Racial Differences in Incidence of Diabetes

More than 12 million Americans suffer from diabetes, and approximately 300,000 people die each year from complications of the disease (Kagan and Gall, 1998). There are two forms of diabetes: Type I diabetics (15 percent to 20 percent of all diabetics)are insulin-dependent, and Type II are usually non-insulin dependent (80 percent to 85 percent of all diabetics) - they are controlled with oral medications. Type I diabetes usually starts in childhood, but a prime cause of Type II diabetes, which usually starts in those over 40 years of age, is obesity. There are racial and socioeconomic differences in the incidence of diabetes, and it is more common in females than in males.

African Americans have a higher risk of developing type II diabetes (adult onset) than whites (Brancati, Kao, Folsom, Watson and Szklo, 2000). A study was conducted to look at the risk of incident diabetes in African American vs white adults and to search for explanations for the racial differences. Subjects for the study were drawn from an ongoing Atherosclerosis Risk in Communities (ARIC) Study. A total of 2,646 African Americans and 9,461 white adults, ranging in age from 45 to 64 years, and diabetes-free at the beginning of the study, were followed for 9 years.

Results showed that the incidence of diabetes was 2.4 times greater in African American women and 1.5 time greater in African American men than in white women and men. It was determined that adiposity accounted for 47.8 percent of the

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, the race difference was explained by a greater prevalence of hypertension and diabetes in both males and females. In men of all ages, and women older than 60 years of age, hypertension and diabetes explained all of the higher rates of CHF hospitalizations in African Americans. It did not matter whether the diabetes was well controlled or not, the rates were still higher for African Americans with diabetes. Erdman et al (2002) did a retrospective analysis of initial and one-year follow-up lipid levels among patients selected from a computerized registry of an urban outpatient diabetes clinic. They looked at the independent effects of lipid-specific medications, glycemic control, and weight loss on serum cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels by analysis of covariance and linear regression. The patients were 91 percent African American and 95 percent had Type II diabetes. In 345 patients, HbA1c decreased from 9.3 percent to 8.2 percent, total and LDL cholesterol and triglycerides levels were significantly reduced, and HDL cholesterol was higher after one year. Total cholesterol, LDL cholesterol and triglycerides were lower after one year in 102 patients taking lipid-specific therapy

Category: Medical - R