Published September 22, 2020

Diabetes mellitus, more simply known as diabetes, is a group of diseases that affects how your body uses glucose. Glucose, or blood sugar, is essential to your body because it provides energy for your brain and muscles (Mayo Clinic, 2018).

According to the American Diabetes Association, 25% of people over the age of 65 have diabetes and 50% have prediabetes. Older adults with diabetes have higher rates of premature death, functional disability, accelerated muscle loss, and other comorbidities such as hypertension, heart disease, and stroke (American Diabetes, 2019).

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Diabetes Among Japanese Americans

Diabetes has a greater prevalence among Asian Americans and Pacific Islanders, affecting about 20% of the population, and about 90-95% of those with diabetes have Type 2 diabetes (Joslin Diabetes Center, 2016). Specifically, non-obese Japanese Americans have a higher prevalence of diabetes compared to nonobese Caucasians. This was found to be 8 percent prevalence for Japanese Americans and 4.5 percent among Caucasians (Kobayashi et al., 2019).

This is alarming since diabetes is the fifth leading cause of death among Asian Americans and Pacific Islanders. The high prevalence rate is due to a combination of genetics and environment. Japanese Americans have higher rates of diabetes compared to Caucasians, pointing to a genetic influence (Joslin Diabetes Center, 2016).

Additionally, environmental factors contribute towards the higher rate of diabetes in Japanese Americans compared to native Japanese living in Japan (Joslin Diabetes Center, 2016). A Westernized lifestyle (such as bigger food portions and higher consumption of dietary fat) fosters greater weight gain and thus promotes insulin resistance. This resistance can lead to glucose intolerance, which then develops into diabetes (Fujimoto et al., 2012). This in turn can lead to elevated blood sugar levels causing severe health problems such as skin infections, eye complications, nerve damage, kidney disease, high blood pressure, and stroke (Complications, n.d.). However, with treatment and lifestyle changes, many people with diabetes can prevent or delay these complications.

Types and Stages of Diabetes

There are two types of diabetes: Type 1, and Type 2. The stage before Type 2 diabetes is called prediabetic.

While Type 1 and Type 2 diabetes differ in causes and treatments, they do not necessarily affect quality of life differently. In a survey of 1,783 adults with diabetes, there were no reported differences in health-related quality of life between those with Type 1 and Type 2 being treated by diet alone (Imayama, Plotnikoff, Courneya, & Johnson, 2011). The same symptoms and diagnostic criteria are used to diagnosis diabetes, and a blood test can help distinguish between the two types (Johns Hopkins, n.d.).

Negative Consequences of Diabetes (American Diabetes Association, n.d.)

Many people with diabetes can prevent different complications through treatment and lifestyle changes. However, if diabetes is untreated and lifestyle modifications are not made, there are a variety of medical complications that can develop. Here are a few of the negative health consequences that can result from diabetes.

Screenings/Diagnosis

Several risk factors should immediately prompt diabetes testing. However, if you are unsure, ask your physician to conduct a diabetes test. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and Type 2 diabetes in adults 40-70 years old who are overweight or obese. This screening should be completed every three years as long as results are normal (Pippitt & Gurgle, 2016). The American Association of Clinical Endocrinologists (doctors who specialize in glands and hormones) suggests screening in association with these risk factors: (Pippitt & Gurgle, 2016)

• 45 years old or over
• Cardiovascular disease/ family history of Type 2 diabetes
• Hypertension (blood pressure over 140/90 mm HG or taking hypertension medication)
• At risk ethnic groups: Asian, Pacific Islander, Hispanic, Black
• Obese or overweight
• Sedentary lifestyle

There are different types of diabetes tests available. The fasting plasma glucose test, A1C test, and oral glucose tolerance test are considered the most accurate for diagnosing prediabetes and diabetes (The Best Tests, 2018). While one test is not necessarily better than the other, some do require fasting, so take that into consideration when choosing a test.

Below are the different  tests for prediabetes and Type 2 diabetes (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.):

You can ask your physician to perform a diabetes screening for you. Some pharmacies such as Rite Aid, CVS, and Walgreens may offer diabetes screenings. Medicare pays for diabetes screening tests if you are at risk for diabetes and may pay for up to two diabetes screening tests in a 12-month period. Fasting blood sugar tests and other tests approved by Medicare are appropriate tests. Medicare also covers the A1C test if ordered by doctor (Medicare Coverage, 2018).

Prevention and Treatment

Prediabetes and Type 2 diabetes can often be prevented through diet and lifestyle changes. In a three-year study, a group following a diet and lifestyle intervention had a 58% lower risk of developing diabetes. In the same study, participants over the age of 60 had an even better response of 71% lower risk of developing diabetes (Tello, 2018).

Strict glucose control can delay and prevent the progression of complications associated with diabetes. In addition, leading a healthy lifestyle (healthy diet, modest weight loss, and regular physical activity) can reduce the risk of Type 2 diabetes complications (Chong et al., 2017). On a long-term scale, diabetes management involves key health behaviors. Overall, each person needs to work with their physician to create an individualized treatment plan to manage and treat their diabetes.

Diabetes significantly affects older adults, especially Asian Americans and Pacific Islanders, which is why it is important to understand its effects on the body. Those who have a family history of diabetes or are at risk of developing diabetes should be tested regularly. After a diabetes diagnosis, learn more about how to manage it. Again, diabetes can be treated and even prevented through diet and lifestyle changes. Consider increasing your consumption of fruits and vegetables, and exercising regularly to prevent or better manage your diabetes.