New Research Finds Improved Ways of Diagnosing Diabetes in Asians

Scientists have come up with new ways to diagnose the two common types of diabetes among Asian Americans, who often do not conform to diabetic types as recognized among whites.  Researchers at the world famous Joslin Diabetes Center have found ways to tell whether diabetic patients are type 1 or 2, which is not always easy with people of Asian race.

As with other populations, diabetes is on the rise among Asian people, with China currently having the largest number of diabetics in the world, at 92 million.  The disease is also on the rise among people of Asian background in the US.  However, diagnosing diabetes in Asian people presents problems.

Diabetes is a disease that causes high blood sugar levels which can damage the major organs and other tissues if left untreated.  In both types of diabetes, insulin and its effect on blood sugar levels is at the heart of the problem, with type 1 diabetics not producing enough of the hormone and type 2 diabetics having lost their ability to respond to it properly.   Type 1 diabetes is believed to occur as a result of an autoimmune problem in which the insulin-producing beta cells in the pancreas are damaged.  However, nine out of ten cases of diabetes are type 2, which typically occurs in older, overweight people who lead sedentary lives and eat poor diets full of fat and starch.  In most populations and ethnicities obesity or a higher Body Mass Index is a prime indicator of type 2 diabetes.

However, in Asian people, many type 2 diabetics are young and slim, making diagnosis difficult for western doctors accustomed to seeing overweight and older people with the disease.  It also makes differentiating between type 1 and type 2 more difficult.  There are also differences with type 1 diabetes in Asians that make diagnosis harder, with only about half showing the typical autoimmune symptoms.  These problems have led to cases of misdiagnosis in the Asian population in the US.

Now a study has been published in the journal PLoS ONE after researchers discovered symptoms that could help with this problem.  The team at the center, in Boston, studied a group of 30 Asian people of healthy BMI, including both diabetics and non-diabetics.  They used the insulin clamp technique, injecting measured insulin into a vein and testing as blood sugar levels changed.

The test showed that type 2 diabetics had greater insulin resistance than both type 1 diabetics and non-diabetics.  They also found a relationship between levels of “fatty acid-binding protein” and insulin resistance in patients.

However, the study also showed that, while type 2 diabetes can affect Asians of normal weight, these people tended to have a higher level of fat within the body, indicating that they are unit and need to make lifestyle changes.

Study author Dr William Hsu commented that the normal advice given to type 2 diabetics is that they need to lose weight, yet Asian patients were typically not overweight or obese.  He said the advice needed to be adjusted to “let’s get fit, let’s exercise.”

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