Changes in racial/ethnic disparities in the prevalence of Type 2 diabetes by obesity level among US adults

Abstract

Objective Ethnic minority status and obesity are two independent risk factors for type 2 diabetes (T2D). There is no clear understanding of how they may have interacted and influenced disparities in T2D prevalence over time. This study examined the trends in racial/ethnic disparities in the prevalence of T2D by weight status among US adults. Methods We used nationally representative data from the National Health and Nutrition Examination Surveys (NHANES) I (1971–1975), II (1976–80), and III (1988–1994), and 1999–2004 among 49,574 adults aged 20–74 years. The prevalence of diagnosed and undiagnosed T2D were estimated by race/ethnicity groups (non-Hispanic white, non-Hispanic black, and Mexican American) and body mass index (BMI) groups (normal, 18.5–24.9; overweight, 25–29.9; obese, 30–34.9; severely obese, >=35). We used logistic regression controlling for age, gender, and education to estimate the odd ratio of T2D across race/ethnicity and BMI groups. Results Trends in racial/ethnic disparities in prevalence of diagnosed T2D varied by BMI. Normal weight group saw increasing racial disparities. In the overweight group, ethnic disparities worsened as diabetes prevalence increased 33.3% in whites, compared to 60.0% in blacks and 227.3% in Mexican Americans. Minimal racial/ethnic disparities were observed in obese and severely obese groups over time. In contrast to diagnosed diabetes, overall racial/ethnic disparities in undiagnosed T2D declined in all BMI groups. Conclusions Racial/ethnic disparities in diabetes prevalence have become most pronounced among normal and overweight groups. Eliminating racial/ethnic disparities in diabetes will require prevention efforts not only in obese minority individuals, but also in normal and overweight minority individuals.

Health Literacy and Antidepressant Medication Adherence Among Adults with Diabetes: The Diabetes Study of Northern California (DISTANCE)

“…2,15,16 Nationally, African American, Hispanic, American Indian/Alaska Native, and multiracial individuals, as well as people who did not speak English before entering school, have worse health literacy than white Americans and those who spoke only English prior to school. 2 Similarly, across the United States, African American, Hispanic, American Indian/Alaska Native, and Asian Americans have a higher prevalence of diabetes and its complications than white Americans, with disparities in diabetes prevalence growing over time.…”

“…2 Similarly, across the United States, African American, Hispanic, American Indian/Alaska Native, and Asian Americans have a higher prevalence of diabetes and its complications than white Americans, with disparities in diabetes prevalence growing over time. 15,16 Several studies have also reported that both Hispanic and African American patients prefer counseling over antidepressant medication when treating affective illness, which could influence adherence to these medications. Furthermore, diabetes control is more closely linked with depression and missing medication doses among African American relative to white patients.…”

Frequency of Obesity and Concomittant Diseases in Patients with Obstructive Sleep Apnea Syndrome OSAS

“…ABD'de yapılan NHANES araştırması 1960'lı yıllardan 2000'li yıllara, 20-74 yaş grubu erişkinlerde VKİ'nin ortalama 25 kg/m 2 'den 28 kg/m 2 'ye çıktığını göstermiştir [8]. Dünya Sağlık Örgütü (DSÖ) verilerine göre ise 2015 yılı içinde dünya nüfusunun yaklaşık %10'un obez olacağı tahmin edilmektedir [9].…”

Magic Strategies: the basic biology of multilevel, multiscale, health promotion

“…The role of epigenetic and environmental factors in type 2 diabetes has long been known (e.g., Zhang et al, 2009;Wallach and Rey, 2009). Haataja et al (2008), for example, conclude that the islet in type 2 diabetes shows much in common with neuropathology in neurodegenerative diseases where interest is now focused on protein misfolding and aggregation and the diseases are now often referred to as unfolded protein diseases.…”