Pathways to Health: Many Asian Americans don’t know they have diabetes

International Community Health Services November 6, 2017 0

Alya Haq, nutrition services supervisor at International Community Health Services (ICHS) • Courtesy photo

May, who does not wish to use her real name, felt tired and sluggish for months but didn’t think she needed to see a doctor. “Who doesn’t feel tired?” she asked. “I thought it would just go away and I wouldn’t have to think about it.”

Her symptoms did not go away and a visit to the doctor revealed a life-changing diagnosis of type 2 diabetes.

“I couldn’t believe it when the doctor told me I had it,” said May, a 53-year-old woman of Chinese decent. “I felt scared and angry that this was happening to me and I was worried for my family. Being sick is expensive in America.”

According to the U.S. Center for Disease Control and Prevention (CDC) in 2016, Asian Americans are 10% more likely to be diagnosed with diabetes than Caucasian Americans. According to research released from the National Institutes of Health and the CDC in 2015, more than half of Asian Americans with the condition are unaware.

Silence, a lack of awareness and late onset of symptoms until other health problems emerge conspire to create a silent killer.

May had not known of the CDC’s recommendation that people 45 years of age and older regularly check their blood sugar levels. According to the CDC, diabetes is a long-lasting disease that affects how the body turns food into energy. A person has the disease when blood glucose or blood sugar levels are too high. Neglecting to control blood sugar levels can cause long-term organ damage and other health issues. Ignoring diabetes can lead to serious medical conditions such as cardiovascular disease, kidney disorders, diabetic foot and eye disorders, and other health issues.

Family history, obesity, diet and an inactive lifestyle are contributing factors.

“I didn’t think I was overweight and I eat food cooked at home, but my sugar number was high,” said May. The number May is referring to is the result of the A1C test, a common blood test used in diagnosis. Having a normal body weight can delay a diagnosis. For decades, doctors have used Body Mass Index (BMI) as a calculator for obesity, a major risk factor for this disease. Asian Americans tend to have lower BMI than their American peers, which can obscure other risk factors.

“It’s hard,” said May. “The doctor told me to change what I eat. How can I do that? I’ve eaten the same food my whole life and I don’t know how to cook and eat anything else. I don’t like the taste of anything else.”

International Community Health Services (ICHS) nutritionist Aliya Haq understands this dilemma all too well. “Cultural habits and foods are hard to change,’ she said. “I understand that food is a social thing and I don’t just give a leaflet on healthy eating and ask them to eat more vegetables and stop eating white rice.”

Lifestyle changes can dramatically make a difference in quality of life for patients as well as their families. In addition to medication, altering diet and increasing activity are the best practices for diabetes management. According to a 2013 Johns Hopkins study, losing 10% of body weight can reduce the risk of developing type 2 diabetes by 85%.

The diagnosis can be overwhelming and many people walk away in fear, Haq said. “I spend 75% of my time listening to them,” she confirmed. “I think this is the key to understanding their lifestyle and ensuring their compliance.”

Haq acknowledges success takes time and effort, as well as collaboration between the patient and their medical team. “We have to work together to be more effective and better benefit the patient,” said Haq. “It’s so important. Knowledge and information are the best tools against this disease. Together we can make a difference.”

The payoffs of proactive diabetes screening and management are tangible.

“I had a patient whose A1C numbers dropped from 11.7 to 5.7,” she said. “He was so happy that he was dancing in my office. It doesn’t happen overnight and it’s important to understand that patients don’t come in here with just diabetes. They come in with many other issues such as high cholesterol, hypertension, heart disease and other quality of life issues.”

“I’m trying to eat good healthy food and I walk every day for as long as I can,” said May, ”I know I have to get more exercise to stay healthy.”

November is American Diabetes Month, when communities across the country bring attention to diabetes and its impact on millions of Americans. For more information about diabetes screenings, contact a health care provider at nearby ICHS clinic, or call: 206-788-3650.

About ICHS

Founded in 1973, ICHS is a non-profit community health center offering affordable primary medical and dental care, acupuncture, laboratory, pharmacy, behavioral health WIC, and health education services. ICHS’ four full-service medical and dental clinics – located in Seattle’s International District and Holly Park neighborhoods; and in the cities of Bellevue and Shoreline – serve nearly 29,000 patients each year. As the only community health center in Washington primarily serving Asians and Pacific Islanders, ICHS provides care in over 50 languages and dialects annually. ICHS is committed to improving the health of medically-underserved communities by providing affordable and in-language health care. For more information, please visit:

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