People with intellectual disabilities are at higher risk of type 2 diabetes mellitus (T2DM) but there are currently gaps in our understanding related to risk of new onset, care of T2DM and complications.

We examined electronic health-record data from Jan 2010 to May 2022 in 189,172 people with intellectual disabilities and 306,697 age, sex and family practice matched controls. We estimated incidence rates per 1,000-person-years, incidence rate ratios (IRRs), risk factors for T2DM (odds ratio, OR), indicators of quality of care and complications (hazard ratio, HR).

Incidence of T2DM in people with intellectual disabilities was 3.74 compared to 2.21 per 1,000 person-years in controls. After allowing for the younger age of T2DM onset in intellectual disabilities, the adjusted IRR was 6.91 (95 % CI 5.81-8.22). Impaired mobility was associated with T2DM incidence in people with intellectual disabilities (OR = 7.72, 5.87-10.15). People with intellectual disabilities received blood tests for HbA1c and cholesterol, and eye and foot examinations less often; and had a 12 % higher risk of developing macrovascular complications.

People with intellectual disabilities are at increased risk of T2DM at younger ages, have specific risk factors, experience inequities in care and are at risk for macrovascular complications.

Gestational diabetes mellitus (GDM) is associated with adverse pregnancy and birth complications. Asian populations have the highest risk of GDM, with even greater risk among foreign-born (FB) residents. Socio-political factors, such as heightened anti-Asian racism and travel restrictions during COVID19 may have further increased their risk of GDM. Our study sought to examine the associations between race/ethnicity, nativity status, and GDM rate and changes during COVID19.

We used the US National Center for Health Statistics natality administrative data (N = 14,219,719). We estimated GDM and birth rates by race/ethnicity (Asian non-Hispanic [NH], Native Hawaiian/Pacific Islander NH, American Indian and Alaska Native NH, Black NH, White NH, Multiracial NH, and Hispanic/Latina) and nativity status (US-born, Foreign-born). Race/ethnicity was evaluated as a social construct for racial discrimination and nativity was evaluated as a proxy for acculturation-related risk factors. We used multivariable robust Poisson regressions to estimate GDM rates per 100 live births for each racial/ethnic group pre-COVID19 (2018-2019) and during COVID19 (2021) by FB status, adjusting for socioeconomic and major pregnancy risk factors.

In adjusted models, both Asian NH and foreign-born persons had higher rates of GDM compared to White NH (rate ratio [RR]: 2.02, 95% confidence interval [CI]: 2.01, 2.04) and US-born (RR; 1.33, 95% CI: 1.32, 1.34) persons, respectively. Overall GDM rates increased significantly during COVID19 (RR: 1.18, 95% CI: 1.17, 1.18), with Asian US- and foreign-born persons experiencing the greatest absolute increase (US-born: +2.5, 95% CI: 2.4, 2.6; foreign-born: +3.6, 95% CI: 3.5, 3.6) compared to other racial/ethnic groups (US-born: range +1.3-1.7, foreign-born range: +0.5-2.9). Disaggregated by Asian ethnicity, Chinese and Vietnamese persons had the highest GDM rates overall and the greatest increase during COVID19.

We found significant disparities in GDM rates by race/ethnicity and nativity status between 2018 and 2021, with Asian and foreign-born persons having the highest rates of GDM. Investigation into potential socio-political and other contributing factors of reproductive health inequities during COVID19 may help explain these disparities.

Hepatocellular carcinoma (HCC) is a major public health issue in the US, linked to hepatitis C virus (HCV), hepatitis B virus (HBV), alcohol-related liver disease (ALD), and metabolic dysfunction-associated steatotic liver disease (MASLD). Monitoring HCC high-risk populations and trends across increasingly diverse groups is crucial for targeted prevention and intervention strategies.

To evaluate incidence patterns and temporal trends in HCC incidence by etiology across sex, race and ethnicity, and detailed Asian subgroups in California, highlighting emerging metabolic risks and declining viral influences, to guide targeted prevention strategies.

This population-based, retrospective cohort study used data from the California Cancer Registry linked to statewide hospital diagnostic records for etiology classification. All HCC cases diagnosed between 2010 and 2018 in California were included. Data were analyzed from March 28 to November 3, 2024.

Etiology of HCC, categorized as HCV, HBV, ALD, MASLD, or other causes.

Age-adjusted incidence rates (AAIRs) of HCC, stratified by sex, race and ethnicity, and etiology. Trends were analyzed using Joinpoint regression.

From 2010 to 2018, 31 671 patients (23 558 [74.4%] male; median [IQR] age, 64 [15] years) were newly diagnosed with HCC in California, with 14 664 (46.3%) due to HCV, 7457 (23.5%) due to MASLD, 3941 (12.4%) due to ALD, and 3271 (10.3%) due to HBV. By 2017 to 2018, MASLD accounted for 27.4% of HCCs, surpassing HCV among women. HCV-related HCC rates per 100 000 population were highest among American Indian (men: 12.8; women: 3.6), Black (men: 10.8; women: 3.0), and US-born Latino (men: 15.7; women: 3.5) populations and specific Asian groups (particularly Cambodian [men: 15.5; women: 6.3] and Vietnamese [men: 13.7; women: 4.8]). Rates of MASLD-related HCC per 100 000 population were highest among American Indian (men: 4.2; women: 2.7), Asian and Pacific Islander (men: 3.9; women: 1.8), and Latino (men: 4.4; women: 2.9) populations. Rates of HBV-related HCC per 100 000 population remained high throughout the study period in some Asian and Pacific Islander subgroups (Cambodian [men: 18.3; women: 3.4], Chinese [men: 10.1; women: 2.6], Korean [men: 11.5; women: 2.8], Laotian [men: 25.0; women: 5.4], and Vietnamese [men: 16.6; women: 3.5]), but not all subgroups, and HBV-related HCC declined overall. During 2014 to 2018, the overall HCC incidence changed annually by -3.1% (95% CI -4.8% to -1.4%) in men and -3.2% (95% CI, -10.9% to -0.9%) in women, largely due to declines in HCV-related HCC. However, MASLD- and ALD-related HCC rates increased throughout 2010 to 2018 (MASLD: 1.9% [95% CI, 0.8% to 3.0%]; ALD: 1.9% [95% CI, 0.6% to 3.1%]).

This retrospective cohort study found that etiology of HCC was associated with detailed racial and ethnic groups, with notable variation across disaggregated Asian groups. Rates of MASLD-related and ALD-related HCC were increasing, posing new challenges for prevention. American Indian, Asian and Pacific Islander, and Latino populations were disproportionately affected by HCC, beyond viral causes. Targeted public health interventions addressing alcohol, viral, and metabolic risk factors are needed.

Minoritized populations face many barriers to accessing evidence-based diabetes intervention.

To evaluate the feasibility, acceptability, and potential efficacy of a social media-based intervention to improve glycemic control among Chinese Americans with type 2 diabetes.

A pilot randomized controlled trial (RCT) with 3-month and 6-month follow-ups.

Chinese Americans (n = 60, mean age 54.3 years old) with limited education (70.0% with high school or less) and low income (50.0% with annual household income < $25,000), and 88.3% have limited English proficiency.

Culturally and linguistically tailored diabetes videos (two videos/week for 12 weeks) delivered via social media and support calls from community health workers.

Primary outcomes include feasibility (video watch rate, biweekly call completion rate, and retention rates), acceptability (patient satisfaction), and HbA1c. Secondary health-related outcomes include body weight, BMI, physical activity, and dietary intake. Video watch rate and biweekly call completion rate were assessed at baseline and 3 months, while others were measured at baseline, 3 months, and 6 months.

We observed high feasibility and acceptability of the intervention, with retention rates over 87%, an 89% video watch rate, 80% biweekly phone call completion, and a satisfaction rating of 9 out of 10. The intervention group showed a significantly greater increase in fruit intake compared to the control group (0.15 cups vs. - 0.44 cups, adj_p = 0.023) at 3 months. While no significant differences in other outcomes were observed between the groups, the intervention group showed significant improvements in key outcomes, including reduced HbA1c levels (- 1.08%, adj_p < 0.001), weight loss (- 5.15 lbs, adj_p = 0.004), lower BMI (- 0.83, adj_p = 0.023), and reduced starchy food intake (- 0.33 cups, adj_p = 0.033) at 6 months.

The observed high feasibility and acceptability suggest the intervention's feasibility. However, due to the limited sample size, a larger-scale RCT is warranted to test the efficacy of the intervention.

ClinicalTrials.gov NCT03557697; https://clinicaltrials.gov/ct2/show/NCT03557697.

A multicenter study in patients with type 2 diabetes mellitus (T2DM) was performed to assess the differences of liver steatosis and fibrosis between lean and nonlean individuals.

Patients with T2DM from 16 centers were recruited and underwent transient elastography examination for diagnosis of liver steatosis and fibrosis. Clinical information, such as diabetes status, serum lipids profiles, and inflammatory markers, were collected. Potential risk factors of liver steatosis and fibrosis in lean (body mass index [BMI] < 23 kg/m2) and nonlean (BMI ≥ 23 kg/m2) groups were analyzed.

A total of 1762 patients were included. The prevalence of liver steatosis and fibrosis in the lean group was 44.7% and 23.4%, respectively. The prevalence of hypertension and cardiovascular disease was higher in lean patients when compared with nonlean group. Lean patients with liver steatosis or fibrosis were older, had longer diabetes duration, lower levels of homeostatic model assessment for insulin resistance and serum lipids. The BMI, visceral fat area, and triglyceride were among the most significant correlators of liver steatosis for both nonlean and lean patients. However, lipid profiles were different between the two groups. Besides, insulin resistance, BMI, and lipid levels were not observed to be associated with fibrosis in the lean group.

In lean patients with T2DM, liver steatosis and fibrosis were less associated with insulin resistance. Risk factors of liver steatosis were different between lean and nonlean patients, indicating the necessity of risk stratification and tailored management strategies.

The majority of Chinese Americans is foreign-born, and it is well-documented that immigration to the United States (US) leads to increased risk for chronic diseases including type 2 diabetes. Increased disease risk has been attributed to changes in lifestyle behaviors following immigration, but few studies have considered the psychosocial impact of immigration upon biomarkers of disease risk.

To examine associations of psychological stress and social isolation with markers of type 2 diabetes risk over time among US Chinese immigrants.

In this longitudinal study of 614 Chinese immigrants, participants completed assessments of perceived stress, acculturative stress, negative life events, and social isolation annually at three time points. Fasting blood samples were obtained at each time point to measure blood glucose, glycated hemoglobin, and insulin resistance. Mean duration between baseline and follow-up assessments was approximately 2 years.

Increases in migration-related stress, perceived stress and social isolation were associated with significant increases in fasting glucose at follow-up independent of age, body mass index, length of US residence, and other potential covariates. Moreover, increases in glucose varied depending on perceived stress levels at baseline, such that those with higher baseline stress had a steeper increase in glucose over time.

Psychological stress and social isolation are associated with increases in fasting glucose in a sample of US Chinese immigrants. Findings suggest that the unique experiences of immigration may be involved in the risk of developing type 2 diabetes, a condition that is prevalent among US Chinese despite relatively low rates of obesity.

Pediatric obesity is a serious global health challenge. In East Asia, rapid socioeconomic changes have increased obesity rates. This study examines weight distribution and obesity trends in East Asian children using WHO criteria. Data from the Non-Communicable Disease Risk Factor Collaboration was used to analyze weight categories (thinness, normal weight, overweight, and obesity) among children aged 5 to 19 in China, Japan, South Korea, and Taiwan. Data were collected through probabilistic sampling and national surveys and classified using WHO BMI standards. Age standardized prevalence rate enabled cross-country comparisons for boys and girls from 2010 to 2022. Statistical methods included arithmetic statistics, linear regression, and time series analysis using the ARIMA model, with SAS 9.4 and SPSS for analysis. Significant trends were found (p for trend < 0.05). Taiwan and South Korea showed increased thinness, while China and Japan showed decreases. Normal weight prevalence declined, notably among South Korean boys. Overweight and obesity rates rose, especially among South Korean boys and Chinese girls. Japan's rates remained stable, while Taiwan showed minor fluctuations. Boys had higher overweight and obesity rates than girls in all countries. The highest rates were among children aged 10 to 11 years. East Asia, particularly South Korea and China, has seen rising obesity rates. Increasing thinness in South Korea and Taiwan also requires attention. The decline in healthy-weight children is concerning. Interventions should target children before ages 10 to 11. Urgent, tailored public health interventions are needed.

Type 2 diabetes (T2D) represents a major public health burden in the United States, with racial disparities in medication use potentially exacerbating inequities in health outcomes. This study examined racial/ethnic differences in the prescription of high-efficacy glucose-lowering medications for T2D using a large EHR network (TriNetX).

A retrospective cohort study included adults with uncomplicated T2D (ICD-10: E11.9), categorized as Hispanic or Latino (Hispanic) or non-Hispanic American Indian/Alaska Native (AI/AN), Asian, Black, Native Hawaiian/Pacific Islander (NH/PI), and White. Adjusted odds ratios for GLP-1 receptor agonist medications (tirzepatide, semaglutide, and dulaglutide) prescriptions in 2022-2023 were calculated by race/ethnicity, controlling for age, sex, and Charlson Comorbidity Index.

Among 57,320 patients included in the analysis, we observed significant racial disparities in the prescribing of GLP-1 medications. Compared to White patients, for tirzepatide, adjusted odds ratios prescriptions were 0.6 (95% CI: 0.4-0.9) for AI/AN, 0.3 (95% CI: 0.3-0.4) for Asian, 0.7 (95% CI: 0.6-0.9) for Black, 0.4 (95% CI: 0.3-0.5) for Hispanic, and 0.4 (95% CI: 0.3-0.6) for NH/PI. For semaglutide, adjusted odds ratios were 0.8 (95% CI: 0.7-0.9) for AI/AN, 0.5 (95% CI: 0.5-0.6) for Asian, 0.8 (95% CI: 0.7-0.9) for Black, 0.6 (95% CI: 0.6-0.7) for Hispanic, and 0.6 (95% CI: 0.5-0.8) for NH/PI. For dulaglutide, adjusted odds ratios were 1.2 (95% CI: 1.0-1.4) for AI/AN, 0.5 (95% CI: 0.4-0.5) for Asian, 1.0 (95% CI: 0.9-1.1) for Black, 0.9 (95% CI: 0.8-1.0) for Hispanic, and 0.5 (95% CI: 0.4-0.6) for NH/PI.

Racial disparities in high-efficacy diabetes medication prescriptions may contribute to unequal health outcomes in T2D, highlighting the need for targeted research and interventions for equitable diabetes care.

Type 2 diabetes is one of the most prevalent chronic diseases in the world, and more people than ever before have impaired glucose tolereance, or prediabetes. Many patients with impaired glucose tolerance and undiagnosed diabetes do not know that their glucose metabolism system has been in a state of disorder. Every year, about 5-10% of prediabetics develop diabetes. One of the important achieving factors may be the increase in blood lipids. However, it is not clear whether triglyceride is associated with impaired glucose tolerance and prediabetes in the Qatari population. Therefore, we investigated the relationship between the first several clinical variables and prediabetes status in normal and overweight populations. We conducted a cross-sectional study using data from the Qatar Biobank program. The study included 5,996 participants who were adults over the age of 20. We collected information about participants' fasting blood glucose levels with other clinical measurements and used various machine learning models and logistic regression to study the association between the clinical measurements and prediabetes for normal and overobese weight groups. The use of several machine learning models showed that, after adjusting the potential confounding factors such as age and sex, Triglyceride has been demonstrated to be positively correlated with prediabetes, and there was a special population dependence phenomenon. Among them, nonobese people (p < 0.05). The effect value and 95% confidence interval and OR of triglyceride on prediabetes was 2.79 and (e0.78, e1.28), respectively.

Type 2 diabetes disproportionately affects older adults, persons from racial and ethnic minority groups, and persons of low socioeconomic status. It can be prevented or delayed through evidence-based interventions such as the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). This analysis is aimed at evaluating the outcomes (i.e., retention, physical activity, and weight loss) associated with participation in the National DPP LCP by participant characteristics and delivery mode (i.e., in-person, online, distance learning, and combination) using the 2012-2018 Diabetes Prevention Recognition Program (DPRP) data. Across all delivery modes, there were generally no substantial differences in retention between male and female participants, but male participants tended to have higher physical activity and weight loss (e.g., average weight loss for in-person delivery: 5.0% for males and 4.3% for females). Older participants had better retention rates than younger participants in all delivery modes and mostly higher physical activity and weight loss except for distance learning delivery (e.g., average weight loss for in-person delivery: 5.1% for those aged 65+ and 3.3% for those aged 18-34). Among the seven racial and ethnic groups studied, retention was generally highest for non-Hispanic/Latino (NH)-White participants and lowest for Hispanic/Latino participants. Physical activity varied by racial and ethnic groups and delivery mode. NH-White participants generally had the most weight loss except for distance learning delivery, and NH-Black/African American participants had the least (e.g., average weight loss for in-person delivery: 5.1% for NH-White participants, 3.3% for both NH-Black/African American and NH-American Indian/Alaska Native participants, and other racial and ethnic minority groups ranged from 3.4% to 4.9%). Monitoring and identifying disparities across demographics and delivery modes, particularly across multiple racial and ethnic groups, provides information that can be used to improve the implementation of the National DPP LCP by tailoring the intervention to reduce disparities.

The purpose of this study is to describe diabetes distress and related factors among Chinese Americans with type 2 diabetes in New York City (NYC).

We conducted a secondary data analysis of the baseline data from three research studies conducted among community-dwelling Chinese American adults with type 2 diabetes. Diabetes Distress Scale (DDS) was used to measure sources of diabetes distress including emotional-, regimen-, interpersonal-, and physician-related distress. A score of 2 or greater indicates moderate diabetes distress or higher. Patient Health Questionnaire-2 (PHQ-2) was used to measure depressive symptoms. Participants' sociodemographic information was also collected. Descriptive statistics were used to describe diabetes distress, and logistic least absolute shrinkage and selection operator (LASSO) regression was used to examine factors associated with diabetes distress level.

Data from 178 participants (mean age 63.55±13.56 years) were analyzed. Most participants were married (76.40%), had a high school degree or less (65.73%), had a household annual income < $25,000 (70.25%), and reported limited English proficiency (93.22%). About 25.84% reported moderate or higher overall distress. The most common sources of distress were emotional burden (29.78%), followed by regimen- (28.65%), interpersonal- (18.54%), and physician-related distress (14.04%). Participants who were younger, female, limited English proficient, and had elevated depressive symptoms were more likely to have higher diabetes distress.

Diabetes distress is prevalent among Chinese immigrants with type 2 diabetes, especially emotional- and regimen-related distress. Given the known link between diabetes distress and poor glycemic control, it is critical to screen for diabetes distress at primary care clinics and incorporate psychological counseling in diabetes care in this underserved population.

The prevalence of diabetes in China is increasing, influenced by economic and genetic factors, with varying rates across regions. The Hakka population in Ganzhou city has unique exposures compared to surrounding districts, while limited research reported the epidemiological characteristics of type 2 diabetes mellitus (T2DM) in this population. This study aims to investigate the prevalence and influencing factors of T2DM among the population, thereby establishing a robust foundation for disease prevention and control measures.

In 2017, a multistage random sampling method selected 3028 individuals from Ganzhou City's permanent resident population. Physical examinations, blood tests, and questionnaire surveys were conducted for data collection, with binary logistic regression analysis used to examine factors affecting T2DM prevalence.

A total of 2978 valid samples were included in this study. The average age of the surveyed population was 52.83±7.88 years, comprising 966 males and 2012 females. The prevalence rates of T2DM were 11.8% and 12.9% in males and females, respectively, while the standardized prevalence rate was recorded as 9.1%. Logistic regression analysis revealed that age (Odds Ratio[OR]=1.05, 95% Confidence Interval [CI]:1.03-1.06), hypertension (OR=2.22, 95% CI:1.71-2.93), family history of diabetes (OR= 3.54, 95% CI: 2.58-4.85), overweight (OR=1.73, 95% CI: 1.20-2.48), high total cholesterol (OR=1.17, 95% CI:1.09-1.27), elevated low-density lipoprotein cholesterol (OR=1.19, 95% CI:1.00-1.40) and serum insulin (OR=1.05, 95% CI:1.03-1.06) were identified as significant risk factors for T2DM, Conversely, a higher level of high-density lipoprotein cholesterol (OR=0.55, 95% CI:0.36-0.84) was found to be inversely related to T2DM development.

The prevalence of T2DM in Ganzhou city has significantly increased. The effective implementation of comprehensive management strategies aimed at addressing hypertension, overweight, dyslipidemia, and abnormal serum insulin level is essential for promoting overall well-being and efficiently controlling the prevalence of T2DM.

Emerging evidence indicates that individuals with type 2 diabetes (T2D) are more prone to mental health issues than the general population; however, there is a significant lack of data concerning the mental health burden in Chinese Americans with T2D.

The aim of this study was to explore the comorbid mental health status, health-seeking behaviors, and mental service utilization among Chinese Americans with T2D.

A cross-sectional telephone survey was performed among 74 Chinese Americans with T2D in New York City. We used standardized questionnaires to assess mental health status and to gather data on mental health-seeking behaviors and service utilization. Descriptive statistics were applied for data analysis.

A total of 74 Chinese Americans with T2D completed the survey. Most participants (mean age 56, SD 10 years) identified as female (42/74, 57%), were born outside the United States (73/74, 99%), and had limited English proficiency (71/74, 96%). Despite nearly half of the participants (34/74, 46%) reporting at least one mental health concern (elevated stress, depressive symptoms, and/or anxiety), only 3% (2/74) were currently using mental health services. Common reasons for not seeking care included no perceived need, lack of information about Chinese-speaking providers, cost, and time constraints. The cultural and language competence of the provider was ranked as the top factor related to seeking mental health care.

Chinese Americans with T2D experience relatively high comorbid mental health concerns yet have low service utilization. Clinicians may consider team-based care to incorporate mental health screening and identify strategies to provide culturally and linguistically concordant mental health services to engage Chinese Americans with T2D.

Chemerin acts as both a chemotactic agent and an adipokine that undergoes proteolytic cleavage, converting inactive precursors into their active forms before being subsequently inactivated. Elevated chemerin levels are linked to obesity and type 2 diabetes mellitus (T2D). This study aimed to elucidate the effects of T2D and obesity on chemerin levels by comparing plasma samples from individuals with a normal weight and T2D (BMI < 25; NWD group n = 22) with those from individuals who are overweight or obese and have T2D (BMI ≥ 25; OWD group n = 39). The total chemerin levels were similar in the NWD and OWD groups, suggesting that T2D may equalize the chemerin levels irrespective of obesity status. The cleavage of chemerin has been previously linked to myocardial infarction and stroke in NWD, with potential implications for inflammation and mortality. OWD plasma exhibited lower levels of cleaved chemerin than the NWD group, suggesting less inflammation in the OWD group. Here, we showed that the interaction between obesity and T2D leads to an equalization in the total chemerin levels. The cleaved chemerin levels and the associated inflammatory state, however, differ significantly, underscoring the complex relationship between chemerin, T2D, and obesity.

To test the feasibility, acceptability, and potential efficacy of a mHealth intervention tailored for Chinese immigrant families with type 2 diabetes (T2D).

We conducted a pilot randomized controlled trial (RCT) with baseline, 3-, and 6-month measurements. Participating dyads, T2D patients and families/friends from NYC, were randomized into the intervention group (n = 11) or the wait-list control group (n = 12). Intervention includes 24 videos covering T2D self-management, behavioral techniques, and family-oriented sessions. Feasibility and acceptability were measured respectively by the retention rate and video watch rate, and a satisfaction survey. Patients' HbA1c, weight, and self-management were also assessed to test potential efficacy.

Most T2D patients (n = 23; mean age 56.2±9.4 years; 52.2% male) and families/friends (n = 23, mean age 54.6±11.2 years; 52.2% female) had high school education or less (69.6% and 69.6%), annual household income < $25,000 (65.2% and 52.2%), and limited English proficiency (95.7% and 95.7%). The retention rates were not significantly different between the intervention and the control groups for both the patients (90.91% vs 83.3%, p = 0.589); and their families/friends (3-month: 90.9% vs 75%, p = 0.313; 6-month: 90.9% vs 83.3%, p = 0.589). The mean video watch rate was 76.8% (7%). T2D patients and families/friends rated satisfaction as 9.4 and 10 out of 10, respectively. Despite no between-group differences, the intervention group had significantly lower HbA1c (p = 0.014) and better self-management (p = 0.009), and lost 12 lbs. on average at 6 months (p = 0.079), compared to their baseline levels.

A culturally-tailored, family-based mHealth intervention is feasible and acceptable among low-income, limited English-proficient Chinese families with T2D in NYC. Significant changes in HbA1c and self-management within the intervention group indicate this intervention may have potential efficacy. Given the small sample size of this study, a future RCT with adequate power is needed to test efficacy.

Asian Indians (AIs), the second largest immigrant population in the United States, are disproportionately affected by type 2 diabetes mellitus (T2DM) at a lower age and body mass index (BMI). The purpose of this study was to examine the relationship between social determinants of health (SDOH) and the diagnosis of T2DM among AIs in New Jersey (NJ).

This was a secondary data analysis of the Behavioral Risk Factor Surveillance System (BRFSS) in NJ from 2013 to 2017. Statistical analyses included descriptive and inferential statistics.

Among 1,132 AIs, 16% had T2DM or prediabetes (PDM) and 69.2% were overweight or obese. The risk for T2DM was significantly associated with internet use, older age, having medical check-ups, and having a personal doctor (p ≤ .05).

These findings inform culturally congruent care by underscoring the importance of weight management, earlier screening, and provider involvement in diabetes prevention strategies for AIs.

Type 2 diabetes (T2D) is a heterogenous disease, and conventionally, peripheral insulin resistance (IR) was thought to precede islet β-cell dysfunction, promoting progression from prediabetes to T2D. New evidence suggests that T2D-lean individuals experience early β-cell dysfunction without significant IR. Regardless of the primary event (i.e., IR vs. β-cell dysfunction) that contributes to dysglycemia, significant early-onset oxidative damage and mitochondrial dysfunction in multiple metabolic tissues may be a driver of T2D onset and progression. Oxidative stress, defined as the generation of reactive oxygen species (ROS), is mediated by hyperglycemia alone or in combination with lipids. Physiological oxidative stress promotes inter-tissue communication, while pathological oxidative stress promotes inter-tissue mis-communication, and new evidence suggests that this is mediated via extracellular vesicles (EVs), including mitochondria containing EVs. Under metabolic-related stress conditions, EV-mediated cross-talk between β-cells and skeletal muscle likely trigger mitochondrial anomalies leading to prediabetes and T2D. This article reviews the underlying molecular mechanisms in ROS-related pathogenesis of prediabetes, including mitophagy and mitochondrial dynamics due to oxidative stress. Further, this review will describe the potential of various therapeutic avenues for attenuating oxidative damage, reversing prediabetes and preventing progression to T2D.

Patients of Asian descent are under-represented in the U.S. health care system and provider cultural competence is inadequate in addressing Asian health disparities.

The purpose of this study was to evaluate the impact of the pharmacist-led cultural competence training on provider self-perceived preparedness and diabetes-related health outcomes in patients of Asian descent.

This study is a cross-sectional followed by a quasi-experimental design conducted in 2 phases in a primary care clinic. Phase one evaluated the association of providers' cross-cultural care survey (CCCS) scores with patients' diabetic health indices: hemoglobin A1c (HbA1C), systolic blood pressure (SBP), diastolic blood pressure, and body mass index. Phase 2 examined the impact of pharmacist-led cultural competence training on providers' cross-cultural competency using survey analysis as well as pre- and post-training diabetic health indices in patients of Asian descent.

Phase 1 CCCS results showed baseline cross-cultural competence of the providers is inadequate (N = 9 providers). Furthermore, a significant negative correlation was found between providers' CCCS score and patients' HbA1C (N = 49, P = 0.04). Phase 2 showed that cultural competence training significantly reduced providers' self-perceived "un-preparedness" to care for patients of alternative cultures (N = 30 providers). Average diabetic health indices for all patients (N = 95) before and after the training were not significantly different. In the subset of patients with uncontrolled diabetes (HbA1C ≥ 7), SBP and HbA1C were significantly reduced after the training (P = 0.032 and P = 0.039, respectively).

Pharmacist-led cultural competence training had a positive impact on provider self-assessment and diabetic clinical outcomes in uncontrolled patients.

Ethnic South Asian Americans have the highest relative risk of type 2 diabetes mellitus in the US. Culturally tailored and language-concordant diabetes care and nutrition interventions can potentially promote South Asian diabetes management and disease progression. From our perspective, the extent of their use and evaluation in the US settings remains limited. This Perspective characterizes and evaluates the necessity and outcomes of culturally and linguistically adapted lifestyle interventions targeted toward type 2 diabetes mellitus indicators among South Asian individuals in the US. Suggestions for how this education could be modified include emphasizing the cultural and linguistic knowledge and self-awareness of diabetes educators and the sociological and historical factors that influence the cultural and linguistic orientation of diabetes care professionals and their clients. Such strategies could ensure better diabetes education and self-management among South Asian individuals.

With more than 4.2 million people, Filipino Americans are the third largest Asian group in the US and the largest Southeast Asian group in the country. Despite relatively favorable average socioeconomic indicators compared to the general US population, Filipino Americans face a significant burden of traditional cardiovascular risk factors, particularly among men. Moreover, Filipino Americans have high rates of cardiovascular death, often occurring at a younger age compared to other minority groups and Non-Hispanic White adults. In view of these trends, in 2010 the American Heart Association designated Filipino Americans as a high cardiovascular risk group. Despite this, in 2023, Filipino Americans remain underrepresented in landmark cardiovascular cohort studies and are often over looked as a group at increased cardiovascular risk. In this updated narrative review, we summarize the current state of knowledge about the burden of cardiovascular risk factors and diseases experienced by the Filipino American population. Our aim is to inform enhanced clinical, population, and policy-level prevention interventions and boost research in this space.

To investigate the polygenicity of complex traits in populations of East Asian (EAS) and European (EUR) descents, we leveraged genome-wide data from Biobank Japan, UK Biobank, and FinnGen cohorts. Specifically, we analyzed up to 215 outcomes related to 18 health domains, assessing their polygenic architecture via descriptive statistics, such as the proportion of susceptibility SNPs per trait (πc). While we did not observe EAS-EUR differences in the overall distribution of polygenicity parameters across the phenotypes investigated, there were ancestry-specific patterns in the polygenicity differences between health domains. In EAS, pairwise comparisons across health domains showed enrichment for πc differences related to hematological and metabolic traits (hematological fold-enrichment = 4.45, p = 2.15 × 10-7; metabolic fold-enrichment = 4.05, p = 4.01 × 10-6). For both categories, the proportion of susceptibility SNPs was lower than that observed for several other health domains (EAS-hematological median πc = 0.15%, EAS-metabolic median πc = 0.18%) with the strongest πc difference with respect to respiratory traits (EAS-respiratory median πc = 0.50%; hematological-p = 2.26 × 10-3; metabolic-p = 3.48 × 10-3). In EUR, pairwise comparisons showed multiple πc differences related to the endocrine category (fold-enrichment = 5.83, p = 4.76 × 10-6), where these traits showed a low proportion of susceptibility SNPs (EUR-endocrine median πc = 0.01%) with the strongest difference with respect to psychiatric phenotypes (EUR-psychiatric median πc = 0.50%; p = 1.19 × 10-4). Simulating sample sizes of 1,000,000 and 5,000,000 individuals, we also showed that ancestry-specific polygenicity patterns translate into differences across health domains in the genetic variance explained by susceptibility SNPs projected to be genome-wide significant (e.g., EAS hematological-neoplasm p = 2.18 × 10-4; EUR endocrine-gastrointestinal p = 6.80 × 10-4). These findings highlight that traits related to the same health domains may present ancestry-specific variability in their polygenicity.

Type 2 diabetes disparities in the USA persist in both the prevalence of disease and diabetes-related complications. We conducted a literature review related to diabetes prevention, management, and complications across racial and ethnic groups in the USA. The objective of this review is to summarise the current understanding of diabetes disparities by examining differences between and within racial and ethnic groups and among young people (aged <18 years). We also examine the pathophysiology of diabetes as it relates to race and ethnic differences. We use a conceptual framework built on the socioecological model to categorise the causes of diabetes disparities across the lifespan looking at factors in five domains of health behaviours and social norms, public awareness, structural racism, economic development, and access to high-quality care. The range of disparities in diabetes prevalence and management in the USA calls for a community-engaged and multidisciplinary approach that must involve community partners, researchers, practitioners, health system administrators, and policy makers. We offer recommendations for each of these groups to help to promote equity in diabetes prevention and care in the USA.

Oxidative stress is associated with insulin resistance and secretion, and antioxidant systems are essential for preventing and managing type 2 diabetes (T2DM). This study aimed to explore the polygenic variants linked to oxidative stress and the antioxidant system among those associated with T2DM and the interaction of their polygenic risk scores (PRSs) with lifestyle factors in a large hospital-based cohort (n = 58,701). Genotyping, anthropometric, biochemical, and dietary assessments were conducted for all participants with an average body mass index of 23.9 kg/m2. Genetic variants associated with T2DM were searched through genome-wide association studies in participants with T2DM (n = 5383) and without T2DM (n = 53,318). The Gene Ontology database was searched for the antioxidant systems and oxidative stress-related genes among the genetic variants associated with T2DM risk, and the PRS was generated by summing the risk alleles of selected ones. Gene expression according to the genetic variant alleles was determined on the FUMA website. Food components with low binding energy to the GSTA5 protein generated from the wildtype and mutated GSTA5_rs7739421 (missense mutation) genes were selected using in silico analysis. Glutathione metabolism-related genes, including glutathione peroxidase (GPX)1 and GPX3, glutathione disulfide reductase (GSR), peroxiredoxin-6 (PRDX6), glutamate-cysteine ligase catalytic subunit (GCLC), glutathione S-transferase alpha-5 (GSTA5), and gamma-glutamyltransferase-1 (GGT1), were predominantly selected with a relevance score of >7. The PRS related to the antioxidant system was positively associated with T2DM (ORs = 1.423, 95% CI = 1.22-1.66). The active site of the GASTA proteins having valine or leucine at 55 due to the missense mutation (rs7739421) had a low binding energy (<-10 kcal/mol) similarly or differently to some flavonoids and anthocyanins. The PRS interacted with the intake of bioactive components (specifically dietary antioxidants, vitamin C, vitamin D, and coffee) and smoking status (p < 0.05). In conclusion, individuals with a higher PRS related to the antioxidant system may have an increased risk of T2DM, and there is a potential indication that exogenous antioxidant intake may alleviate this risk, providing insights for personalized strategies in T2DM prevention.

To investigate the polygenicity of complex traits in populations of East Asian (EAS) and European (EUR) descents, we leveraged genome-wide data from Biobank Japan, UK Biobank, and FinnGen cohorts. Specifically, we analyzed up to 215 outcomes related to 18 health domains, assessing their polygenic architecture via descriptive statistics, such as the proportion of susceptibility SNPs per trait (π _c ). While we did not observe EAS-EUR differences in the overall distribution of polygenicity parameters across the phenotypes investigated, there were ancestry-specific patterns in the polygenicity differences between health domains. In EAS, pairwise comparisons across health domains showed enrichment for π _c differences related to hematological and metabolic traits (hematological fold-enrichment=4.45, p=2.15×10 ^-7 ; metabolic fold-enrichment=4.05, p=4.01×10 ^-6 ). For both categories, the proportion of susceptibility SNPs was lower than that observed for several other health domains (EAS-hematological median π _c =0.15%, EAS-metabolic median π _c =0.18%) with the strongest π _c difference with respect to respiratory traits (EAS-respiratory median π _c =0.50%; Hematological-p=2.26×10 ^-3 ; Metabolic-p=3.48×10 ^-3 ). In EUR, pairwise comparisons showed multiple π _c differences related to the endocrine category (fold-enrichment=5.83, p=4.76×10 ^-6 ), where these traits showed a low proportion of susceptibility SNPs (EUR-endocrine median π _c =0.01%) with the strongest difference with respect to psychiatric phenotypes (EUR-psychiatric median π _c =0.50%; p=1.19×10 ^-4 ). Simulating sample sizes of 1,000,000 and 5,000,000 individuals, we also showed that ancestry-specific polygenicity patterns translate into differences across health domains in the genetic variance explained by susceptibility SNPs projected to be genome-wide significant (e.g., EAS hematological-neoplasm p=2.18×10 ^-4 ; EUR endocrine-gastrointestinal p=6.80×10 ^-4 ). These findings highlight that traits related to the same health domains may present ancestry-specific variability in their polygenicity.

The present study aims to provide a narrative review of the molecular mechanisms of Western diet-induced obesity and obesity-related carcinogenesis. A literature search of the Cochrane Library, Embase and Pubmed databases, Google Scholar and the grey literature was conducted. Most of the molecular mechanisms that induce obesity are also involved in the twelve Hallmarks of Cancer, with the fundamental process being the consumption of a highly processed, energy-dense diet and the deposition of fat in white adipose tissue and the liver. The generation of crown-like structures, with macrophages surrounding senescent or necrotic adipocytes or hepatocytes, leads to a perpetual state of chronic inflammation, oxidative stress, hyperinsulinaemia, aromatase activity, activation of oncogenic pathways and loss of normal homeostasis. Metabolic reprogramming, epithelial mesenchymal transition, HIF-1α signalling, angiogenesis and loss of normal host immune-surveillance are particularly important. Obesity-associated carcinogenesis is closely related to metabolic syndrome, hypoxia, visceral adipose tissue dysfunction, oestrogen synthesis and detrimental cytokine, adipokine and exosomal miRNA release. This is particularly important in the pathogenesis of oestrogen-sensitive cancers, including breast, endometrial, ovarian and thyroid cancer, but also 'non-hormonal' obesity-associated cancers such as cardio-oesophageal, colorectal, renal, pancreatic, gallbladder and hepatocellular adenocarcinoma. Effective weight loss interventions may improve the future incidence of overall and obesity-associated cancer.

Background: Aromatase inhibitors (AI) are widely used for treating hormone-sensitive breast cancer (BC). Obesity, however, due to aromatase-mediated androgen conversion into estradiol in the peripheral adipose tissue, might impair AI inhibitory capacity. We aimed at identifying a cut-off of body mass index (BMI) with significant prognostic impact, in a cohort of stage I-II BC patients on systemic adjuvant therapy with AI. Methods: we retrospectively evaluated routinely collected baseline parameters. The optimal BMI cut-off affecting disease-free survival (DFS) in AI-treated BC patients was identified through maximally selected rank statistics; non-linear association between BMI and DFS in the AI cohort was assessed by hazard-ratio-smoothed curve analysis using BMI as continuous variable. The impact of the BMI cut-off on survival outcomes was estimated through Kaplan−Meier plots, with log-rank test and hazard ratio estimation comparing patient subgroups. Results: A total of 319 BC patients under adjuvant endocrine therapy and/or adjuvant chemotherapy were included. Curve-fitting analysis showed that for a BMI cut-off >29 in AI-treated BC patients (n = 172), DFS was increasingly deteriorating and that the impact of BMI on 2-year DFS identified a cut-off specific only for the cohort of postmenopausal BC patients under adjuvant therapy with AI. Conclusion: in radically resected hormone-sensitive BC patients undergoing neoadjuvant or adjuvant chemotherapy and treated with AI, obesity represents a risk factor for recurrence, with a significantly reduced 2-year DFS.