Incident Type 2 Diabetes Mellitus in African American and White Adults

Abstract

Diabetes mellitus imposes a major burden on the public health of the United States, leading annually to more than 300,000 deaths and about $100 billion in total costs.^1,2 Approximately 90% of diabetic Americans are classified as having type 2 diabetes.³ Data from studies of nationally representative samples indicate that, compared with their white counterparts, African American men are 20% to 50% more likely and African American women more than 100% more likely to have⁴ or to develop^5,6 diabetes. One possible explanation for this excess risk is racial differences in the prevalence of established risk factors for type 2 diabetes, such as adiposity, physical inactivity, low socioeconomic status, and family history of diabetes.⁷ The identification of potentially modifiable risk factors as contributors to excess diabetes risk in African Americans would suggest possible targets for prevention strategies. Unfortunately, previous investigations in this area have been limited by cross-sectional study designs,^8-10 samples atypical of the general population,^11,12 and lack of data on diabetes-related health behaviors and traits, such as fasting blood glucose levels.^5,6