Outline

2. Background of Arab Americans.
3. Arab Americans Population.
4. Arab American Worldview: Family, Political, and Economic Factors.

• Arab Americans and Diabetes.

1. Diabetes rate among Arab American versus another ethnicity.
2. The causes of Diabetes in Arab American.
3. Risk factor for diabetes in Arab America.
4. Prevalence of diabetes and glucose intolerance among Arab Americans, according to

Age, sex, obesity, and family history of diabetes

1. Demographic and biomedical indicators of the populations.
2. The prevalence of diagnosed and undiagnosed diabetes, IFG, IGT, and combined glucose intolerance
3. Diversity of the genetic composition, cultural backgrounds, and socioeconomic status of the population.
4. Disparities in Self-Reported Diabetes Mellitus among Arab American.
5. Acculturation and Diabetes in Arab American.
6. The association between Acculturation level and diabetes among Arab American.

• Perceived risk and the willingness to enroll in a diabetes prevention lifestyle intervention in Arab-Americans
• Quality of diabetes care in Arab Americans

1. The level of care received by Arab American patients with diabetes.
2. The quality of care received by Arab American patients with diabetes by assessing the adherence to the ADA standards of care.
3. The quality of diabetes care using the DQIP measures for a Arab American population in comparison to other racial and cultural groups in the US.

       

Introduction

This paper aims at integrating various articles on the history, and spread of diabetes and prediabetic conditions among Arab Americans. The history includes their population and views on social, political, and economic conditions. The prevalence of diabetic and prediabetic is analyzed according to sex, age, obesity, and people history of obesity. The paper also analyzes the worth of diabetes care in Arab Americans in comparison to other racial groups in America. The paper further gives a background history of Arab Americans.

Background of Arab Americans

Population

In the 1890s, Arabs started immigrating into the United States. However, in the late 1960s and 1970s, there was political instability in the eastern Mediterranean region leading to an increase in the immigration of Arabs into the U.S. Currently, the population of Arab Americans in the US is between two to three million people, and is the highest population in the state of Michigan (Jaber et al, 2003, p 308). The population is heterogeneous with a majority of immigrants from rural communities.

Worldview of Family, Political, and Economic Factors

The Arab American community is characterized by a transition from the Middle East lifestyle to a western lifestyle in the recent years. They changed their Arabic culture and adopted the American way of living

Arab Americans and Diabetes

Diabetes rate among Arab American versus another ethnicity

According to a study conducted by researchers, the Arab Americans are reported to have the highest toll of diabetes compared to the other communities in the US. The rates are higher than those among the whites, blacks, or Latinos. The research done on 542 non-pregnant adults between the age of 20 and 75 years reported that 19.6 % of the people had diabetes. This is a very number given their small population compared to other groups. In another research, 34% of the people involved in the research had obesity compared to twenty six percent of the whole population of Americans (Roberts, 2003, p 28).

The causes of Diabetes in Arab American

There are two suspected causes of high toll in diabetes which include weight and unwholesome habits. The Arab Americans have also adopted detrimental habits from the west including wearing tight pants. Arab Americans have ignored to take precautionary measures by checking on their weight and eating habits. Bad eating habits also result in increases in weight.

Risk factor for diabetes in Arab America

The main risk factor for diabetes in Arab America is the wide spread obesity among Arab Americans. Results from the study carried out carried out by Robert (2003) suggest that the rate of obesity is likely to rise in the near future if the Arab Americans do not take adequate preventive measures against obesity. Robert (2003) advices doctors to monitor obese Arab Americans very closely like high risk patients.

Prevalence of diabetes and glucose intolerance among Arab Americans, according to Age, sex, obesity, and family history of diabetes

Demographic and biomedical indicators of the populations

The demographic indicators of the research done to determine the rate of the spread of diabetes include age, ethnicity, education, employment and occupation. The age studied in the research is between less than ten years, and equal to or above forty years. The countries of origin studied include Lebanon, Yemen, Iraq, Palestine and other countries. Level of education is measured in terms of whether an individual has completed secondary education or higher, and less than high school. Individual were assessed of their levels of employment in terms of full-time, part-time, retired, unemployed, in school, homemaker, and inability to work. Occupation is analyzed in terms of profession, white collar, blue collar, and self – employed. Biomedical indicators include obesity, WHR and Central fat distribution.

The prevalence of diagnosed and undiagnosed diabetes, IFG, IGT, and combined glucose intolerance

Diagnosed and undiagnosed diabetes affects 18% of the studied Arab Americans aged between 20 and 75 years, and more than 70% of those above the age of 60. Aged Arab Americans are at a higher risk of having diabetes compared to young ones. In Arab countries, the rate of diabetes ranges from 3% in Sudan to 35% in Bahrain. In the past two decades there has been an increase in the prevalence of diabetes among Arab Americans due to rapid expansion and prolonged existence. Urban areas record high levels of glucose intolerance due to changes in nutritional patterns, physical activity and obesity. People living in urban areas are exposed to many activities and numerous eating patterns.

Diversity of the genetic composition, cultural backgrounds, and socioeconomic status of the population.

Differences in the incidence of diabetes among intragroups have been noted in the study conducted by Jaber and associates. These differences reflect the diversity of genetic composition, cultural backgrounds, and socioeconomic status of the population. The study shows that the spread of diabetes is related to a larger extent to genetic make-up of the cultural groups. The percentage of Lebanese American with diabetes is close that of Lebanese in Lebanon. There is a high possibility of suffering from diabetes if a relative has a history of diabetes. The disease is passed from one generation to the next one.

Disparities in Self-Reported Diabetes Mellitus among Arab American

Married and unmarried male Arabs in America are likely to have diabetes compared to their counterparts. Arab males were also highly likely to have diabetes compared to females. Arab Americans have the second highest overall sex-adjusted occurrence of diabetes at 7% for each group. Female Arabs occasionally visit physicians compared to men who are always busy fending for the family.

Acculturation and Diabetes in Arab American

The association between Acculturation level and diabetes among Arab American

Arab American women exhibit low levels of acculturation. This condition is confused with age and BMI as risk factors for dysglycemia. However, results indicate that lack of acculturation is a hazardous factor affecting commonness of dysglycemia among Arab Americans. Researches indicate high levels of dysglycemia among women living in rural areas of Middle East (Jaber, L et al, 2003, pp 2012). This is mainly due to lack of integration into other communities. This would help them change their culture and belief hence reducing levels of diabetes. Acculturation also affects Arab American men, but it’s independent of age.

Perceived risk and the willingness to enroll in a diabetes prevention lifestyle intervention in Arab-Americans

            Pinelli and associates carried out a study on Arab Americans living in Dearborn. They were aged thirty and above with a body mass of 27 kg per square meter. Subjects were identified between 2007 and 2009 from a sample list and the public in Dearborn.  Results show that most of the subjects have a high risk perception of diabetes among other diseases and its complication. These perceptions are as a result of individual health beliefs, past experiences, culture and interaction with healthcare professionals.

According to the study, Arab Americans showed slight to moderate risk perceptions on different magnitude of perceived risk. Arab Americans who were willing to participate in the study showed a higher risk perception than those who refused (Pinelli, 2010, p e2). The study also suggests that risk perception is associated with eagerness to engage in diabetes prevention activities.                                 

Quality of diabetes care in Arab Americans

The level of care received by Arab American patients with diabetes

Non-pregnant Arab Americans between the age of 20 and 75 years were studied from the year 2000 to 2001. The sample population was from two parts of Dearborn, MI. the researchers conducted household interviews for any previous medical diagnosis. The distribution of HbA1c, LDL, SBP and DBP were used to measure the level of healthcare received by the study population (Herman et al 2008, p 251). Another tools used were accountability measures and used as a comparator of the level of healthcare using a Diabetes Report Card. Results show that Arab Americans receive medium levels of care. Out of the total sample, only 9.8% of the subjects had received previous diagnosis and all of them had seen a physician. 75.5 % reported seeing physicians four or more times in a year.

The quality of care received by Arab American patients with diabetes by assessing the adherence to the ADA standards of care

Arab Americans received sub-optimal care according to the ADA principles of medical care. Only 30% of the population under study met 7% of HbAc goal whereas 36% met the LDL goal of less than 100ml/dL. These goals are recommended by ADA. However the sample population recorded higher levels of lipid control (LDL less than 130 mg/dL) than the US participants (Herman et al 2008, p 253). Arab Americans did not receive maximum care from health experts. Aspirin and reductase inhibitors were all underutilized in the patient population. The researchers suspect that this is mainly due to various factors such as linguistic, cultural, and social and health belief barriers.

The quality of diabetes care using the DQIP measures for Arab American population in comparison to other racial and ethnic groups in the US.

Using DQIP measures, Arab Americans males have a poor glycemic control than the national sample of US males. Arab American males had 33.3% against 16.1% among US males. The Arab American population had the highest rate of dropping out of school and the lowest rate of insulin use compared to non-Hispanic whites and non-Hispanic blacks. Poor glycemic control occur when HbA1c rise above 9.5%. Both Arab American women and females from the national population under study showed poor glycemic control.30% of Arab American patients without degrees had higher levels of glycemic control compared to 16.1% of the national sample without degrees and suffering from a similar condition (Herman et al 2008, p 253).

Conclusion

Diabetes is a prevalent disease among various racial groups in America. Many researchers have conducted studies on the spread of diabetes among the various tribal groups, but ignored the Arab Americans (Roberts, p 26, 2003). However, new studies indicate that Arab Americans have high rates of diabetes and prediabetic conditions. Arab Americans have the highest number of diabetes infection caused by weight and bad habits. The most affected group is above the 60 years of age. Most of the diabetic conditions are inherited from one generation to another. Majority of Arab Americans above the age of 30 have a high risk perception and are willing to change their lifestyle in order to reduce the prevalence of the disease. Despite the high levels of diabetes among Arab Americans, they receive the lowest care in their treatment for diabetes.

References

Herman, W, Brown, M, Hammadd, A & Jaber, L. (2008). Value of diabetes care in Arab   Americans p 250-255.

Jaber, L, Brown, M, Hammad, A, Nowak, S, Zhu, Q, Ghafoor, A & Herman, W. (2003). Epidemiology of Diabetes Among Arab Americans. p 308-313.

Jaber, L, Brown, M, Hammad, A, Nowak, S, Zhu, Q, Ghafoor, A & Herman, W. (2003). Lack of             Acculturation Is a Risk Factor for Diabetes in Arab Immigrants in the U.S.  p 2010-2014.

Jamil, H, Monty, F, Dallo, F, Templin, T, Khoury, R & Fakhouri, H. (2007). Disparities in Self-     Reported Diabetes Mellitus among Arab, Chaldean and Black Americans in Southeast           Michigan Springer Science+Business Media, LLC 2007.

Pinelli, N, Herman, W, Brown, M, Morton, B & Jaber, L. (2010). Perceived risk and the    willingness to             enroll in a diabetes prevention lifestyle intervention in Arab-Americans p     e1-e3.

Roberts, S. (2003). High diabetes rate discovered in Arab Americans. Diabetes       Forecast;         ProQuest Health and Medical Complete

6. 26.