In 2015, the American Diabetes Association (ADA) lowered the BMI cut-off for diabetes screening for Asian-Americans (AA) from BMI ≥ 25 to ≥ 23 kg/m2. We asked whether this led to increased screening among AA with BMI 23-25. We analyzed pooled, weighted data from the 2013, 2014, 2018, and 20Behavioral Risk Factor Surveillance System (BRFSS) , a nationally-representative phone survey. A question on self-reported incidence of diabetes screening in the past three years was included by 20 states in all 4 study years. We included AA ages 18-80 with BMI 23-24.9 and 25-29.9 without prediabetes or diabetes. We calculated screening rates before (2013, 2014) and at least three years after (2018, 2019) the update. By a difference-in-differences approach, we compared change in diabetes screening by BMI group, using generalized linear models with an identity link adjusted for age and sex. A total of 6,672 respondents were included. The weighted screening rate among AA with BMI 23-25 was similar before and after the guideline update (Table) . The change in likelihood of diabetes screening among AA with BMI 23-25 did not differ from those with BMI 25-30 (difference in differences -3.5%, 95% CI: -13.3% to 6.4%, p=0.49) . We found no increase in diabetes screening among AA with lower BMI despite updated ADA guidelines. Increased attention to screening in this at-risk group is needed. Note: Two first authors contributed equally.

Disclosure

A.Demarsilis: None. I.Usiskin: None. K.J.Mukamal: Other Relationship; US Highbush Blueberry Council.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.