Association of Modifiable Risk Factors in Young Adulthood With Racial Disparity in Incident Type 2 Diabetes During Middle Adulthood

Abstract

The prevalence of type 2 diabetes among black adults in the United States is nearly twice that of their white counterparts, and the difference in prevalence and incidence between black and white adults has increased between 1980 and 2012.^1-3 Brancati et al⁴ first described the relative association of established diabetes risk factors with the racial differences observed in diabetes incidence in middle-aged and older adults in 2000. However, racial and ethnic minority populations remain at higher risk for incident diabetes and its complications, leading the American Diabetes Association to prioritize the elimination of disparities in diabetes research, treatment, and education.⁵ Epidemiological studies have identified factors at the individual and neighborhood levels that are associated with the excess prevalence of diabetes among black vs white individuals, but those studies include middle-aged and older-aged populations.^4,6-12 However, since 2002, diabetes incidence has increased most rapidly among black youth and young adults as compared with white individuals in the same age groups.¹³