Type 2 diabetes is increasing in prevalence across the United States at a rate that cannot be explained by genetics alone. Obesity and inactivity are thought to play a strong role in the notable spike in the number of sufferers. On the other hand, genetics still plays a significant role in the likelihood of developing the disorder. As noted by Nguyen (et al. 2015) type 2 diabetes currently is present in approximately 9% of Asian Americans, with disproportionate numbers among Filipino, Pacific Islander, Japanese, and South Asian groups. Asian-Americans appear to develop type 2 diabetes at lower BMIs than those of other ethnic groups, suggesting the need for greater vigilance of patients’ weights and different clinical guidelines based upon genetic differences. According to a randomized clinical control trial of pre-diabetics (n = 3234) called the Diabetes Prevention Program, development of diabetes was reduced by 58% through a lifestyle education program, although the program was not Asian-American specific (Nguyen et al. 2015).
But even a study of diabetes among a specific population group in and of itself is not homogeneous. In a study by Choi (et al. 2013), gender as well as race was found to significantly affect tendencies to develop type 2 diabetes. Researchers used the California Health Interview Survey (CHIS) 2009, 2011) and examined California adults aged 18 and older (n=46,091 projected to 26.6 million) to determine like likelihood of developing diabetes based upon gender within different ethnic groups. Overall, men had a higher prevalence of diabetes than women, while within certain subcategories such as African-Americans and Korean-Americans, women actually had a higher likelihood of manifesting diabetes.
A systematic review by King (et al. 2012) likewise found that Asian-Americans are more likely to manifest diabetes at lower, even normal BMIs compared with the rest of the population. Additionally, King also confirmed that certain subsets, such as Pacific Asian Americans, are more apt to manifest the condition. On the other hand, the fact that Asian-Americans are such a diverse population can make comparisons extremely difficult. Certain groups are more apt to have second and third-generation status than other populations and socio-economic conditions can vary widely, making it difficult to engage in cross-comparisons between studies. King (et al. 2012) also notes that traditional beliefs may affect how the illness is perceived within the community and should be taken into consideration when making prescriptions about how to treat the population, such as dietary preferences for specific foods, attitudes towards food, and cultural beliefs about health (such as a preference for traditional Chinese medicinal techniques).
As well as systematic reviews, there have also been a number of qualitative case studies which support the idea that systematic interventions can be useful in treating diabetes. In one case study of a Sikh population, community health worker-led interventions in New York City of 175 Sikhs with borderline diabetes used a combination of education and monitoring of BMI, blood glucose, and other health measures to reduce the prevalence of diabetes in this high-risk group (Islam et al. 2014). Sikhs were selected because India has seen a particularly precipitous spike in its diabetes rates as affluence has increased; again, within that national context, even individuals with relatively normal BMIs have manifested diabetes at higher rates and this specific community was used to see if early intervention could improve the health outlook of at-risk patients.
Data was accumulated through private interviews with the participants. The focus of the program as a whole was upon interacting with patients in a one-on-one fashion to educate them about risk factors in diabetes. Six sessions were facilitated by the community health worker of two hours in length on the subject of diabetes education. After the six sessions, there was follow-up through phone interviews (Islam et al. 2014). Participants reported a positive effect upon their sense of autonomy and control...
An integrative review by Hsu (et al. 2015) found that in studies of specific Asian populations abroad, Asians with much lower BMIs than in Caucasian populations are still at risk for diabetes-related disorders. Other studies of Asian-Americans specifically focusing on behaviors using indexes such as the Behavioral Risk Factor Surveillance System (BRFSS) found much higher risks for Asians, even when undertaking relatively moderate risk activities that could increase prevalence of diabetes.
Viewed in conjunction, all of these studies suggest that Asian-Americans face certain unique risks regarding their tendency to develop diabetes; they may be more affected by the obesogenic society in which calories are plentiful and physical activity is minimal. This trend holds true in both Asia and in the United States context, implying a genetic component to the risk of diabetes. However, community-specific interventions can be useful to address the needs of diabetes. Healthcare practitioners can use screening devices specific to Asian-Americans, not simply those used for the general population. Interventions designed to target Asian-Americans within a cultural context, preferably those particular to gender and nation-specific group, seem to be more effective. Thus, it is anticipated that the hypothesis of the planned study will be confirmed, and that culturally tailored lifestyle modification programs are likely to be more effective than those which take a more general approach to screening and advice.
Type of Study:
Design Type: Quantitative
Framework/Theory: Multiculturalism
Setting: Pre-diabetic patients in the United States
Key Concepts/Variables: Diabetes education program
Independent variable: Participation in educational program
Dependent: Risk for diabetes
Findings: Statistically significant reduction in diabetes
Hierarchy of Evidence: Randomized Control
Design Type: Descriptive
Framework/Theory: Feminism/ Gender-based
Adult Californians
Concepts: Gender
Independent Variable: Diabetic status
Dependent Variable: Race and Gender
Controlled Variable: Socio-economic status
In certain Asian-American groups, women have a greater likelihood of developing diabetes than women
Descriptive
King, G. L., McNeely, M. J., Thorpe, L. E., Mau, M. L. M., Ko, J., Liu, L. L., … Chow, E. A. (2012). Understanding and addressing unique needs of diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders. Diabetes Care, 35(5), 1181–1188. http://doi.org/10.2337/dc12-0210
Type of Study: Quantitative
Design Type: Systematic Review
Framework/Theory: Multiculturalism
Diabetics of various races
Concepts: Different policies needed to address diabetes in Asian Americans
Independent Variable: Race
Dependent Variable: Diabetes
Controlled Variable: Socio-economic status
Asian-Americans are a multifaceted category and require different approaches to effectively address diabetes
Systematic review
Islam, N. S., Zanowiak, J. M., Wyatt, L. C., Kavathe, R., Singh, H., Kwon, S. C., & Trinh-Shevrin, C. (2014). Diabetes prevention in the New York City Sikh Asian Indian Community: A pilot study. International Journal of Environmental Research and Public Health, 11(5), 5462–5486. http://doi.org/10.3390/ijerph110505462
Type of Study: Qualitative
Design Type: Case study
Framework/Theory: Community health
Setting: Sikh community in New York
Key Concepts/Variables: A culturally specific approach to diabetes management in a high-risk category
Findings: Community-based healthcare worker education was effective in reducing diabetes risk
Hierarchy of…
References
Choi, S. E., Liu, M., Palaniappan, L. P., Wang, E. J., & Wong, N. D. (2013). Gender and ethnic differences in the prevalence of type 2 diabetes among Asian subgroups in California. Journal of Diabetes and Its Complications, 27(5), 429–435. http://doi.org/10.1016/j.jdiacomp.2013.01.002
King, G. L., McNeely, M. J., Thorpe, L. E., Mau, M. L. M., Ko, J., Liu, L. L., … Chow, E. A. (2012). Understanding and addressing unique needs of diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders. Diabetes Care, 35(5), 1181–1188. http://doi.org/10.2337/dc12-0210
Hsu, W. C., Araneta, M. R. G., Kanaya, A. M., Chiang, J. L., & Fujimoto, W. (2015). BMI cut points to identify at-risk Asian Americans for type 2 Diabetes Screening. Diabetes Care, 38(1), 150–158. http://doi.org/10.2337/dc14-2391
Islam, N. S., Zanowiak, J. M., Wyatt, L. C., Kavathe, R., Singh, H., Kwon, S. C., & Trinh-Shevrin, C. (2014). Diabetes prevention in the New York City Sikh Asian Indian
community: A pilot study. International Journal of Environmental Research and Public Health, 11(5), 5462–5486. http://doi.org/10.3390/ijerph110505462
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
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
Introduction There are various risk factors that have been associated with the development of type 2 diabetes. These include, but they are not limited to, ethnicity and lifestyle. With regard to ethnicity, it is important to note that people of Asian descent have a higher predisposition to type 2 diabetes, in comparison to persons of European ancestry. Some of the complications associated with type 2 diabetes include cardiovascular disease, kidney damage,
Research Article ChartCriteria and Defining CharacteristicsArticle 1: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.2014.302523Article 2:Islam, N., Zanowiak, J., Wyatt, L., Chun, K., Lee, L., Kwon, S., & Trinh-Shevrin, C. (2013). A Randomized-Controlled, Pilot Intervention on Diabetes Prevention
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……Pre-diabetes and Diabetes Early Awareness Education and Its Effects on BMISubmitted by:Nancy L. Gee Comment by Pamela Love: Looks like an interesting project, Nancy.Very good start! Be sure whenever you submit your manuscript that you change wording from �study� to �project� and avoid referring to the project as research. Review carefully for grammar, punctuation, sentence structure, format, or APA errors. Pay close attention to the reviewer�s comments as you continue
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