title: The Burden of Diagnosed and Undiagnosed Diabetes in Native Hawaiian and Asian American Hospitalized Patients.
abstract: OBJECTIVE
  Little is known about diabetes in hospitalized Native Hawaiians and Asian Americans. We determined the burden of diabetes (both diagnosed and undiagnosed) among hospitalized Native Hawaiian, Asian (Filipino, Chinese, Japanese), and White patients.
  
  
  METHODS
  Diagnosed diabetes was determined from discharge data from a major medical center in Hawai'i during 2007-2008. Potentially undiagnosed diabetes was determined by Hemoglobin A1c ≥6.5% or glucose ≥200 mg/dl values for those without diagnosed diabetes. Multivariable log-binomial models predicted diabetes (potentially undiagnosed and diagnosed, separately) controlling for socio-demographic factors.
  
  
  RESULTS
  Of 17,828 hospitalized patients, 3.4% had potentially undiagnosed diabetes and 30.5% had diagnosed diabetes. In multivariable models compared to Whites, Native Hawaiian and all Asian subgroups had significantly higher percentages of diagnosed diabetes, but not of potentially undiagnosed diabetes. Potentially undiagnosed diabetes was associated with significantly more hospitalizations during the study period compared to both those without diabetes and those with diagnosed diabetes. In all racial/ethnic groups, those with potentially undiagnosed diabetes also had the longest length of stay and were more likely to die during the hospitalization.
  
  
  CONCLUSIONS
  Hospitalized Native Hawaiians (41%) and Asian subgroups had significantly higher overall diabetes burdens compared to Whites (23%). Potentially undiagnosed diabetes was associated with poor outcomes. Hospitalized patients, irrespective of race/ethnicity, may require more effective inpatient identification and management of previously undiagnosed diabetes to improve clinical outcomes.
authors.affiliation: Office of Public Health Studies, University of Hawai'i at Manoa, 1960 East-West Road, Biomed T102, Honolulu, HI 96822, USA;
authors.forename: T L
authors.initials: TL
authors.lastname: Sentell
authors.affiliation: Biostatistics & Data Management Core, University of Hawai'i John A. Burns School of Medicine, 651 Ilalo Street, Biosciences Building, Suite 211, Honolulu, HI 96813, USA;
authors.forename: Y
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: John A. Burns School of Medicine, 677 Ala Moana Blvd #1015, Honolulu HI 96813, USA;
authors.forename: E
authors.initials: E
authors.lastname: Saito
authors.affiliation: The Queens Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813, USA;
authors.forename: T B
authors.initials: TB
authors.lastname: Seto
authors.affiliation: Hawaii Health Information Corporation, 733 Bishop Street, Honolulu, HI 96813, USA;
authors.forename: J
authors.initials: J
authors.lastname: Miyamura
authors.affiliation: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i, 677 Ala Moana Boulevard, Suite 1016; Honolulu, HI 96813, USA;
authors.forename: M
authors.initials: M
authors.lastname: Mau
authors.affiliation: The Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, 677 Ala Moana Boulevard, Suite 1025; Honolulu, HI 96813, USA;
authors.forename: D T
authors.initials: DT
authors.lastname: Juarez
keywords: Asian American; Diabetes; Hospitalization; Native Hawaiian