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Objective: Although numerous studies have identified an elevated risk of diabetes or impaired fasting glucose among Asians, there are limited data examining variability in risk among Asian subpopulations. We estimated prevalence of diabetes (DM), metabolic syndrome (MS) and impaired fasting glucose (IFG), by race/ethnicity and by Asian subgroup.Design, Settings and Participants: This study was conducted using the fasting subsample of the 2004 New York City Health and Nutrition Examination Survey (NYC HANES; n = 1,324), a local version of the NHANES. Using country of origin information, we constructed South Asian and other Asian categories.Main Outcome Measures: DM, MS and IFG.Results: Age-standardized prevalence estimates of DM, MS and IFG were 10.8%, 13.3% and 21.4% among Whites, 16.1%, 12.0% and 32.4% among all Asians, and 35.4%, 17.7% and 15.9% among foreign-born South Asians, respectively. After adjusting for potential confounders, Asians had significantly higher odds of prevalent IFG (Adjusted odds ratio [AOR]:2.64; 95% confidence interval [CI]: 1.60-4.38) and MS (AOR:2.09; 95%CI: 1.19-3.68), compared to Whites. South Asians were more likely to have DM (AOR:4.88; 95%CI: 1.52-15.66) and MS (AOR:5.59; 95%CI: 1.69-18.50) compared to Whites, while other Asians were at increased prevalence of IFG (AOR:2.89; 95%CI: 1.65-5.07).Conclusion: Our findings suggest that the observed White/Asian disparity in DM risk may be primarily attributable to elevated risk among South Asians. [ABSTRACT FROM AUTHOR]

Although several observational studies have consistently reported an inverse association between moderate alcohol consumption and risk of coronary heart disease (CHD), it is yet not well established if this association also exists among people with type 2 diabetes. The aim of this study is to evaluate the association between the frequency and quantity of alcohol intake and the risk of developing CHD among postmenopausal women with diabetes. We conducted a prospective cohort study, which included 3,198 women with self-reported diabetes and without any history of cardiovascular disease at baseline, in the Women's Health Initiative Observational Study. Alcohol intake was assessed by a semiquantitative food frequency questionnaire. The primary outcome of this study was CHD, which was validated by medical record review. Cox proportional hazards regression was used to estimate the hazard ratio (HR) for the association of alcohol intake and risk of incident CHD while adjusting for several potential confounders. During the 22,546 person-years of follow-up, there were 336 incident cases of CHD. Both frequency and quantity of alcohol intake were inversely associated with the risk of developing CHD. Compared to nondrinkers, the multivariable HRs across categories of frequency of alcohol consumption (<=0.5, 0.5-2 and >=2 drinks/week) were 0.89 (95% confidence intervals [CI]: 0.63, 1.26), 0.84 (95% CI: 0.56, 1.25) and 0.65 (95% CI: 0.43, 0.99), respectively ( p for trend: 0.04). This association did not appear to differ based on the type of the alcoholic beverage consumed. Moderate alcohol consumption of postmenopausal women with type 2 diabetes may have a benefit on CHD similar to that seen in postmenopausal nondiabetic women. The potential risks of alcohol on noncardiac outcomes may need consideration when recommending alcohol to women with diabetes. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this investigation was to estimate the glycemic load (GL) of nutritionally promoted fast-food menu items and to compare menu items nutritionally. METHODS: Published glycemic index (GI) values and nutritional information from the Web sites of Subway and Burger King were used to calculate the GL of nutritionally promoted items. Menu items were compared based on calories, macronutrients, saturated fat, GI, and GL as basic items and as often served. RESULTS: Subway offered 7 low-fat (total/saturated fat: 3-5/1-2 g), low-calorie (230-330) sandwich options that had an average GL of 29. If the customer accepts the soda and baked potato chips, the total calories exceed 600 and the total/saturated fat becomes 13/4 g, with a doubling of the GL. The Burger King low-fat options contained 4.5 g total fat and 1.5 g saturated fat, with GLs of 53 to 54, and low-calorie options (265-310 calories) had low GLs (0-18.3). Adding fries and a soda brings the GL up from a 53 for just the sandwich to 123 for the meal. The bunless low-carb Whopper has the same fat content (total/saturated fat: 42/13g) as the original Whopper, but the GI and GL are zero. CONCLUSIONS: The nutritional information for meal options available at Burger King and Subway can help the patient with diabetes make choices. Accepting the fries or chips and soda can dramatically increase the calories, carbohydrate, fat, and GL of the nutritionally promoted fast-food meal. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to assess inner-city clinic patient attitudes about weight loss counseling and to assess practice behaviors of primary care physicians in residency training. METHODS: This is a cross-sectional survey of consecutive patients attending an outpatient internal medicine resident continuity clinic in the Bronx, New York. Participants completed a 30-item questionnaire; a 17-item Quick Weight, Activity & Excess Screener (WAVE); and 13 items to assess patients' attitudes about the physician's role in weight management. A chart review was conducted to ascertain resident practice patterns. Relationships of categorical data were evaluated using chi(2) analyses and odds ratios. RESULTS: Chart reviews (n = 84) indicated that 80% of patients were either obese or overweight; 21% of obese patients and 11% of overweight patients had the diagnosis documented. Of the obese patients (n = 42), 17% had dietitian referrals and 36% had an indication of physician weight loss recommendation. A patient survey indicated that 86% of obese patients wanted to lose weight, 64% wanted a dietitian referral, and 62% felt that their physician could help with weight loss. Obese patients were significantly more likely to receive weight loss recommendations than were overweight patients, but frequency of visits and the diagnosis of diabetes did not increase the likelihood that weight would be addressed. CONCLUSIONS: Physicians need to address how to manage obesity including assessing patient attitudes about making lifestyle changes and using dietitian and other referrals for weight reduction counseling. [ABSTRACT FROM AUTHOR]

PurposeThis study evaluated the feasibility of using the youth Weight, Activity, Variety, and Excess (WAVE) screener in a classroom setting for assessing student weight control intentions and the extent to which they used the WAVE strategies to control their weight.MethodsThe Youth WAVE Screener was administered to fifth-grade students in an inner-city school located in the Bronx, New York. The study was conducted in part to increase student awareness of snack foods and sugary beverages in relation to weight.ResultsOf the 169 students who completed the survey, 45.5% (n = 77) were trying to lose weight. Students who were trying to lose weight were more likely to have low-fat dairy products, less likely to have sugary beverages, and less likely to eat junk foods than those who were not trying to lose weight. Students who reported exercising 3 times weekly were more likely to report healthier dietary patterns and less sedentary behaviors than were students who exercise less often. Feedback and dialogue with fifth graders addressed the relationship between TV viewing and eating behavior, advertisement, availability, and preferences of fruits and vegetables.ConclusionsThe Youth WAVE Screener can be used to quickly identify children who are concerned about their weight as well as those with dietary and physical activity patterns that may increase the risk of obesity. Diabetes educators can use this screener to start a dialogue with children about their weight-related behaviors. [ABSTRACT FROM AUTHOR]

The initial 1992 Diabetes Quality Assurance (DQA) Checklist was developed as a tool to facilitate chart auditing for evaluating clinician adherence to the current quality-of-care standards. This article describes how the authors revised and updated the 1992 DQA Checklist to incorporate more recent evidence related to clinical interventions that improve outcome. The revised version is designed to address the 2005 American Diabetes Association Standards for Medical Care. Additional changes were made to facilitate the review process. The revised instrument has been named the Revised 2005 Diabetes Quality Improvement (DQI) Checklist to reflect the emphasis on its potential use in quality improvement activities. The 2005 DQI Checklist is an updated version of the original 1992 DQA Checklist, with additional modifications based on the 2005 American Diabetes Association Standards of Medical Care, the National Cholesterol Education Program Adult Treatment Panel III, the Seventh Joint National Committee on the Prevention, Detection and Treatment of High Blood Pressure Guidelines, and the Centers for Disease Control and Prevention Adult Immunizations Guidelines. [ABSTRACT FROM AUTHOR]