First, a big "Thank You!" to everyone, from honored guests and speakers, to the conference planners and attendees, who came together and made "Diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders: A Call to Action" a very successful event. Experts covered a wide range of diabetes topics, and while no two-day conference can be expected to yield the blueprint that effectively ends the diabetes epidemic, it did lay the groundwork for an action plan that will have the full support of the newly formed Asian American, Native Hawaiian, and Pacific Islander Diabetes Coalition (AANHPIDC, or "the Coalition" for short) as well as the AANHPI community. Below you will find a breakdown of the conference and action steps. To the right are links to more data in the form of the actual presentations from the conference.
2011 Diabetes Conference – What We've Learned, Where We're Going
Does diabetes really constitute a serious issue for AANHPI?
Absolutely. The data we have seen shows that Diabetes Mellitus (DM), is a national (not to mention global) health problem that adversely affects AANHPI populations.
The notion that "skinny Asians" are not at risk for developing DM is false:
Besides weight, what are some other factors to consider for this higher DM prevalence?
BMI, fat distribution, level of insulin secretion, insulin resistance, brown fat distribution, beta cell masking, visceral fat areas, and more. Some of these factors have been extensively researched with regard to AANHPI subpopulation, for others there is much more to learn. While this data sheds a significant amount of light on the situation, more comprehensive, disaggregated data is needed (ideally by individual ethnic subgroups) to avoid masking DM prevalence to influence health policy and quality improvement.
How would one design treatment guidelines for AANHPI?
The pathophysiological differences among AANHPI subgroups present challenges to diagnosing and prescribing treatments: there is no one size fits all, and continued research and data are critical to form a stronger basis of understanding who is at risk and why, as well as to create diagnostic and treatment guidelines that are subgroup specific.
Something that is nearly universally accepted for the treatment and management of DM is a healthy lifestyle that includes a nutritional diet and exercise. Research from numerous sources shows that diet and exercise intervention programs work to reduce the burden of DM through weight loss and overall health of body and mind.
What about culture and environment?
The term "lifestyle" itself takes on a multitude of factors: communities, industry, policies, and environments that influence behaviors. There has been a failure to adequately address psycho-social variables and their impact on DM. Guidelines and interventions must be created and implemented with regard to community and culture. Initiatives in multiple states were highlighted, and stressed a community based approach that could include classroom education, peer-to-peer teaching, and family support in patients¡¦ DM self management. Experts on nutritional guidelines talked about making alternative choices for healthier eating that maintained the flavor and character of ethnic AANHPI cuisine. All intervention programs and initiatives must have language that patients understand, both linguistically and from a health literacy standpoint. All these considerations need to be made for efficacy and retention of programs, and to achieve better health outcomes. The findings presented in this conference came from national, regional, and local research and data. Some of the richest came from Hawaii, where research on diabetes among AANHPI populations has been leading the way. This made holding this conference in Hawaii not only appropriate, but necessary.
So how are we going to do all this? Where do we go from here?