The Particulars: In the Veterans Affairs system, researchers have observed that many patients with diabetes on renal dialysis are thin, Asian men who exercise frequently and have access to healthcare. The current recommendation of screening for diabetes in adults aged 45 and older with a BMI of 25 kg/m2 or higher and one known risk factor may not be sufficient for the Asian-American population.
Data Breakdown: Diabetes screening tests were performed on participants in a study who self-reported being Chinese, Filipino, Japanese, Korean, or of mixed Asian ancestry. To detect diabetes, the optimal BMI cut points were higher than 24 kg/m2 for all patients, women, those aged 55 and older, and those with isolated post-challenge hyperglycemia. The optimal cut point was higher than 25 kg/m2 when screenings were limited to fasting plasma glucose or A1C measurements, and greater than 26 kg/m2 for men and those aged 35 to 54.
Take Home Pearls: Using the recommended BMI cut point of 25 kg/m2 or higher for diabetes screening does not appear to identify a substantial number of Asian Americans with the disease. A BMI cut point of 24 kg/m2 may be more appropriate for diabetes screenings this population.