Inequalities in Diabetes in the USA Volume 2 - Issue 5

Nasser Mikhail MD* and Soma Wali MD

• Department of Medicine, OliveView-UCLA Medical Center, David-Geffen-UCLA School of Medicine, USA

Received: July 01, 2020   Published: July 10, 2020

Corresponding author: Nasser Mikhail MD, Chief, Endocrinology Division, Department of Medicine, OliveView-UCLA Medical Center, David-Geffen-UCLA School of Medicine, USA

DOI: 10.32474/ADO.2020.02.000148

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Abstract

Background: Diabetes disproportionably impacts minorities in the USA.

Objective: To review the latest data regarding diabetes epidemiology and management among different ethnic groups in the USA.

Methods: PubMed research of all pertinent articles up to June 29, 2020. Search terms included diabetes, ethnicity, African Americans, Blacks, Hispanics, Latinos, Asians, minorities, glycemic control, obesity, lifestyle changes, treatment, metformin, sodiumglucose co-transporter 2 inhibitors. Type of studies included are randomized, observational, epidemiological, consensus guidelines, and review articles.

Results: Diabetes prevalence and incidence in adults continue to increase among African Americans and Hispanics. In youths, the fastest increase in type 1 and type 2 diabetes occurs among Asians/Pacific Islanders followed by Hispanics and African Americans. The gap in glycemic control between Whites and minorities is widening. Whereas mortality rates decreased in patients with diabetes overall, the least mortality reduction was observed among Hispanics and non-Hispanic blacks. The diabetes epidemic among nonwhites patients is mainly due to obesity and physical inactivity. Lifestyle changes are generally effective for both prevention and treatment of diabetes among minorities. Metformin may be particularly effective among African Americans. Metformin and sodiumglucose co-transporter 2 (SGLT2) inhibitors are the most convenient drugs for treatment of diabetes in minorities.

Conclusion: Substantial disparities still exist in the USA with respect to diabetes incidence, glycemic control, and mortality.

Keywords: Ethnicity; Disparities; Diabetes; Obesity; Prevention; Treatment; Lifestyle changes

Abstract| Introduction| Disparities in Diabetes Prevalence| Disparities and Trends in Diabetes Incidence| Prevalence of Pre-Diabetes| Disparities in Diabetes in Youths| Disparities in Prevalence of Gestational Diabetes| Diabetes Prevalence Among African Immigrant Population| Disparities in Glycemic Control| Trends and Disparities in Diabetes Care in the US| Disparities in Diabetes-Related Complications| Disparities in Diabetes-Related Mortality| Causes of Ethnic/Racial Diabetes Disparities: Role of Obesity| Guidelines for Diagnosis of Diabetes Among Minorities| Prevention of Diabetes Among Minority Groups| Sodium-Glucose Co-Transporters Type 2 Inhibitors| Glucagon-Like Peptide-1 Receptor Agonists| Amelioration of Patient-Provider Communication| Summary and Current Needs| Introduction|