Risk Factors Amenable to Primary Prevention of Type 2 Diabetes Among Disaggregated Racial and Ethnic Subgroups in the U.S.

Abstract

OBJECTIVE Race and ethnicity data disaggregated into detailed subgroups may reveal pronounced heterogeneity in diabetes risk factors. We therefore used disaggregated data to examine the prevalence of type 2 diabetes risk factors related to lifestyle behaviors and barriers to preventive care among adults in the U.S. RESEARCH DESIGN AND METHODS We conducted a pooled cross-sectional study of 3,437,640 adults aged ≥18 years in the U.S. without diagnosed diabetes from the Behavioral Risk Factor Surveillance System (2013–2021). For self-reported race and ethnicity, the following categories were included: Hispanic (Cuban, Mexican, Puerto Rican, Other Hispanic), non-Hispanic (NH) American Indian/Alaska Native, NH Asian (Chinese, Filipino, Indian, Japanese, Korean, Vietnamese, Other Asian), NH Black, NH Pacific Islander (Guamanian/Chamorro, Native Hawaiian, Samoan, Other Pacific Islander), NH White, NH Multiracial, NH Other. Risk factors included current smoking, hypertension, overweight or obesity, physical inactivity, being uninsured, not having a primary care doctor, health care cost concerns, and no physical exam in the past 12 months. RESULTS Prevalence of hypertension, lifestyle factors, and barriers to preventive care showed substantial heterogeneity among both aggregated, self-identified racial and ethnic groups and disaggregated subgroups. For example, the prevalence of overweight or obesity ranged from 50.8% (95% CI 49.1–52.5) among Chinese adults to 79.8% (73.5–84.9) among Samoan adults. Prevalence of being uninsured among Hispanic subgroups ranged from 11.4% (10.9–11.9) among Puerto Rican adults to 33.0% (32.5–33.5) among Mexican adults. CONCLUSIONS These findings underscore the importance of using disaggregated race and ethnicity data to accurately characterize disparities in type 2 diabetes risk factors and access to care.

Association of Gut Microbiota-Related Metabolites and Type 2 Diabetes in Two Puerto Rican Cohorts

“…Hispanic individuals living in the U.S. have a high prevalence of cardiometabolic risk factors and incidence of diabetes, compared to non-Hispanic White individuals [15]. In particular, Puerto Ricans are the second largest Hispanic sub-group in the US [16], and among Hispanic sub-groups, they have the highest prevalence of type 2 diabetes [17] and higher prevalence of cardiometabolic diseases, along with established health disparities [18,19]. Therefore, the aim of this study was to examine whether baseline circulating L-carnitine, betaine, choline, and TMAO are associated with baseline and longitudinal changes in cardiometabolic risk factors (anthropometrics, glycemia measures, and dyslipidemia measures) as well as prevalent and incident type 2 diabetes in two Puerto Rican cohorts.…”