Impact of Lowering BMI Cut Points as Recommended in the Revised American Diabetes Association's Standards of Medical Care in Diabetes—2015 on Diabetes Screening in Asian Americans

OBJECTIVE: This study estimated the screening prevalence of prediabetes and diabetes using a lower BMI cutoff of 23 kg/m(2) in Asians in the U.S. using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012. RESEARCH DESIGN AND METHODS: A cross-sectional analysis was conducted of non-Hispanic Asians, aged 45 years and older, with available BMI, HbA(1c), and fasting glucose data. These overall criteria were met by 341 participants. RESULTS: Lowering the screening BMI to 23 kg/m(2) increased the sensitivity of screening for prediabetes and diabetes from 50.2 to 74.1% (P < 0.0001) but decreased the specificity from 62.9 to 38.7% (P < 0.0001). CONCLUSIONS: Although this will add additional health care costs resulting from more widespread screening, early identification of these conditions may be beneficial for primary and secondary prevention in this unique population that develops prediabetes and diabetes at lower BMI levels.