In Reply: In response to Dr Rajpathak and colleagues, while our study focused on epidemiology of type 2 diabetes in Asian countries, there is a clear need to examine social, cultural, and behavioral factors and diabetes risk in Asian immigrant populations in the United States and other Western countries. Despite having lower body mass index (BMI) than other ethnic groups, Asian Americans have experienced the largest increase in diabetes prevalence in recent years. In a random multiethnic sample of 5% of Medicare fee-for-service beneficiaries 65 years or older, the prevalence of diabetes among Asians increased by nearly 70% from 1997 to 2004.1 In a population-based telephone survey, the prevalence of diabetes was significantly higher among Asian Americans than among non-Hispanic white individuals, after adjusting for a lower BMI among Asian individuals.2 Similarly, in the Nurses' Health Study, the incidence of diabetes was significantly higher among Asian than among white individuals, after accounting for BMI and other diabetes risk factors.3 Also, the increased risk of diabetes associated with BMI and weight gain was more pronounced among Asian women than other ethnic groups.
Chan JCN, Malik V, Hu FB. Diabetes in Asian Immigrant Populations—Reply. JAMA. 2009;302(15):1646-1647. doi:10.1001/jama.2009.1441