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© 2003 by the American Diabetes Association, Inc.
Epidemiology/Health Services/Psychosocial Research |
Lack of Acculturation Is a Risk Factor for Diabetes in Arab Immigrants in the U.S.
1 Department of Pharmacy Practice, Wayne State University, Detroit, Michigan
2 Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
3 Community Health Center, ACCESS, Dearborn, Michigan
4 Departments of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, Michigan
Address correspondence and reprint requests to Linda A. Jaber, PHARMD, Associate Professor, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Detroit, MI 48201-2417. E-mail: ljaber{at}wayne.edu.
OBJECTIVE—To examine the relationship between dysglycemia (impaired fasting glucose, impaired glucose tolerance, and diabetes) and acculturation, physical activity, and perceived stress in Arab immigrants in the U.S.
RESEARCH DESIGN AND METHODS—In a cross-sectional population-based study, we examined 520 Arab Americans, aged 20–75 years, who were born in the Middle East and immigrated to southeastern Michigan. Dysglycemia was assessed by history and with a 2-h 75-g oral glucose tolerance test. Acculturation, physical activity, and perceived stress were measured with standardized questionnaires.
RESULTS—Associations were found between dysglycemia in men and older age at immigration, unemployment, speaking Arabic with friends, being less active in Arabic organizations, more frequent consumption of Arabic food, and less integration into American society. Dysglycemia in women was associated with being raised in rural areas of the Middle East, older age at immigration, longer length of stay in the U.S., not being employed outside the home, less than high school education, not attending Arabic or American schools, and not being able to read Arabic. Among men, older age at immigration, shorter length of stay in the U.S., less activity in Arab organizations, and eating Arabic food were associated with dysglycemia independent of age and BMI. Among women, acculturation was very low and was confounded with age and BMI as powerful risk factors for dysglycemia. No association was found between physical activity, perceived stress, and the risk of dysglycemia in either sex.
CONCLUSIONS—Lack of acculturation is an important risk factor for dysglycemia in immigrant Arab Americans. Intervention programs aimed at diabetes prevention should consider the acculturation process.
Abbreviations: IFG, impaired fasting glucose • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • PSS, perceived stress scale • WHR, waist-to-hip ratio
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