Diabetes in Asian Americans: Type-What?

Type 1 and type 2 diabetes in Asian Americans identified by Joslin researchers

(RxWiki News) Even though type 1 and type 2 diabetes are different conditions, they can look similar in young Asian Americans. These similarities can make it hard for some doctors to diagnose this population.

Now, researchers have identified a few ways to tell the difference between the two types of diabetes in this population.

"Make sure you get a proper diabetes diagnosis."

For more than a decade, William Hsu, M.D., of the Joslin Diabetes Center and Harvard Medical School, and colleagues have been working to tackle the problem of diagnosing diabetes in Asians and Asian Americans. According to Dr. Hsu, "Diabetes in Asian Americans is somewhat of a mystery."

While white Americans with type 2 diabetes are usually overweight and older, Asian Americans with type 2 diabetes are often young and have a normal body weight.

White Americans with type 1 diabetes typically have a strong autoimmune response against the pancreas's beta cells - the cells that excrete insulin. In other words, their body mistakenly attacks the beta cells, slowing down or stopping the production of insulin.

In comparison, Asian Americans with type 1 diabetes only show this autoimmune response less than 50 percent of the time.

These different manifestations of the two types of diabetes can make it difficult for doctors to diagnose Asian Americans. In fact, many Asian Americans are misdiagnosed.

Through a pilot study of 30 healthy-weight Asian Americans with and without diabetes, Dr. Hsu and colleagues were able to find clear differences between type 1 and type 2 diabetes that could lead to more accurate diagnoses.

The researchers found that Asian Americans with type 2 diabetes are more resistant to insulin (a hormone that controls blood sugar) than those with type 1 diabetes or no diabetes, even if their body mass index (BMI) is normal.

They also found that insulin resistance is associated with levels of a protein called fatty acid-binding protein, but more research is needed to see if targeting this protein could help treat insulin resistance.

This study showed that insulin resistance plays an important role in normal-weight Asian Americans with type 2 diabetes. Generally, type 2 diabetes patients are told to lose weight. However, if a person's body weight is normal, losing weight is not recommended. So, how should normal-weight Asian Americans deal with their insulin resistance?

The study also revealed that Asian Americans with type 2 diabetes have more bad fats hidden away in their torso, compared to those with type 1 diabetes or no diabetes.

This shows that even though they are not overweight, this population may not be in the best physical shape.

According to Dr. Hsu, it is "not that they necessarily need to lose weight; it should be 'let's get fit, let's exercise."

This study - which was part of the Asian American Diabetes Initiative - appears in the journal PLoS ONE

Review Date: 
December 7, 2011