Incidence of diabetes and prediabetes and predictors of glycemic change among South Asians in the USA: the MASALA study

• Type of Material: Article
• Authors: Unjali Gujral, Emory University; Kabayam Venkat Narayan, Emory University; Namratha R. Kandula, Northwestern University; Kiang Liu, Northwestern University; Alka M. Kanaya, University of California San Francisco
• Language: English
• Date: 2020-01-01
• Publisher: BMJ Publishing Group
• Publication Version: Final Published Version
• Copyright Statement: © Author(s) (or their employer(s)) 2020.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjdrc-2019-001063
• Title of Journal or Parent Work: BMJ Open Diabetes Research & Care
• Volume: 8
• Issue: 1
• Grant/Funding Information: KMVN was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number R01HL125442.; Both UPG and KMVN are supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number P30DK111024.; The MASALA study was supported by the NIH grant no. 1R01 HL093009. Data collection at UCSF was also supported by NIH/NCRR UCSF‐CTSI grant number UL1 RR024131.
• Keywords: Body composition; incidence; type 2 diabetes; Glucose tolerance; Objectives; Endocrinology & Metabolism; Japanese; Asian Indians; Indians; Life Sciences & Biomedicine; Visceral adiposity; Insulin resistance; Science & Technology; Atherosclerosis; impaired fasting glucose; Prevalence; Risk
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology; Biology, Biostatistics

Abstract

Introduction South Asians have a high prevalence of type 2 diabetes mellitus (T2DM). This may be associated with high rates of conversion through the natural history of disease. However, there is a paucity of data on prediabetes and T2DM incidence and related predictors in South Asians in the USA. Research design and methods We estimated prediabetes and T2DM incidence after 5 years of follow-up in the Mediators of Atherosclerosis in South Asians Living in America study (n=481) and examined the associated correlates. We defined T2DM and prediabetes using the American Diabetes Association criteria. Prediabetes included isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined IFG and IGT. Results Overall, 152 (32%, 95% CI: 27.6 to 35.9) individuals progressed either from normal glucose tolerance to prediabetes or T2DM, or from prediabetes to T2DM. In standardised logistic regression models controlling for age and sex, only hepatic fat attenuation (increased hepatic fat) (OR: 0.67 (95% CI: 0.55 to 0.87) per SD, visceral fat area (OR: 1.36 (95% CI: 1.06 to 1.74) per SD and hypertension (OR: 2.21 (95% CI: 1.44 to 3.40) were associated with any glycemic progression. Conclusions South Asians in the USA have a high incidence of dysglycemia. Hepatic and visceral fat may be factors in glycemic progression, and prevention efforts should target ectopic fat reduction.