Arti D Shah1, Eric Vittinghoff2, Namratha R Kandula3, Shweta Srivastava4, Alka M Kanaya5. 1. Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco. Electronic address: Arti.Shah@ucsf.edu. 2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco. 3. Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL. 4. Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco. 5. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco.
Abstract
PURPOSE: In this study, we aim to elucidate the role of sociodemographic, lifestyle, and cultural factors in prediabetes and diabetes in South Asian immigrants to the United States, a population at high risk of type II diabetes. METHODS: We performed a cross-sectional analysis of a community-based cohort of 899 South Asians without known cardiovascular disease from the Mediators of Atherosclerosis in South Asians Living in America study. Glycemic status was determined by fasting glucose, 2-hour postchallenge glucose, and use of diabetes medication. We used multinomial logistic regression models to estimate the independent associations of sociodemographic, lifestyle, and cultural factors with prediabetes and diabetes, adjusting for confounders identified using directed acyclic graphs. RESULTS: Approximately 33% of participants had prediabetes and 25% had diabetes. In multivariate analyses, an independent correlate of prediabetes was low exercise. Additional covariates associated with diabetes included lower family income, less education, high chronic psychological burden score, and greater time spent watching television; and fasting monthly or annually was inversely associated with diabetes prevalence. CONCLUSIONS: We found several modifiable risk factors associated with prediabetes and diabetes that may help guide diabetes prevention interventions for South Asian immigrants to the United States.
PURPOSE: In this study, we aim to elucidate the role of sociodemographic, lifestyle, and cultural factors in prediabetes and diabetes in South Asian immigrants to the United States, a population at high risk of type II diabetes. METHODS: We performed a cross-sectional analysis of a community-based cohort of 899 South Asians without known cardiovascular disease from the Mediators of Atherosclerosis in South Asians Living in America study. Glycemic status was determined by fasting glucose, 2-hour postchallenge glucose, and use of diabetes medication. We used multinomial logistic regression models to estimate the independent associations of sociodemographic, lifestyle, and cultural factors with prediabetes and diabetes, adjusting for confounders identified using directed acyclic graphs. RESULTS: Approximately 33% of participants had prediabetes and 25% had diabetes. In multivariate analyses, an independent correlate of prediabetes was low exercise. Additional covariates associated with diabetes included lower family income, less education, high chronic psychological burden score, and greater time spent watching television; and fasting monthly or annually was inversely associated with diabetes prevalence. CONCLUSIONS: We found several modifiable risk factors associated with prediabetes and diabetes that may help guide diabetes prevention interventions for South Asian immigrants to the United States.
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