The new guidelines issued by the American Diabetes Association (ADA) call for people of Asian ancestry to be checked for type 2 diabetes at a lower body mass index (BMI). Being obese or overweight is a risk factor for diabetes, but Asian-Americans appear to develop diabetes at a lower weight than other groups.
The general definition of being overweight starts at a BMI of 25 and that for obesity at 30, according to the National Institutes of Health, which will still be true for Asian-Americans. The ADA's new guidelines call for diabetes screening to start at a BMI of 23 in Asian-Americans. Type 2 diabetes used to be called adult-onset diabetes.
Asians appear to develop diabetes at a lower weight because they are more likely to put on weight around their waists rather than on the thighs or elsewhere on the body. Weight gain around the waist is where fat poses a greater risk to health. This population group also includes people of Indian, Pakistani, and Bangladeshi and Pacific Island ancestry as well as those from China, Japan, and Southeast Asia. Asian-Americans have twice the prevalence of type 2 diabetes as white Americans, according to an ADA press release.
"Clinicians have known this intuitively for quite some time," said William C. Hsu, MD, Vice President, International Programs, Joslin Diabetes Center and Assistant Professor, Harvard Medical School, who was lead author of the position paper. "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 [ADA] 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."
The new ADA guidelines will be published in the January issue of the ADA's journal, Diabetes Care.