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Asian Americans and Pacific Islanders are prone to getting diabetes at younger ages and at lower weights than the general population. NPR's Pien Huang spoke with doctors and researchers from these communities who are working to figure out why that is and what to do about it.
PIEN HUANG, BYLINE: In the mid-1990s, when Maria Rosario Araneta came to UC San Diego as an epidemiologist, she noticed how many men at a nearby Veterans Administration hospital had kidney damage from diabetes.
MARIA ROSARIO ARANETA: Most of the patients in the dialysis unit are thin Filipino men. They're not overweight. They have access to care. They're in the Navy. They have to exercise.
HUANG: It hit home for Araneta, a Filipina whose father and grandmother both got diabetes while slim and seemingly healthy.
ARANETA: And I thought, I am definitely at risk. My community is at risk.
HUANG: It set her on a decadeslong path looking into why Asian Americans and Pacific Islanders tend to get diabetes when they're slimmer and younger than the general population. Dr. Alka Kanaya, a diabetes researcher at UC San Francisco, says one of the main culprits is that Asian bodies store fat in all the wrong places.
ALKA KANAYA: Like in the liver, around the abdominal organs, in the muscle, around the heart. For some reason that's most likely genetically determined, more fat gets stored in these other adverse places.
HUANG: This can lead to being skinny fat - when someone looks thin on the outside, but stores a lot of fat in and around their organs. And this hidden fat can be more damaging than the fat you can see. Researchers say it's not clear why Asian bodies store more fat this way, and it's not clear how to lose that hidden fat. Dr. George King, out of the Joslin Diabetes Center's Asian American Initiative, says it's been hard to get funding to study the problem. Still, he says...
GEORGE KING: So it's not that we have to wait for the research. There's plenty we can do ourselves.
HUANG: King, Araneta, Kanaya and others are among a group of Asian American health workers that successfully lobbied for changes to screening guidelines. In 2015, the American Diabetes Association recommended Asian Americans get tested for diabetes at a body mass index of 23, lower than other groups. And they've worked from the inside to make their communities healthier. Dr. Namratha Kandula at Northwestern University started a diabetes prevention program for South Asians living near Chicago.
NAMRATHA KANDULA: And so what that means is in addition to talking about diet and exercise. We specifically address the stress that comes from being an ethnic minority in this country.
HUANG: Many participants immigrated from India and Bangladesh, and they spoke about losing family structure and friends in the move to a different country. Shaheen Amir, a 32-year-old homemaker and mother of two, came from Pakistan a few years ago. She went through the four-month program, and she says it changed her life.
SHAHEEN AMIR: Before the program, I wasn't exercise at all - like, at all. Now, the first thing in the morning is I do exercise, even a little bit. But that's a part of my routine now.
HUANG: Amir says back in Pakistan, she ate whatever delicious, often deep-fried foods her mother made. Now, as the main cook at home, she's serving brown rice with veggies and trading the deep fryer for an air fryer. She's learned to manage her weight and now has more energy to play with her kids.
AMIR: I used to tell them, OK, you guys can play. I'm tired. Mom wants to sit. But now I'm literally playing with them - like, you know, hide and seek and tag and everything, just like a kid. So I feel a lot of changes in me.
HUANG: Advocacy and prevention programs are helping some, but overall, the number of Asians and Pacific Islanders with diabetes keeps going up. The researchers say their work is laid out for years to come.
Pien Huang, NPR News.
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