school districts and neighborhoods that have high Asian populations. While the general treatments and interventions for type II diabetes are not completely different for Asians than they would be for anyone else, the PICOT question to be explored for this report will show that there are unique facets and factors that should be in play for Asians but these are often missed due to the marginalized and ignored nature of the population and its unique needs.
PICOT Details & Review
As noted in the introduction, the PICOT question for this research shall center on Asian-Americans with type II diabetes. It will be assessed how the current treatment and intervention patterns are deficient and what could or should be done to correct that. As one might expect, the main deficiencies that do exist center on culture. Before getting to that and the material that underpins and supports the same, a quick review of the PICOT framework and details in question are as follows:
· Population: The population in question are Asian-Americans that have been newly diagnosed with Type II diabetes.
· Intervention: The intervention in question is a health education program that includes patient-specific dietary and lifestyle modifications that are meant to reduce blood sugar and better regulate blood sugar/insulin in the body of type II patients. Of course, the optimal outcome would be for patients to reach a point where their bodies do this regulation on its own, as would be the norm or non-diabetic patients.
· Comparison: The key part of the analysis relating to this study will be the compare and contrast of the different cultural, language and societal patterns that help or hurt when it comes to Asian-Americans with type II diabetes and the outcomes they encounter after they go through a cycle of treatment.
· Outcome: The desired outcome and what will be considered “success” for any given patient is the reduction of A1C levels. Of course, A1C is basically the 90 day running average of blood sugar. The higher the number, generally, the worse off the patient would happen to be.
· Time Frame: The overall time frame of this study will coincide with the overall A1C measurement lookback period, and that would be 90 days.
Scholarly Research
Source One
The review, summary and detail of the study that is to come in relation to this PICOT question will, of course, center on scholarly and peer-reviewed research. With that in mind, there will be a quick review of three peer-reviewed studies that meet the proper depth and breadth needed to execute a proper PICOT study on this subject. One study that was reviewed for this report was done in 2013 by Islam et al. As alluded to before, while the aggregate percentage of Asians in the United States is rather small, there are pockets in the United States that are high-Asian in concentration. One example of this would be the Korean population in New York City. The Islam study looked at this population and what interventions were the most useful for that group. The research vehicle used was a six-month plan whereby the people in question were educated using a community-based approach. A number of metrics and measurements were employed over that time horizon including weight, BMI levels, waist circumference, blood glucose level, nutrition details, physical activity levels and so forth. As one might expect, the interventions for the Koreans were successful provided that the form and function of the interventions were sensitive and catering to the unique facets of Korean culture, both in the United States and in general. The study in question for this source was a simple before and after and there was a literature review offered as part of the data offered. It was presumed that education and lifestyle interventions, juts like with other cultures, are what is needed to get Koreans in NYC healthier and less attacked by diabetes symptoms. Indeed, the study found that problematic behaviors being minimized or sunset led to much better outcomes. There were a total of 9 references offered in this source. (Islam et al, 2013).
Source Two
Something else that is useful when it comes to the PICOT question and Asians as they operate within and around diabetes management is to look at the disparities that exist and try to fathom and measure why those disparities exist and what the genesis of those gaps happens to be. Other groups that would be useful to use as comparison points would include Hispanics, African-Americans and Caucasians. Just like the other Islam source, the target area was NYC. However, there was a compare and contrast between Asians and other groups such as those mentioned above. As one might expect, the behavior modificaitons were the key to lowering A1C and otherwise helping people get healthier. What varied, of course, was the cultural values and trends that were used when crafting and providing the education in question. There was a total of 28 sources offered in this study. (Islam et al, 2015).
Source Three
One last and important thing that will be pointed out for this PICOT study is that even differing Asian groups will tend to have at least some differences. Such was the focus of a study by Stewart, Dang and Chen (2016). They looked at groups in Sacramento County, California. Rather than just look at Asians as a singular group with no layers or sub-groups, they looked at nearly 1,000 people that were from Chinese, Hmong, Korean or Vietnamese ancestry. A brief literature review was indeed provided to back up the claims made and offered. A total of three charts were done as part of the results and review of the study. There was a total of more than thirty references (Stewart, Dang & Chen, 2016).
Conclusion
While the culture mores and details of the groups were different, it is clear that behavior modification is key if success is going to be found. The same pattern could and would be found even when looking at differing groups of Latinos or even Caucasians. The key is to seize on the cultural patterns and details that are feeding the proverbial fire and then start from there, whether it be portion size, what types of foods are being eaten, the environmental influences and patterns in question, parenting skills and so forth.




References
Islam, N. S., Kwon, S. C., Wyatt, L. C., Ruddock, C., Horowitz, C. R., Devia, C., & Trinh-Shevrin, C. (2015).
Disparities in Diabetes Management in Asian Americans in New York City Compared with Other
Racial/Ethnic Minority Groups. American Journal of Public Health, 105S443-S446.
doi:10.2105/AJPH.2014.302523
Islam, N., Zanowiak, J., Wyatt, L., Chun, K., Lee, L., Kwon, S., & Trinh-Shevrin, C. (2013). A Randomized-Controlled,
Pilot Intervention on Diabetes Prevention and Healthy Lifestyles in the New York City Korean
Community. Journal of Community Health, 38(6), 1030-1041. doi:10.1007/s10900-013-9711-z
Stewart, S. S., Dang, J., & Chen, M. (2016). Diabetes Prevalence and Risk Factors in Four Asian American
Communities. Journal of Community Health, 41(6), 1264-1273.