Diabetes and minorities

by Frank Monney, MBS 2019, Geisinger Commonwealth School of Medicine

Mentor: Raj Kumar, PhD


Diabetes can be considered a residual disorder in the United States; that means that the risk factors and the prevention measures for diabetes are widely known but there seems to be an issue on how to stop the higher rates of diabetes. Diabetes is a very important issue for public health because of the different associated health outcomes that serve as risk factors for the disease; obesity, high blood pressure etc. In simple terms, diabetes refers to having too much sugar in the blood.

Looking more into the disease and how it affects populations in the United States, there is striking evidence that segregates the rate of diabetes among different populations. In the United States, the highest rates of diabetes are seen among Native Americans, followed by African Americans. However, among Native Americans, there have been successful population-based interventions that resulted in Native Americans having the fastest dropping rates of diabetes among minorities.

Such facts led me to looking into what would be the reason for the observed disparity of diabetes rates in African Americans as compared to other populations. After finding the reasons for these disparities, how can we come up with a care plan that is tailored to the diabetic African American population?

 Researchers used different study designs and looked at what could be contributing to these differences in the rates of diabetes among populations in the United States. The evidence that they came up with suggests that some genes called “thrifty genes” could potentially be involved in higher diabetic rates among African Americans. Thrifty genes were defined as genes among people of African descent that are thought to be helpful in times of drought and famine in Africa. With African people moving to the United States, in a place of relative abundance, those genes could now be detrimental in diabetic predisposition. Another aspect of the study that came up was the relationship between low socioeconomic status and higher diabetic rates. This relates back to the systems of oppression that are deeply rooted in the history of this country. Black people attended segregated schools, which led to low paying jobs and eventually to food deserts in black neighborhoods.

Across the board, diabetic African American populations in the United States not only have higher rates, but they also have more serious complications due to the disease. Another important fact that came up was the role of the church and religion in the black community and the care for diabetes. A lot of diabetic African Americans reported that they looked to God when thinking about the progression of their disease and overall health. Looking at that data, we can use black churches as a medium to educate diabetic populations on how to care and prevent diabetes.

Using this pertinent information that surrounds diabetic rates in the African American populations, we can develop a tailored treatment plan. Seeing that the disease does not affect population in a uniform manner, the approach to care of diabetes should also not be “one size fits all”. Another important finding from our review revealed a genetic similarity between diabetic Mexican Americans and diabetic African Americans. I believe that looking at minorities’ diabetic populations in the United States and comparing them could reveal much more information as opposed to always using non-Hispanic Whites as the “standard” or the control in population health studies. Lastly, targeting a disease such as diabetes requires thorough investigation into policy making and public health decisions in order to make sure all populations have the same chances from the start.