Diabetes Care of Non-obese Korean Americans: Considerable Room for Improvement

Korean J Fam Med. 2019 Mar;40(2):72-79. doi: 10.4082/kjfm.18.0002. Epub 2018 Dec 19.

Abstract

Background: Family doctors are increasingly managing the diabetes care of Korean-Americans. Little is known about the prevalence of diabetes among non-obese Korean-Americans, or the extent to which they receive timely and appropriate diabetes care. The purpose of this investigation is to: (1) identify the prevalence of diabetes and to determine the adjusted odds of diabetes among non-obese Korean-Americans compared to non-Hispanic White (NHW) Americans, (2) examine the factors associated with having diabetes in a large sample of non-obese KoreanAmericans, and (3) determine the prevalence and adjusted odds of optimal frequency of eye care, foot care and A1C blood glucose level monitoring among non-obese Korean-Americans with diabetes in comparison to NHWs with diabetes.

Methods: Secondary analysis of population-based data from the combined 2007, 2009, and 2011 adult California Health Interview Survey. The sample included 74,361 respondents with body mass index (BMI) <30 kg/m2 (referred to as 'non-obese BMI'), of whom 2,289 were Korean-Americans and 72,072 were NHWs, and 4,576 had diabetes.

Results: The prevalence and adjusted odds of diabetes among non-obese Korean-Americans are significantly higher than among their NHW peers. More than 90% of Korean-Americans with diabetes were non-obese. NHWs had substantially higher odds of having optimal frequency of eye care, foot care and A1C glucose level monitoring, even after adjusting for insulin dependence, sex, age, education, income, and BMI.

Conclusion: Non-obese Korean-Americans are at higher risk for diabetes and are much less likely to receive optimal diabetes care in comparison to NHWs. Targeted outreach is necessary.

Keywords: Chronic Disease; Community Medicine; Cross Cultural Comparison; Healthcare Disparities; Immigrants.