Understanding and Addressing Unique Needs of Diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders

  1. Edward A. Chow, MD7
  1. 1Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
  2. 2Department of Medicine, University of Washington, Seattle, Washington
  3. 3City University of New York School of Public Health at Hunter College, New York, New York
  4. 4Center for Native and Pacific Health Disparities Research, Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii
  5. 5Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington
  6. 6Chinese Community Health Resource Center, San Francisco, California
  7. 7California Chinese Community Health Care Association, San Francisco, California
  1. Corresponding author: George L. King, george.king{at}joslin.harvard.edu.

The Asian American (AA) population is currently the fastest growing population in the U.S., having expanded six times faster than the general population in the 1990s (1). In addition, diabetes prevalence continues to rise in this population, as observed for other populations around the world. However, given the diverse natures, cultures, and physiologies among the AA, Native Hawaiian (NH), and Pacific Islander (PI) (AANHPI) populations, and in particular the distinct diabetes profiles, an understanding of these factors can provide important clues to understand the genesis, pathophysiology, and treatment response of diabetes, as well as characterize community outreach programs needed for the wider net of diverse communities throughout the U.S. In this regard, a meeting, whose theme was “Diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders: A Call to Action,” was held in Honolulu, Hawaii, in September 2011 by a coalition of health care organizations and scientists with strong interests in the topic and in the health of AANHPI populations. There was consensus that there is a great need to understand the prevalence and pathophysiology and discuss potential intervention strategies regarding diabetes in AANHPI populations given the unique characteristics of this population. This information may help health care providers understand and improve diabetes prevention, treatment outcomes, and complications in AANHPI populations. In this review, we examine diabetes prevalence in different AANHPI populations to highlight the similarities and differences.

AANHPI POPULATION OVERVIEW

The various groups that comprise AANHPI populations are hugely diverse geographically, culturally, and genetically. The U.S. census defines AAs as persons who have origins in the East, Southeast, or South Asia. NHs and PIs are people who have origins in Hawaii, Samoa, or any other Pacific island (2,3). Diversity within each of these groups is also large. For example, although grouped as AAs, the language, culture, and genetics of someone …

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