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Diabetes among Indian Americans (DIA)

Diabetes among Indian Americans (DIA) Study: A national (epidemiological) study of the prevalence of diabetes, pre-diabetes, metabolic syndrome and CVD risk factors among Indian Americans in the US and Indians in India

Executive Summary:

  • High prevalence of diabetes and heart disease among Indians
  • Currently there is a lack of national studies on Indian Americans or South Asians in the US on the prevalence of diabetes and CVD risk factors
  • Diabetes among Indian Americans (DIA) Survey was launched in 2003
  • Seven study sites in the US and 2 sites in India – Phoenix, San Diego, Houston, Boston, Edison, Jersey City, and Washington DC in the US; New Delhi (urban site) and Madurai (rural site) in India.
  • Results have established high rates of diabetes (17.4%) and pre-diabetes (33%) among Indian Americans in the US.  Also the prevalence of diabetes is increasing in India (13% in Delhi and 8% in Madurai).
  • Information will help plan public health programs to prevent these diseases in this high-risk population.

Why study the Risk Factors for Chronic Diseases in Asian Indians?

Asian Indians around the world have one of the highest rates of coronary artery disease (CAD) and diabetes mellitus (DM). When compared to Whites, Blacks, Hispanics and other Asians, the CAD rates among Asian Indians worldwide are 2-4 times higher at all ages and 5-10 times higher in those < 40 years of age.
There is a lack of information on prevalence of CAD and diabetes in Asian Indians living in the USA. One thing is certain every Asian Indian knows of a person who died of heart attack at a young age. Diabetes can cause blindness, high blood pressure, heart disease and kidney failure and neurological disorder leading to amputation of limbs. It is very important to get data in the community and identify intervention strategies and programs.

What does the study hope to accomplish?

The primary purpose of this study is to (1) get baseline information on the prevalence of diabetes, pre-diabetes, metabolic syndrome and CVD risk factors among Indian American males and females, and (2) explore other co-morbid conditions in this population (e.g. blood pressure, dyslipidimia, etc); and (3) health behaviors, knowledge of risk factors for diabetes and CAD, and acculturative changes among Indian Americans as they migrate from India to the US. The information gathered from this project will help to determine the prevalence of diabetes, coronary artery disease (CAD), high cholesterol levels, and obesity in our population and will dictate the urgency of prevention and management programs and interventions at a state, national and global level.

Where will the study be conducted?

The data collection was focused in seven study sites in the US: Houston (Texas), Edison and Jersey City (New Jersey), Boston (Massachusetts), San Diego (California), Phoenix (Arizona), and Washington DC. Indian Americans, aged 18 years and older, were selected based on the population density identified in Census 2000.

How were participants selected?

Sampling frames were created at each study site through a compilation of telephone directories (subjects were identified by their last names using a list of 100 most common Indian surnames in the US), ethnic association directories, faith-based organization directories, and directories of professional associations that permitted recruitment of a diverse cross-section of the US Asian Indian population. The final database included approximately 43,000 Asian Indians in the seven study sites.  A total of 5000 respondents were randomly selected from the database using computerized random numbers and sent letters of invitation to participate in the study.  For individuals who consented to participate, telephone interviews were conducted by trained, multilingual AI staff fluent in Gujarati, Hindi, Telugu, Tamil, Oriya, Bengali, and Punjabi and English.

Of the 2900 valid contact information, 1838 respondents completed the telephone interviews and 1038 participants completed blood work (after a 10-hour fast) and anthropometric measurement. Blood samples were centrifuged to separate plasma or serum, and shipped on ice to three core laboratories for analysis of the lipid profile [Atherotech Laboratory (Birmingham, AL)], A1c [Diabetes Diagnostic Laboratory (Columbia, MO)], and serum blood glucose [Translational Metabolism Unit, Baylor College of Medicine (Houston, TX)].

Those individuals who did not agree to participate in the study were asked a few questions on their demographics (age, gender, education, income, smoking status, personal and family history of chronic diseases (diabetes and cardiovascular disease).

The study was approved by the Institutional Review Board of Texas A&M University and several hospitals and the Indian Council for Medical Research in India.

Funding Source?

This research project is being funded by American Association of Physicians of Indian Origin (AAPI).

Need more information?

If you are interested to get more information about this project, please contact

Ranjita Misra, PhD, CHES
Professor and Director, Public Health Practice [MPH] Program
Department of Social & Behavioral Sciences
School of Public Health
West Virginia University
Morgantown, WV 26506-9190
Tel: 304-293-4168
Fax: 304-293-6685
Email: ramisra@hsc.wvu.edu
E-Mail: misra@hlkn.tamu.edu


Dr. T.G. Patel, M.D., M.A.C.P
Co-Investigator, AAPI-DIA
Program Chief, Renal Diseases,
Oncology & Diabetes, VA,
Washington DC 20420

DIA Photos