A Comprehensive School Health Program to Reduce Disparities and Risk for Type 2 Diabetes in Overweight At-Risk Youth

Background: South Asian Immigrants (SAIs) are the second fastest growing Asian immigrant population in the US, and at a higher risk of type 2 diabetes (diabetes) than the general US population. Coronary Artery Disease (CAD) is the principal cause of mortality globally, particularly in diabetic subjects. In this study, we sought to determine the; 1) distribution of risk factors for CAD in diabetic and non-diabetic SAIs; and 2) presence of sub-clinical CAD in diabetic and non diabetic SAIs in the US. Methods: 213 first generation SAIs subjects were recruited and broadly divided into two subgroups; 35 diabetics and 178 non diabetics. Their risk factors for CAD were compared. For sub-clinical CAD assessment, Common Carotid Artery Intima-Media Thickness (CCA-IMT) was used as a surrogate marker for atherosclerosis. For CAD diagnosis, Exercise Tolerance stress Test (ETT) was performed. Results: Both diabetics and non diabetics SAIs in general, share a very heavy burden of CAD risk factors. Hypertension (p=0.003), high cholesterol (p<0.0001) and family history of diabetes (p<0.0001) was significantly associated with diabetes. Presence of sub-clinical CAD was also higher in diabetics as compared to non diabetics (63% Vs 52%). 45% of diabetics (who were not previously diagnosed with CAD) were found to be ETT positive for CAD (p<0.0001). Conclusion: CAD risk factors and sub-clinical CAD are more prevalent amongst diabetic SAIs. Early screening and aggressive treatment for risk factor reduction in SAIs is the key to combating the increasing incidence of CAD. Larger prospective trials are required to confirm these study findings.