The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations

Chow, Edward A.; Foster, Henry W.; González, Víctor; McIver, LaShawn

doi:10.2337/diaclin.30.3.130

Cited by 134 publications

(114 citation statements)

References 4 publications

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“…Minority enrollment in cancer clinical trials remains inadequate despite striking racial/ethnic disparities in cancer incidence and mortality [22,23]. Similar incongruities between disease burden and representation in biomedical research exist for cardiovascular diseases and diabetes [24,25]. These disparities have economic consequences: eliminating racial/ ethnic health disparities would have reduced total medical costs during 2003-2006 by more than $1.2 trillion [26].…”

Section: Past Research Has Under-studied Minoritiesmentioning

confidence: 99%

Diversity in Clinical and Biomedical Research: A promise yet to be fulfilled

Galanter

Thakur

et al. 2015

Preprint

115

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Summary Points Health disparities persist across race/ethnicity for the majority of Healthy People 2010 health indicators. Most physicians and scientists are informed by research extrapolated from a largely homogenous population, usually White and male. A growing proportion of Americans are not fully benefiting from clinical and biomedical advances since racial and ethnic minorities make up nearly 40% of the U.S. population. Ignoring the racial/ethnic diversity of the U.S. population is a missed scientific opportunity to fully understand the factors that lead to disease or health. U.S. biomedical research and study populations must better reflect the country's changing demographics. Adequate representation of diverse populations in scientific research is imperative as a matter of social justice, economics, and science.

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Section: Past Research Has Under-studied Minoritiesmentioning

confidence: 99%

Diversity in Clinical and Biomedical Research: A promise yet to be fulfilled

Galanter

Thakur

et al. 2015

Preprint

115

View full text Add to dashboard Cite

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“…Racial/ethnic minorities are at substantially higher risk for type 2 diabetes and continue to experience greater rates of hospitalization due to diabetes-related complications and 50-100 % higher morbidity and mortality than their white counterparts [6][7][8]. To address such health disparities effectively, interventions need to attend to cultural factors to increase engagement of ethnic minority populations in prevention programs [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…In 2007, the cost associated with diabetes was $174 billion [1]. Diabetes and its complications are largely preventable [2,3]; obesity, physical inactivity, and unhealthy eating account for over half of new cases [4,5].Racial/ethnic minorities are at substantially higher risk for type 2 diabetes and continue to experience greater rates of hospitalization due to diabetes-related complications and 50-100 % higher morbidity and mortality than their white counterparts [6][7][8]. To address such health disparities effectively, interventions need to attend to cultural factors to increase engagement of ethnic minority populations in prevention…”

mentioning

confidence: 99%

A review of diabetes prevention program translations: use of cultural adaptation and implementation research

Tabak

Sinclair

Baumann

et al. 2015

Behav. Med. Pract. Policy Res.

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The Diabetes Prevention Program (DPP) has been shown to prevent type 2 diabetes through lifestyle modification. The purpose of this study was to describe the literature on DPP translation, synthesizing studies using cultural adaptation and implementation research. A systematic search was conducted. Original studies evaluating DPP implementation and/or cultural adaptation were included. Data about cultural adaptation, implementation outcomes, and translation strategies was abstracted. A total of 44 were included, of which 15 reported cultural adaptations and 38 explored implementation. Many studies shortened the program length and reported a group format. The most commonly reported cultural adaptation (13 of 15) was with content. At the individual level, the most frequently assessed implementation outcome (n=30) was adoption. Feasibility was most common (n=32) at the organization level. The DPP is being tested in a variety of settings and populations, using numerous translational strategies and cultural adaptations. Implementation research that identifies, evaluates, and reports efforts to translate the DPP into practice is crucial. Keywords Diabetes prevention, Translation, Cultural adaptation, Implementation INTRODUCTIONNearly 26 million people in the USA-8.3 % of the population-have diabetes, and 90-95 % have type 2 diabetes [1]. Diabetes in adults is the leading cause of new cases of blindness, kidney failure, and non-injury amputations of the feet and legs. In 2007, the cost associated with diabetes was $174 billion [1]. Diabetes and its complications are largely preventable [2,3]; obesity, physical inactivity, and unhealthy eating account for over half of new cases [4,5].Racial/ethnic minorities are at substantially higher risk for type 2 diabetes and continue to experience greater rates of hospitalization due to diabetes-related complications and 50-100 % higher morbidity and mortality than their white counterparts [6][7][8]. To address such health disparities effectively, interventions need to attend to cultural factors to increase engagement of ethnic minority populations in prevention

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“…10 AAs had faster cognitive decline following preexisting DM than EAs in old age. 22,23 However, the association of late-life onset of DM with cognitive decline among AAs and EAs is not well-investigated.…”

mentioning

confidence: 99%

Cognitive decline following incident and preexisting diabetes mellitus in a population sample

et al. 2016

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Objective: To examine if incident and preexisting diabetes mellitus (DM) were associated with cognitive decline among African Americans (AAs) and European Americans (EAs).Methods: Based on a prospective study of 7,740 older adults (mean age 72.3 years, 64% AA, 63% female), DM was ascertained by hypoglycemic medication use and Medicare claims during physician or hospital visits, and cognition by performance on a brief battery for executive functioning, episodic memory, and Mini-Mental State Examination (MMSE). Decline in composite and individual tests among those with incident DM, with preexisting DM, and without DM was studied using a linear mixed effects model with and without change point.Results: At baseline, 737 (15%) AAs and 269 (10%) EAs had preexisting DM. Another 721 (17%) AAs and 289 (12%) EAs had incident DM in old age. Following incident DM, cognitive decline increased by 36% among AAs and by 40% among EAs compared to those without DM. No significant difference was observed between AAs and EAs (p 5 0.64). However, cognitive decline increased by 17% among AAs with preexisting DM compared to those without DM, but no increased decline was observed among EAs with preexisting DM. In secondary analyses, faster decline in executive functioning and episodic memory was observed following incident DM. Conclusions:In old age, faster cognitive decline was present among AAs and EAs following incident DM, compared to cognitive decline prior to DM, and among those without DM. This underscores the need for stronger prevention and control of DM in old age. Type 2 diabetes mellitus (DM) is associated with poor cognitive performance.1-4 Several studies have found preexisting DM to be associated with worsening cognition among older women 5,6 and among those with higher severity of DM. [7][8][9] This association appears to be stronger among those who develop DM during midlife, 10-13 particularly among those with a longer duration of DM, 10 and across several areas of cognition including decline in memory 10,11 and executive functioning.10,14 Some studies have reported that incident DM is not associated with worsening cognition, even though these studies found preexisting DM to be associated with cognitive decline.9,15 However, the onset of DM during late life is still not well-understood. The association of preexisting and incident DM during late life (over 65 years of age) has not been wellexamined. It is in this age group that cognitive decline and DM have their highest prevalence and incidence.African Americans (AAs) tend to develop DM earlier and have a higher prevalence and incidence of DM than European Americans (EAs). [16][17][18] A racial difference in the association of DM with poor cognitive function is believed to be mediated by poverty 19 and vascular risk factors. 20 No difference in the association of DM with cognition was found in a cross-sectional study, 21 or in long-term change in cognition following an onset during midlife.

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The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations

Cited by 134 publications

References 4 publications

Diversity in Clinical and Biomedical Research: A promise yet to be fulfilled

Diversity in Clinical and Biomedical Research: A promise yet to be fulfilled

A review of diabetes prevention program translations: use of cultural adaptation and implementation research

Cognitive decline following incident and preexisting diabetes mellitus in a population sample

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