Non-Obese Vietnamese Americans 60% More Likely to Have Diabetes as White Counterparts

Leanne De Souza, PhD

New research from the University of Toronto is shedding light on an apparent increase in risk of diabetes among non-obese Vietnamese Americans.

Results of the study, which analyzed data from more than 120,000 patients, suggest Vietnamese Americans with a BMI of less than 30 were at a 60% greater risk of having diabetes than their non-Hispanic white counterparts with similar BMI.

"While obesity is commonly associated with diabetes risk, the study's findings indicate that this is not necessarily the case for Vietnamese Americans," said lead investigator Leanne De Souza, PhD, assistant professor of Human Biology and Health Studies Programs, University College, University of Toronto, in a statement. "As a result, health care professionals may miss screening for preventing and treating this potentially life-threatening disease in the Vietnamese-American population. Screening of Vietnamese adults who have normal weight would be helpful."

With Vietnamese Americans representing one of the most understudied populations, investigators sought to more fully understand prevalence and risk factors for Vietnamese Americans compared to their non-Hispanic White counterparts. To do so, De Souza and colleagues designed their study with the specific aim of estimating diabetes prevalence among non-obese Vietnamese American, identify factors associated with type 2 diabetes among these patients, and examine whether diabetics were as likely to receive optimal care as their non-Hispanic White counterparts.

Using data from the California Health Interview Survey (CHIS), the team of investigators obtained data from biennial and annual surveys performed in 2007, 2009, 2011, 2013, 2014, 2015, and 2016. In total, CHIS provided data related to 4339 Vietnamese Americans and 156,388 non-Hispanic Whites. Of these total sample, 123,620 were considered non-obese, including 3969 Vietnamese Americans and 119,651 non-Hispanic Whites.

Compared to non-Hispanic White patients, Vietnamese Americans had a lower prevalence of obesity (22.7% vs 8.7%) and a lower prevalence of diabetes (7.2% vs 5.6%). Most Vietnamese Americans with diabetes (90.6%) had a BMI of less than 30—in comparison, under half of the non-Hispanic Whites with diabetes were not obese (49.6%).

In analyses adjusted for smoking status, exercise level, age, BMI, socioeconomic status, and other factors, investigators found non-obese Vietnamese Americans had 60% greater odds of developing diabetes. Additionally, results of the adjusted analyses indicated non-obese patients had a similar likelihood of receiving optimal frequency of care regardless of whether patients were Vietnamese Americans or non-Hispanic Whites.

"Better identification of those in the 'pre-diabetes' stage may increase awareness of personal risk and interventions to promote lifestyle changes. Such interventions may substantially decrease the risk of progression to full diabetes," added lead investigator Esme Fuller-Thomson, PhD, director of the Institute for Life Course & Aging and professor at the University of Toronto's Factor-Inwentash Faculty of Social Work and Department of Family & Community Medicine, in the aforementioned statement.

This study, “The prevalence and management of diabetes among Vietnamese Americans: A population-based survey of an understudied ethnic group,” was published in Chronic Illness.