Epidemiology of diabetes among South Asians in the United States: lessons from the MASALA study. Issue 1 (20th November 2020)

• Record Type: Journal Article
• Authors: Gujral, Unjali P.; Kanaya, Alka M.
• Other Names: Ahima Rexford S. guestEditor.
• Is Part Of: Annals of the New York Academy of Sciences. Volume 1495:Issue 1(2021)
• Page Start: 24
• Page End: 39
• Publication Date: 2020-11-20
• Subjects: type 2 diabetes -- South Asian -- ethnicity -- the United States -- MASALA -- BMI -- insulin resistance; Medical sciences -- Periodicals; Medicine -- Periodicals; Science -- Periodicals; 610
• DOI: 10.1111/nyas.14530
• Languages: English
• ISSNs: 0077-8923

Abstract

Abstract: South Asian individuals in the United States are at an increased risk of type 2 diabetes (T2DM); however, the mechanisms behind this are not well understood. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study is the only longitudinal cohort of South Asians in the United States and provides key insights as to the epidemiology of T2DM in South Asians. Evidence from the MASALA study suggests that South Asians experience a disproportionately high burden of prevalent and incident T2DM compared with members of other race/ethnic groups. Higher insulin resistance in South Asians, even with low body mass index (BMI), more impairment in insulin secretion, and greater deposition of ectopic fat likely play a role in T2DM etiology. Furthermore, South Asian migrants to the United States experience a range of factors related to acculturation, social networks, and religious beliefs, which may impact physical activity and dietary practices. Interventions to prevent T2DM in South Asians should include a focus on cultural factors related to health and should consider the complete mechanistic pathway and the relative contributions of insulin resistance, β cell dysfunction, and ectopic fat deposition on T2DM development in South Asians, particularly in those with lower BMI. Abstract : The MASALA study is currently the only longitudinal cohort assessing the determinants of cardiometabolic diseases in South Asians in the United States. Evidence from the study suggests that South Asians experience a disproportionately high burden of prevalent and incident T2DM compared with members of other race/ethic groups. This notion is highlighted by evidence indicating that South Asians (1) are more insulin‐resistant than White Americans, African Americans, and Hispanic Americans, even at lower BMI; (2) have early impairments in insulin secretion; and (3) have higher deposition of ectopic fat.