Diabetes in African Americans: Risk and Prevention


According to statistics from the Centers for Disease Control and Prevention (CDC), diabetes affects more than 34 million children, adolescents and adults in the United States.

Although diabetes affects people of all races and ethnicities, it is more prevalent in certain racial and ethnic groups. In fact, non-Hispanic African Americans are 60% more likely to be diagnosed with diabetes than non-Hispanic white Americans.

In this article, we’ll explain why diabetes is more prevalent among black Americans, how to lower your risk of developing diabetes, and support resources if you’ve been diagnosed with diabetes.

While diabetes can affect people within any racial or ethnic group, it disproportionately affects people of certain racial or ethnic backgrounds.

  • According to the American Diabetes Association (ADA), the prevalence of diabetes among non-Hispanic blacks is 11.7%, compared with just 7.5% among non-Hispanic whites.
  • Asian Americans are slightly more affected by diabetes than white Americans, with a prevalence of 9.2%.
  • Hispanics and Native Americans / Alaska Natives have the highest rates of diabetes, at 12.5% ​​and 14.7%, respectively.

Among non-Hispanic black Americans in 2018, the prevalence of diabetes was 13.4% among black men compared to 12.7% among black women, according to statistics from the Office of Minority Health.

In addition to having higher rates of diabetes, black Americans are also more likely to suffer from complications from diabetes.

For example, the rates of diabetic retinopathy are 46% higher in African Americans than in non-Hispanic whites.

End-stage kidney disease from diabetes is also 2.6 times more common in black Americans than in non-Hispanic white Americans.

Diabetes is an umbrella term for multiple conditions that cause the body’s ability to metabolize glucose, secrete insulin, or both to malfunction.

When you take in glucose (sugar) from the food you eat, you need a hormone called insulin. Insulin is released by the beta cells in your pancreas. When insulin reaches the cells in your body, it attaches to receptors that help cells identify and absorb glucose from your bloodstream.

  • Type 1 diabetes is an autoimmune disease that most commonly develops in childhood. With type 1 diabetes, the body attacks the beta cells in the pancreas, limiting their ability to produce insulin. Without enough insulin, cells cannot absorb glucose, which in turn causes high blood sugar.
  • Type 2 diabetes is a type of chronic disease that often begins in adulthood. With type 2 diabetes, it becomes more difficult for your body to recognize insulin, a condition called insulin resistance. Without an adequate insulin response, it becomes more difficult for your cells to absorb glucose and, as a result, blood sugar levels rise.

While type 1 diabetes is only caused by a lack of insulin, type 2 diabetes can be caused by both insulin sensitivity and a lack of insulin.

However, the insulin deficiency in type 2 diabetes is not autoimmune. Instead, it happens because the pancreas cannot meet the increased demand for insulin due to insulin resistance.

Older research from 2005 suggested that an increased prevalence of type 2 diabetes in African Americans could be due to genetic and environmental factors. Let’s take a closer look at these factors.

Genetic factors

In the past, scientists have proposed the “thrifty gene” as a theory for increasing rates of diabetes in black Americans. According to this theory, it was believed that previous populations who had been exposed to times of famine were more likely to store fat efficiently, especially in times of plenty.

In modern America, according to this theory, this equates to an increase in overall body weight, and therefore to an increase in diabetes.

However, given that African Americans are an extremely diverse population, especially genetically, this theory does not necessarily hold.

Instead, another theory suggests that a higher prevalence of G6PD deficiency in black men, associated with the typical “Western diet”, may contribute to a higher risk of diabetes.

Health factors

Obesity is one of the most important risk factors for the development of type 2 diabetes. Black Americans, especially black women, have statistically higher obesity rates than white Americans. Research has shown that black Americans face inequalities, such as lower socioeconomic status and limited access to nutritious foods, which can contribute to these higher rates of obesity.

When paired with lower levels of physical activity, especially in black women and teenage girls, the risk of diabetes is dramatically increased.

Research has also suggested that insulin resistance is more prevalent among black Americans, especially black teens. Since insulin resistance is linked to the development of type 2 diabetes, this may explain the increased risk of this disease.

Yet there is no single risk factor for diabetes, including in black Americans.

Social factors

Socio-economic factors have an impact on health care outcomes and the risk of developing certain health problems.

In 2014 study, researchers studied the link between poverty and the prevalence of diabetes. According to this study, black Americans and poor white Americans have higher rates of diabetes than non-poor white Americans.

In addition, underfunded socio-economic groups experience higher levels of stress, which is believed to increase the risk of diabetes in those predisposed to the disease.

Many studies have shown associations between acute stress and long-term stress and the development of diabetes. However, more research is still needed.

Regular check-ups are one of the best ways to prevent the development of type 2 diabetes. During these check-ups, your healthcare professional may use several tests to check your blood sugar and determine your risk for developing diabetes.

A fasting blood sugar test measures your blood sugar after an 8 to 12 hour fast, with results indicating the following:

An oral glucose tolerance test measures your blood sugar within 2 hours of consuming a sugary drink, with results indicating the following:

An A1C test measures your average blood sugar over the past 2-3 months, with results indicating the following:

If your blood sugar is in the prediabetes range, your doctor will likely recommend some lifestyle changes to lower your risk of developing diabetes.

If your blood sugar indicates that you have diabetes, your doctor will work with you to find the right plan to manage your diabetes.

Even if you are at increased risk of developing type 2 diabetes, there are steps you can take to reduce your risk.

According to the Diabetes Prevention Program study, people who maintained certain lifestyle changes reduced their risk of developing type 2 diabetes by 58 percent over 3 years. This applied to all racial and ethnic groups.

Some of these changes include:

  • Weight management. Although weight is not the only indicator of health, being overweight can increase the risk of developing type 2 diabetes. If you are overweight, even losing 5 to 10 percent of your body weight. can lower your risk of diabetes.
  • Dietary changes. Eating a balanced and well-balanced diet can help lower your risk of developing diabetes. Filling your plate with whole foods like fruits, vegetables, whole grains, lean protein, and healthy fats can help with weight and blood sugar management. Try to avoid foods high in fat and calories.
  • Regular exercise. Regular exercise can help reduce the risk of many chronic diseases, including type 2 diabetes. Experts recommend getting at least 150 minutes of physical activity per week. You can break it down into 30 minutes of physical activity at least 5 days a week, or 22 minutes of exercise a day.
  • Stress management. Research suggests that chronic stress can negatively impact health and increase the risk of many health problems. Activities like mindfulness, meditation, and gentle exercise are just a few ways to reduce your stress, both short and long term.
  • Regular checks. If you are at a higher risk of developing type 2 diabetes, it is important to schedule regular check-ups with a doctor. Your doctor can work with you to identify lifestyle changes that can help further reduce your risk.

If you’ve been diagnosed with diabetes, there are resources available to help you learn more about how to manage your blood sugar and how to live with your disease. The following resources can be particularly helpful.

Diabetes is more prevalent in certain racial and ethnic groups, including Native Americans, Hispanics, and Black Americans. A variety of genetic, health, and social factors contribute to higher rates of diabetes among black Americans.

Research suggests that the biggest impact comes from a higher obesity rate in black men and women.

If you are concerned about your risk of developing diabetes, contact a healthcare professional to discuss your concerns and explore steps you can take to lower your risk.


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