title: Type 2 diabetes: identifying high risk Asian American subgroups in a clinical population.
abstract: OBJECTIVE
  We compared the prevalence and treatment of type 2 diabetes across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and Non-Hispanic Whites (NHWs) in a Northern California healthcare system.
  
  
  METHODS
  A three-year, cross-sectional sample of patient electronic health records was accessed to compare diabetes prevalence in 21,816 Asian and 73,728 NHWs aged 35+ years. Diabetes was classified through ICD-9 codes, abnormal laboratory values, or use of oral anti-diabetic medication. Multivariate adjusted prevalence rates for each Asian subgroup, and adjusted odds ratios (OR) relative to NHWs, were compared.
  
  
  RESULTS
  Age-adjusted prevalence ranged from 5.8% to 18.2% (women) and 8.1 to 25.3% (men). Age-adjusted ORs of Asian subgroups ranged 1.11-3.94 (women) and 1.14-4.56 (men). The odds of diabetes were significantly higher in Asian Indians (women OR 3.44, men OR 3.54) and Filipinos (women OR 3.94, men OR 4.56), compared to NHWs. Results for Asian Indians and Filipinos were similar with age-and-BMI adjustment. Treatment rates across subgroups were 59.7-82.0% (women) and 62.9-79.4% (men).
  
  
  CONCLUSIONS
  Heterogeneity exists in the prevalence of diabetes across Asian subgroups, independent of obesity prevalence. Asian Indian and Filipino subgroups had particularly high prevalence of diabetes when compared to NHWs. Future studies should explore these clinically important differences among Asian subgroups.
authors.affiliation: Palo Alto Medical Foundation Research Institute, Department of Health Policy Research, Palo Alto, CA, United States.
authors.forename: Elsie J
authors.initials: EJ
authors.lastname: Wang
authors.affiliation: Palo Alto Medical Foundation Research Institute, Department of Health Policy Research, Palo Alto, CA, United States.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Wong
authors.affiliation: Columbia University, Mailman School of Public Health, United States.
authors.forename: Anjali A
authors.initials: AA
authors.lastname: Dixit
authors.affiliation: Kaiser Permanente Center for Health Research, United States.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fortmann
authors.affiliation: Palo Alto Medical Foundation, Palo Alto, CA, United States.
authors.forename: Randolph B
authors.initials: RB
authors.lastname: Linde
authors.affiliation: Palo Alto Medical Foundation Research Institute, Department of Health Policy Research, Palo Alto, CA, United States. Electronic address: lathap@pamfri.org.
authors.forename: Latha P
authors.initials: LP
authors.lastname: Palaniappan
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000208:ethnology*; D044466:Asian People / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D044465:White People