No one has ever accused Dr. Bhupendra Sheoran of packing on the pounds. At 5 foot 10, the Oakland resident is a healthy 175 pounds. A physician for most of his life, he habitually avoids fast food and hits the gym.


So it came as a shock five years ago when he was diagnosed with Type 2 diabetes - a disease traditionally associated with being overweight or obese.


A phone call home put the situation in perspective, said Sheoran, 40, who lived in his native India until he moved to the Bay Area in 2005. He discovered that his sister and two uncles have the disease, and his father had symptoms.


"I don't think anybody talked about it," he said. "It didn't seem that they were taking any dietary precautions. They would eat whatever I ate: dessert, white-flour stuff, high-carb stuff."


Sheoran's case is not unique. Diabetes is a rapidly growing epidemic that affects almost 26 million people in the United States, according to the Centers for Disease Control and Prevention.


Tailoring treatment


A disproportionate number of racial minorities have it, but Asian Americans have historically been seen as less affected. About 8 percent of Asian adults were reported to have the disease in a recent national survey, while about 16 percent of American Indians, 13 percent of African Americans and 12 percent of Latinos had it.


Now, increasingly nuanced data argue against lumping Asians into a single group. Certain subgroups - such as Filipinos, South Asians and Pacific Islanders - actually appear to suffer from Type 2 diabetes more than previously believed and, in some cases, more than other minorities altogether, studies suggest.


The statistics on Asian subgroups can help physicians provide the best treatment for the fastest-growing ethnic population in the nation, health experts say, whether it's devising healthy alternatives to traditional dishes or urging less fasting during religious observances.


"Each group is extremely different, with different lifestyles, different diets, different levels of physical activity, and beliefs and traditions and cultural issues that impact food and lifestyle changes," said Alka Kanaya, associate professor of medicine at UCSF. "How can we impact this diabetes epidemic in Asians if we don't start looking at them as distinct ethnic groups?"


No longer ignored


Until 2000, Asians were statistically overlooked by most national health surveys, which classified them as part of "other races," or combined them with Pacific Islanders.


Since then, Asians have become difficult to ignore as an increasing number of them make the United States their home. Asians and Pacific Islanders made up 5 percent of the U.S. population in the 2010 census - a 43 percent rise from 2000. About 5.6 million Asians live in California, more than any other state.


Diabetes has also become an epidemic both domestically and abroad, particularly in Asia. One in 3 U.S. adults is expected to have the disease by 2050. Most troubling to experts is diabetes' link to more serious complications such as cardiovascular disease and blindness.


"It's a costly disease, not only to individuals, but to families and societies," said William Hsu, co-director of the Asian American Diabetes Initiative in Boston. "I think this is one of the health issues that will continue to plague the Asian American community for a long time."


In an October study, Kanaya and other researchers examined diabetes rates among 1.7 million adult members of Kaiser Permanente in Northern California, including Asians, and found surprising results.


Exceeding other races


At the beginning of 2010, diabetes rates among Pacific Islanders, South Asians and Filipinos were 18 percent, 16 percent and 16 percent, respectively - rates that exceeded those of all other races, including African Americans and Latinos, the researchers said.


As 2010 went on, diabetes diagnosis rates in those same subgroups also exceeded other Asian subgroups, the study found.

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