November is Diabetes Awareness Month. Please join Clinical Diversity Solutions as we raise awareness about diabetes and highlight the persistent racial disparities in diabetes that disproportionately affect the health of communities of color.
What is Diabetes?
Diabetes is a chronic health condition caused by elevated blood glucose (i.e., blood sugar). When blood glucose levels rise after a meal, the body signals your pancreas to release insulin. Insulin is a hormone produced by the pancreas that helps the body absorb glucose from the blood. Therefore, insulin is crucial for regulating and maintaining the body’s blood glucose at a safe and healthy level. In the case of diabetes, the body either does not make enough insulin or cannot use insulin as well as it should.
Types of Diabetes
There are three main types of diabetes.
Type 1 Diabetes
Type 2 Diabetes
Gestational Diabetes
Type 1 Diabetes
Type 1 diabetes accounts for about 5.2% of all diagnosed cases of diabetes. It is caused by an autoimmune response in which your immune system attacks and destroys the cells in your pancreas that produce glucose. As a result, the pancreas does not make any or enough insulin. Thus, instead of your cells absorbing glucose from the blood after a meal, the glucose builds up in your bloodstream, causing hyperglycemia (i.e., elevated blood sugar).
People with type 1 diabetes must take insulin every day to survive, which is why this type is also known as insulin-dependent diabetes. It is most common in children and young adults but can be diagnosed at any age.
Type 2 Diabetes
This is the most common type of diabetes, accounting for 95% of all diagnosed cases of diabetes. Type 2 diabetes occurs when your body does not use or respond to insulin normally and cannot maintain blood sugar at normal levels. It is known as insulin-resistant diabetes because your body is resisting the normal effects of insulin.
Type 2 diabetes is most common in middle-aged and older adults but can occur at any age.
Unfortunately, many people have no symptoms and remain undiagnosed and untreated until they develop diabetes-related complications. Risk factors for type 2 diabetes include obesity, little or no physical activity, being African-American, a family history of type 2 diabetes, a history of gestational diabetes, being pre-diabetic, and being older than 35.
Gestational Diabetes
Gestational diabetes occurs when a woman with no previous history of diabetes develops diabetes during pregnancy. It is most common during the third trimester of pregnancy. Gestational diabetes can cause complications for the fetus, including large birthweight and neonatal hypoglycemia (low blood sugar), and increases the risk of preeclampsia and type 2 diabetes in the mother.
Risk factors for gestational diabetes include:
Gestational diabetes during a previous pregnancy
A family history of type 2 diabetes
Being African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander
Symptoms of Diabetes
Risk Factors, Prevention, and Complications of Diabetes
Diabetes in the U.S.
Diabetes is the seventh leading cause of death in the U.S.4. In 2018, approximately 34.2 million people, or 10.5% of the U.S. population, had diabetes.
Racial Disparities in Diabetes
African American adults are 60% more likely than White adults to be diagnosed with diabetes. The incidence of type 2 diabetes among Blacks has increased significantly over the years, despite remaining stable among Whites. Data from the CDC for 2017-2018 reveals that African-Americans (8.2 per 1,000 persons) had a higher incidence of diabetes than Whites (5.0 per 1,000 persons)1. Furthermore, in 2018, African-Americans were twice as likely as Whites to die from diabetes2.
Source: CDC 2021. National Vital Statistics Report, Vol. 69, No. 13. Table 10.
Racial Disparities in Clinical Trials for Diabetes
Between 2017 and 2021, the FDA approved three new treatments for type 2 diabetes. Despite being 60% more likely than White adults to be diagnosed with diabetes, African-Americans accounted for less than 15% of the clinical participants for these treatments.
Source: FDA Drug Trials Snapshot Report, 2017 and 2021.
These differences in clinical trial enrollment between racial groups contribute to poor outcomes among African-American diabetes patients due to the underutilization of innovative treatments.
We must fight to ensure equal representation of African-Americans in clinical research to address these disparities in diabetes mortality, treatment uptake, and clinical trial enrollment among communities of color. Please join Clinical Diversity Solutions as we gather the information needed to advocate for the inclusion of communities of color in medical research on treatments for diseases that disproportionately affect our community. Click the button below to complete our HIPAA-compliant survey today! Results are confidential, and a biostatistician will analyze the data.
Sources
Centers for Disease Control and Prevention. National Diabetes Statistics Report website. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed November 11, 2022.
Office of Minority Health (OMH). (n.d.). Diabetes and African Americans. https://minorityhealth.hhs.gov/Default.aspx?lvl=4
Diabetes Research Institute Foundation. (2022, May 27). Diabetes Statistics. DRIF. https://diabetesresearch.org/diabetes-statistics/
Advancing Health Equity. (2022, April 6). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/health-equity/index.html