Asian and Pacific Island youths have a lower rate of diabetes than other ethnic groups nationally, but they have higher risk factors for heart disease

Helen Altonn:

About one in 750 Asian-Pacific Island youths ages 10 to 19 has diabetes, a low rate compared with other ethnic groups, said Dr. Beatriz L. Rodriguez, principal investigator in Hawaii for the study "SEARCH for Diabetes in Youth."

However, 37 percent of Asian-Pacific Island youths ages 3 to 19 with diabetes have two or more additional cardiovascular risk factors -- more than twice the 16 percent rate found in Caucasian children with diabetes, she said.

Risk factors may include diabetes or high blood sugar, high blood pressure, increased fats in the blood (trigylcerides), decreased "good" HDL (high-density lipoprotein) cholesterol and obesity.

Untreated in youths, these factors could lead to premature heart disease and death, said Rodriguez, with the Pacific Health Research Institute and University of Hawaii John A. Burns School of Medicine.

The SEARCH findings underscore the importance of prevention, recognition, treatment and control of the risk factors, she said.

The national study began in 2000, sponsored by the Centers for Disease Control and Prevention and National Institutes of Health, to learn more about diabetes in children and adolescents. Hawaii has one of six participating clinical centers.

About 12,000 cases of diabetes among youths under age 20 have been identified since the study began, for a total of about 154,000 children nationally with diabetes.

The Hawaii study has identified 400 young diabetes patients, Rodriguez said, and about 50 new cases are identified here each year.

She said 92 percent of young people with Type 2 diabetes have two or more cardiovascular disease risk factors.

"Something surprising was among youths with Type 1 diabetes, we found 14 percent have metabolic syndrome, especially among ethnic minorities," Rodriguez said, adding the figure is high compared with the overall population in the study.

When three or more risk factors for heart disease are present, it's known as a meta-bolic syndrome.

Rodriguez is lead author of a paper on the new SEARCH study in the August journal Diabetes Care. The issue also includes new treatment guidelines developed by the ADA to help physicians choose the most effective therapies to lower blood glucose levels in patients with Type 2 diabetes.

Type 1 diabetes is the most common form in youth, especially starting from age 10, Rodriguez said. The immune system attacks and destroys cells that produce insulin in the pancreas.

In type 2 diabetes, the body produces insulin but cannot use it well. It rarely occurs under age 10, Rodriguez said. It is found in youths of all races, but is more common among ethnic minorities and Asian and Pacific Islanders, she said.

Type 2 diabetes is increasing, particularly in kids age 10 and older, Rodriguez said. Ninety percent are overweight, and "children of ethnic minorities have a higher prevalence of being overweight compared to Caucasian youths," she said.

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