Diabetes mellitus poses a significant public health challenge for the US. Some 800,000 cases are diagnosed each year, and changing demographic patterns in the US are expected to increase the number of people at risk for diabetes and who eventually develop the disease. Diabetes is a chronic disease that usually manifests as one of two major types. In type 1, which occurs mainly in children and adolescents, the body does not produce insulin, and insulin administration is required to sustain life. In type 2, which usually occurs in adults over 30 years of age, the body’s tissues become unable to use its own limited supply of insulin effectively. (US DHHS, 2000).

Adult-onset diabetes also has strong physiologic ties to cardiovascular disease (CVD). The majority of patients with diabetes mellitus die of CVD complications rather than of causes associated directly with glucose control. (US DHHS, 2003). [Read more]

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Diabetes is a major clinical and public health challenge among certain racial and ethnic groups in which both new cases of diabetes and the risk of associated complications are great. Vulnerable and high-risk populations include Asian Americans and Pacific Islanders, elderly persons, and economically disadvantaged persons. Factors that account for this chronic disease epidemic include behavioral elements (e.g., increased fat consumption, decreased physical activity, obesity), demographic changes (aging, increased growth of at-risk populations), genetics, cultural and community traditions, and socioeconomic status. The level of patient knowledge and empowerment has a great impact on the disease burden associated with diabetes. (US DHHS, 2000).

Diabetes and obesity have been established as major health problems among AAPIs. Whether residing on their home islands or the US mainland, Samoans, native Hawaiians, and Micronesians are frequently affected by obesity and type 2 diabetes. (Crews, 1988; Crews et al., 1991; Pawson and Janes, 1981; Zimmet, 1979). AAPIs appear to be at increased risk for both obesity and type 2 diabetes whether they migrate to or are born in the US or adopt Western lifestyles in their homelands. Their risk of diabetes is significantly greater than that of Europeans or European Americans. (Crews, 1994).

Overweight and Obesity Overweight and obesity are major contributors to many preventable causes of death. On average, higher body weights are associated with higher death rates. Those who are overweight or obese have a substantially higher risk of developing high blood pressure, high cholesterol, type 2 diabetes, heart disease and stroke, gallbladder disease, arthritis, sleep disturbances and breathing problems, and certain types of cancer. (US DHHS, 2000).