Restricted accessResearch articleFirst published online 2024-3
The Impact of Social Determinants of Health on the Diagnosis of Type 2 Diabetes Mellitus (T2DM) Among Asian Indians (AIs) in New Jersey: A Secondary Analysis of the BRFSS Survey From 2013 to 2017
Asian Indians (AIs), the second largest immigrant population in the United States, are disproportionately affected by type 2 diabetes mellitus (T2DM) at a lower age and body mass index (BMI). The purpose of this study was to examine the relationship between social determinants of health (SDOH) and the diagnosis of T2DM among AIs in New Jersey (NJ).
Methodology:
This was a secondary data analysis of the Behavioral Risk Factor Surveillance System (BRFSS) in NJ from 2013 to 2017. Statistical analyses included descriptive and inferential statistics.
Results:
Among 1,132 AIs, 16% had T2DM or prediabetes (PDM) and 69.2% were overweight or obese. The risk for T2DM was significantly associated with internet use, older age, having medical check-ups, and having a personal doctor (p ≤ .05).
Discussion:
These findings inform culturally congruent care by underscoring the importance of weight management, earlier screening, and provider involvement in diabetes prevention strategies for AIs.
Al-SofianiM.LanganS.KanayaA. M.KandulaN. R.NeedhamB. L.KimC.VaidyaD.GoldenS. H.GudzuneK. A.LeeC. J. (2020). The relationship of acculturation to cardiovascular disease risk factors among U.S. South Asians: Findings from the MASALA study. Diabetes Research and Clinical Practice, 161, Article 108052. https://doi.org/10.1016/j.diabres.2020.108052
BasraS. P.KhanS. S.KandulaN. R.KanayaA. M.ShahN. S. (2023). Body mass index in young adulthood and mid-life cardiovascular risk factors in South Asian American adults: The MASALA study. Indian Heart Journal, 75(2), 153–155. https://doi.org/10.1016/j.ihj.2023.02.005
4.
BhardwajS.MisraA. (2015). Obesity, diabetes and the Asian phenotype. World Review of Nutrition and Dietetics, 111, 116–122. https://doi.org/10.1159/000362308
5.
BhupathirajuS. N.SawickiC. M.GoonS.GujralU. P.HuF. B.KandulaN. R.KanayaA. M. (2022). A healthy plant-based diet is favorably associated with cardiometabolic risk factors among participants of South Asian ancestry. The American Journal of Clinical Nutrition, 116(4), 1078–1090. https://doi.org/10.1093/ajcn/nqac174
BujangM. A.Sa’atN.SidikT. M. I. T. A. B.JooL. C. (2018). Sample size guidelines for logistic regression from observational studies with large population: Emphasis on the accuracy between statistics and parameters based on real life clinical data. The Malaysian Journal of Medical Sciences, 25(4), 122–130. https://doi.org/10.21315/mjms2018.25.4.12
Commodore-MensahY.SelvinE.AboagyeJ.Turkson-OcranR. A.LiX. M.HimmelfarbC. D.AhimaR. S.CooperL. A. (2018). Hypertension, overweight/obesity, and diabetes among immigrants in the United States: An analysis of the 2010-2016 National Health Interview Survey. BMC Public Health, 18, Article 773. https://doi.org/10.1186/s12889-018-5683-3
12.
FagherazziG.RavaudP. (2019). Digital diabetes: Perspectives for diabetes prevention, management and research. Diabetes & Metabolism, 45(4), 322–329. https://doi.org/10.1016/j.diabet.2018.08.012
13.
GujralU. P.MohanV.PradeepaR.DeepaM.AnjanaR. M.MehtaN. K.GreggE. W.NarayanK. M. (2016). Ethnic variations in diabetes and prediabetes prevalence and the roles of insulin resistance and β-cell function: The CARRS and NHANES studies. Journal of Clinical & Translational Endocrinology, 4, 19–27. https://doi.org/10.1016/j.jcte.2016.02.004
14.
GujralU. P.NarayanK. M. V.KandulaN. R.LiuK.KanayaA. M. (2020). Incidence of diabetes and prediabetes and predictors of glycemic change among South Asians in the USA: The MASALA study. BMJ Open Diabetes Research & Care, 8(1), Article e001063. https://doi.org/10.1136/bmjdrc-2019-001063
JaraA. J.ZamoraM. A.SkarmetaA. F. G. (2011). An internet of things-based personal device for diabetes therapy management in ambient assisted living (AAL). Personal and Ubiquitous Computing, 15(4), 431–440. https://doi.org/10.1007/s00779-010-0353-1
17.
JosephN. M.MisraR.WangJ.CronS.RamaswamyP. (2018). Mediating role of acculturation and lifestyle behaviors on cardiometabolic risks among Asian Indians in the United States. Diabetes, 67(Supplement 1), 247-OR-OR. https://doi.org/10.2337/db18-247-OR
KochanekK. D. M. A.MurphyS. L.XuJ.AriasE. (2019). National vital statistics reports deaths: Final data for 2017. Centers for Disease Control and Prevention.
20.
McCoyM. R.CouchD.DuncanN. D.LynchG. S. (2005). Evaluating an internet weight loss program for diabetes prevention. Health Promotion International, 20(3), 221–228. https://doi.org/10.1093/heapro/dai006
21.
MillardA. V.GrahamM. A.MierN.MoralezJ.Perez-PatronM.WickwireB.MayM. L.OryM. G. (2017). Diabetes screening and prevention in a high-risk, medically isolated border community. Frontiers in Public Health, 5, Article 135. https://doi.org/10.3389/fpubh.2017.00135
22.
MisraA.SoaresM. J.MohanV.AnoopS.AbhishekV.VaidyaR.PradeepaR. (2018). Body fat, metabolic syndrome and hyperglycemia in South Asians. Journal of Diabetes and its Complications, 32(11), 1068–1075. https://doi.org/10.1016/j.jdiacomp.2018.08.001
23.
MisraR.MadhavanS. S.DhumalT.SambamoorthiU. (2023). Prevalence and factors associated with diagnosed diabetes mellitus among Asian Indian adults in the United States. PLOS Global Public Health, 3(2), Article e0001551. https://doi.org/10.1371/journal.pgph.0001551
PierannunziC.HuS. S.BalluzL. (2013). A systematic review of publications assessing reliability and validity of the Behavioral Risk Factor Surveillance System (BRFSS), 2004-2011. BMC Medical Research Methodology, 13(1), 1–14. https://doi.org/10.1186/1471-2288-13-49
26.
RaiS. K.KanayaA. M.KandulaN.SunQ.BhupathirajuS. N. (2021). Abstract MP57: A South Asian Mediterranean-style diet pattern is associated with favorable measures of adiposity and a lower risk of incident diabetes: Findings from the masala study. Circulation, 143, Article AMP57. https://doi.org/10.1161/circ.143.suppl_1.MP57
27.
RodriguezL. A.JinY.TalegawkarS. A.OttoM. C. d, O.KandulaN. R.HerringtonD. M.KanayaA. M. (2020). Differences in diet quality among multiple U.S. Racial/Ethnic Groups from the mediators of atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA). The Journal of Nutrition, 150(6), 1509–1515. https://doi.org/10.1093/jn/nxaa050
28.
ShahM. D.VittinghoffE.KandulaN. R.SrivastavaS.KanayaA. M. (2015). Correlates of prediabetes and type II diabetes in U.S. South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Annals of Epidemiology, 25(2), 77–83. https://doi.org/10.1016/j.annepidem.2014.10.013
29.
ShahV. N.MohanV. (2015). Diabetes in India: What is different?Current Opinion in Endocrinology & Diabetes and Obesity, 22(4), 283–289. https://doi.org/10.1097/MED.0000000000000166
Venkat NarayanK. M.KondalD.KobesS.DeepaM.DayaN. R.PatelS. A.AnjanaR. M.StaimezL. R.AliM. K.GujralU.PrabhakaranD.ShivashankarR.KadirM.SelvinE.MohanV.HansonR. L.TandonN. (2019). 1597-P: Incidence of diabetes in young adult South Asians compared with Pima Indians. Diabetes, 68(Suppl. 1), 1597. https://doi.org/10.2337/db19-1597-P
32.
VenkateshS.ConnerT.SongW. O.OlsonB. H.WeatherspoonL. J. (2017). The relationship between dietary acculturation and type 2 diabetes risk among 112 Asian Indians in the U.S. Journal of Immigrant and Minority Health, 19(2), 294–301. https://doi.org/https://dx.doi.org/10.1007/s10903-016-0482-3
33.
VicksW. S.LoJ. C.GuoL.RanaJ. S.ZhangS.RamalingamN. D.GordonN. P. (2022). Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: An electronic health record study. BMC Public Health, 22(1), Article 1954. https://doi.org/10.1186/s12889-022-14362-8
34.
WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363(9403), 157–163. https://doi.org/10.1016/S0140-6736(03)15268-3
ZhangY. L.TsaiJ. L. (2014). The assessment of acculturation, enculturation, and culture in Asian- American sample. Guide to Psychological Assessment with Asians, 75–101. https://doi.org/https://doi.org/10.1007/978-1-4939-0796-0_6
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
