TY - JOUR TI - Factors related to undiagnosed diabetes and prediabetes in Asian Americans: A cross-sectional analysis of NHANES 2011-2016 DO - https://doi.org/doi:10.7282/t3-fjv3-ec38 PY - 2019 AB - OBJECTIVES: Asian Americans, the fastest-growing race in the U.S., are disproportionately affected by diabetes (DM), particularly undiagnosed DM (51% of all diabetes cases) and prediabetes. The goal of this study was to examine differences and identify predictors in social determinants of health factors and health-related factors associated with undiagnosed diabetes, diagnosed diabetes, prediabetes, and no diabetes/prediabetes among Asian Americans. METHODS: Three cycles of National Health and Nutrition Examination Survey (NHANES) from 2011-2016 were analyzed for exploratory and inferential statistics—using the chi-square test of independence, linear regression and multinomial logistic regression models—to assess the associations and predictive factors (i.e., Social Determinants of Health, obesity, HbA1c, and sleep) in those with undiagnosed diabetes, diagnosed diabetes, prediabetes, and no diabetes/prediabetes among Asian Americans (n=1,685). RESULTS: Diabetes estimates—both undiagnosed and diagnosed—were different when stratifying by nativity (U.S.-born vs. foreign-born). Differences in age (p<.001), marital status (p<.001), education(p<.001), acculturation (p=0.010), poverty (p=0.009), regular healthcare provider (p<.001), overweight/obese body mass index (BMI) (p<.001), and sleep duration (p=0.033) were observed. Education was a significant predictor especially when comparing those who attained college degrees or higher to high school graduates; they are 3.3 times more likely to have no diabetes or prediabetes compared to undiagnosed diabetes (p=0.0031) OR: 3.337, (CI: 1.534 to 7.261). In addition, those who had some college or an Associate’s degree when compared to high school graduates were 2.5 times more likely to not have diabetes/prediabetes compared to having undiagnosed diabetes (p=0.0453), OR: 2.497 (CI:1.020 to 6.112). CONCLUSIONS: This study suggests that BMI is an inadequate predictor of diabetes—either diagnosed or undiagnosed—and prediabetes. Nativity, gender, education, regular healthcare provider and sleep duration are potential factors that need to be considered when developing interventions, preventive strategies, and clinical guidelines for Asian Americans. KW - Biomedical Informatics KW - EHR KW - Diabetes -- Diagnosis KW - Asian Americans -- Health and hygiene LA - English ER -