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Health Commission unanimously endorses diabetes screening at BMI 23 for Asian adults
Summary
The commission voted unanimously to adopt Resolution 15-13 endorsing screening Asian American adults for type 2 diabetes at a BMI of 23, citing data on underdiagnosis and a projected increase in identified cases across the San Francisco Health Network.
The San Francisco Health Commission voted unanimously to adopt Resolution 15-13 endorsing type 2 diabetes screening at a body-mass index (BMI) of 23 for Asian American adult residents.
"We are going to be endorsing the screening for type 2 diabetes mellitus at a body mass index of 23 and Asian American adult residents of San Francisco County," the commission introduced before hearing a multi-part presentation.
Health Officer Tomas Aragon presented national and local evidence showing that a substantial proportion of diabetes among Asian Americans is undiagnosed. He told commissioners that changing the BMI screening cutoff improves sensitivity. "By dropping the cutoff to 23, you increase the sensitivity to 84.7%," Aragon said.
Dr. Ben Louie, medical director at the Chinatown Public Health Center, described the operational impact for the San Francisco Health Network: the network serves about 72,000 primary-care patients, roughly 25% of whom are Asian (about 18,000 people). Using local clinic data, he estimated the changed cutoff would lead to about 4,000 additional patients screened, roughly 1,150 additional prediabetes diagnoses and about 640 additional diabetes diagnoses within the network.
Multiple clinicians and public-health organizations testified in favor of the resolution, including the Chinese American physician society, the Asian & Pacific Islander American Health Forum and the American Diabetes Association. Testimony focused on health equity and the evidence that Asians develop metabolic risk at lower BMI values.
Commissioners discussed the resolution—s wording to make clear it is an encouragement consistent with American Diabetes Association guidance rather than a mandate for all providers. After debate and a motion, the commission voted. "All those opposed, the resolution has passed unanimously," the chair announced.
Staff said they will supply interim implementation data and the annual report required to the state; a more comprehensive three-year evaluation will follow to assess efficacy and cost.
Resolution 15-13 instructs the department to promote screening at BMI 23 for Asian adults in clinical settings, to use available electronic registries to identify candidates, and to report initial data to the commission before the state filing deadline.
