SAHRI

Dear All:

I would like to inform all readers of a national study on Asian Indians
called the Diabetes for Indian Americans (DIA) Initiative. Below are
details of the project:


(c) Ranjita Misra
Diabetes among Indian Americans (DIA) Study

Introduction
	Although Asian Indians are the third largest Asian group (1.6
million population; U.S. Census 2000), there is a paucity of
epidemiological studies to determine the prevalence of diabetes and
cardiovascular disease. The current body of research on Asian American
health issues does not adequately address the needs of Indian Americans
(Kar, Campbell, Jimenez, & Gupta, 1995; Hacker, 1997). Despite the
higher age-adjusted CVD rates among Asian Indians, there is limited
metabolic (albeit increasing) & non-clinical data from community-based
studies to provide a clear understanding of risk factors for these
chronic diseases. Limited studies on Indian Americans have been based 
on
convenient samples with limited generalizability of the results to the
Indian American community. The Diabetes among Indian Americans (DIA)
study is the first community-based random study to investigate age and
gender difference in risk factors (family history of diseases, medical
background of the respondents, dietary habits, health promotion
behaviors, access to care, and preventive health behaviors) for 
diabetes
and other chronic diseases, especially cardiovascular disease and
cancer, among Indian Americans in the United States.  

Specific Aims

The Specific Aims of the study are as follows: 
1.	Identify and determine behavioral, clinical, anthropometrics,
and dietary risk factors for diabetes and CVD in Indian American males
and females in the United States.  

2.	To determine the prevalence of diabetes, hypertension,
hyperlipidimia and metabolic syndrome among the respondents. 

Results of the proposed study will generate baseline data and will be
used to develop culturally appropriate diabetes and CVD
prevention/treatment strategies to reduce morbidity and mortality
associated with these diseases. 

Sites of study:
There are six study sites: Houston TX, Phoenix AZ, Washington DC, 
Boston
MA, Edison & Parsippany NJ, and San Diego CA. The six sites were
selected based on the Indian American population and co-investigators/
collaborators in those sites.  Data collection is complete in Houston,
Phoenix, Boston, and DC and currently on-going in San Diego and Edison.

 
Sampling and data collection:
Participants are randomly selected from a master directory created from
the telephone book, temple directories, area association directories,
and local ethnic association directories. Those who agree to 
participate
complete a telephonic interview followed by fasting blood drawing at 
the
community centers/clinics/hospitals (based on the site of the study). 
 
Survey data provides information on respondent's perceived risk for
diabetes and heart disease, health status and behaviors, dietary 
habits,
medical history of diseases, knowledge of the disease, and use of
preventive health services. Survey information is supplemented by
bioclinical profile: lipid profile (total cholesterol, LDL, HDL,
triglycerides), subclasses of HDL (HDL2, HDL3), subclasses of LDL
(LDL-C, LDL-R, VLDL12, VLDL3), Lipoprotein a, Homocysteine, C-Reactive
protein, fasting blood glucose, fasting insulin, adiponectin, free 
fatty
acid, and hemoglobin A1c. 
 
Anthropometrics measurements (height, weight, waist-hip ratio), fasting
blood glucose, and blood pressure measurements are taken at the time of
blood drawing. Serum samples are being analyzed at Atherotech 
laboratory
in Birmingham AL, Diabetes Diagnostic laboratory in Columbia MO, and
Baylor College of Medicine, TX. Samples are currenlty stored at
Atherotech for tests not currently done due to limited funding. 
 
We hope to identify undiagnosed diabetes cases and the prevalence
diabetes, metabolic syndrome, hypertension, and dyslipidemias. Results
of blood tests are provided to the respondents free of cost.  
 
Cross-cultural Component:
	We have also added a cross-cultural component to this study and
we will examine the risk factors for Type 2 diabetes mellitus (DM) and
cardiovascular disease (CVD) in 500 rural Indians, 500 urban Indians,
and 500 Indian Americans in the US.   Texas A&M University will be the
formal Data Coordinating Center (DCC). Data for the rural population is
collected from Aalamarathupatti in Tamil Nadu, India and urban
population in New Delhi. The All India Institute of Medical Sciences 
and
Gandhigram Rural Insititute are the collaborating institutions for the
study. Atherotech Laboratory  in Alabama and Diabetes Diagnostic
Laborary in Missouri will provide the core facilities in the US for
diagnostic services while the All India Institute of Medical Sciences 
in
New Delhi will provide core facilities for similar bioclinical marker
studies for the Indian populations.  Standardization of blood tests in
the US and India will be conducted for the cross-cultural comparison.  
 
Principal Investigator: Dr. Ranjita Misra (Texas A&M University) 
Co-Investigator: TG Patel, MD (Washington, DC)

Co-Investigators/Site Coordinators:
Houston TX:
Dr. Ranjita Misra (site coordinator)

Phoenix AZ:
Dr. Kris Vijay (site coordinator)

Washington DC:
Dr. TG Patel (site coordinator)

Boston MA: 
Dr. Raji Annaswamy (site coordinator)
Dr. Om Ganda

Edison NJ
Dr. Reema Patel (site coordinator)

San Diego CA
Dr. Purushotham Kotha (site coordinator)
Dr. Sundar Mudaliar 

Urban India
Dr. Anoop Misra, All India Institute of Medical Sciences, New Delhi
(site coordinator)

Rural India
Ms. Padmini Balagopal & Dr. N Kammalama, Gandhigam Rural Insititute
(site coordinators)








 


Ranjita Misra, PhD, CHES
Associate Professor
4243 TAMU, Rm # 158P Read Building
Department of Health and Kinesiology
Texas A&M University
College Station, TX 77843
979-845-8726; 979-847-8987 (Fax)
email: [email protected]

-----Original Message-----
From: [email protected] [mailto:[email protected]] On Behalf Of
S. Jay Jayasankar, MD
Sent: Thursday, June 09, 2005 3:12 PM
To: [email protected]; biren_saraiya
Subject: Re: [sapha] Getting the Data

Dear Biren:

You hit the nail on the head and your questions are central!

Lack of US South Asian health data is an important impediment both in
its substantive value and since it dampens the award of grants to study
South Asian problems which in turn is a significant disincentive to
grant writers.

I believe that we need to work on both facilitating  new primary
research and also help create a South Asian category in existing data
collection systems such as NHANES.  The latter will require two
concerted approaches.
One is to advocate at HHS, CDC and the agency and the other is to lobby
the US Legislative and Executive branches.

It is my hope that the agenda that is developed from the UMDNJ
conference will include this category addition as a goal along with the
reason to do so.  Using this as a springboard, we need to involve
various politically active South Asian organizations (and perhaps
others) to then advance this goal.  I have worked on this in my
capacities such as President of AAPI (American Association of 
Physicians
of Indian Origin) for some years but clearly we need a more concerted
effort.  It also appears that the time may be more ripe than has been.

Encourage dialogue and coordination by all.

Jay
S. Jay Jayasankar, MD
Former President, AAPI
Former Director, AAPI's Diabetes among Indian Americans Initiative
Keynote and Summation Speaker, UMDNJ conference on South Asian Health


----- Original Message -----
From: "biren_saraiya" <[email protected]>
To: <[email protected]>
Sent: Thursday, June 09, 2005 1:33 PM
Subject: [sapha] Getting the Data


>I was at the UMDNJ conference as well and one of the biggest concern
> was: there is no data.  One suggsetion was have "south
> asian" as a category in large population databases such as NHANES.
>
> Any thoughts on that?  Does it make sense?  How do we go about
> advocating for a category such as that?  etc.
>
> Biren
>
>
>