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According to statistics from the Centers for Disease Control and Prevention (CDC), diabetes affects more than 34 million children, teens, 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 percent more likely to be diagnosed with diabetes than non-Hispanic white Americans.

In this article, we’ll discuss why diabetes is more prevalent in Black Americans, how to lower your risk of developing diabetes, and resources for support 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 in non-Hispanic Blacks is 11.7 percent, versus only 7.5 percent in non-Hispanic whites.
  • Asian Americans are slightly more affected by diabetes than white Americans, with a prevalence of 9.2 percent.
  • Hispanics and American Indians/Alaskan Natives have the highest rates of diabetes, at 12.5 percent and 14.7 percent, respectively.

Among non-Hispanic Black Americans in 2018, the prevalence of diabetes was 13.4 percent in Black men versus 12.7 percent in 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 experience complications from diabetes.

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

End stage renal disease due to diabetes is also 2.6 times more prevalent in Black Americans than non-Hispanic white Americans.

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

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

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

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

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

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

Genetic factors

In the past, scientists proposed the “thrifty gene” as a theory for the increased rates of diabetes in Black Americans. According to this theory, previous populations who were exposed to periods of famine were thought to be more likely to efficiently store fat, especially in periods of plenty.

In modern America, according to this theory, it would equate to an increase in overall body weight, and thus an increase in diabetes.

However, given the fact that African Americans are an extremely diverse population, especially genetically, this theory doesn’t necessarily hold up.

Instead, another theory suggests that a higher prevalence of G6PD deficiency in Black males, paired with the typical “Western diet“ may contribute to a higher diabetes risk.

Health factors

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

When paired with lower physical activity levels, particularly in Black women and adolescent girls, the risk of diabetes is greatly increased.

Research has also suggested that insulin resistance is more prevalent in Black Americans, especially in Black adolescents. Since insulin resistance is tied to the development of type 2 diabetes, this may explain the increased risk of this condition.

Still, there is no single risk factor for diabetes, including in Black Americans.

Social factors

Socioeconomic factors have an impact on healthcare outcomes and the risk of developing certain health conditions.

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

In addition, under-resourced socioeconomic groups experience higher levels of stress, which is believed to increase diabetes risk in people who are predisposed to the disease.

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

Regular checkups are one of the best ways to prevent the development of type 2 diabetes. During these checkups, there are several tests your healthcare professional can use to check your blood sugar levels and determine your risk of developing diabetes.

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

Fasting blood glucose levels

  • Normal range. Less than 100 milligrams per deciliter (mg/dL).
  • Indicates prediabetes. Between 100–125 mg/dL.
  • Indicates diabetes. Higher than 125 mg/dL on two occasions.
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An oral glucose tolerance test measures your blood sugar levels over the course of 2 hours after drinking a sugary drink, with results indicating the following:

Oral glucose tolerance test levels

  • Normal range. Less than 140 mg/dL.
  • Indicates prediabetes. Between 140–199 mg/dL.
  • Indicates diabetes. Higher than 200 mg/dL.
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An A1C test measures your average blood sugar levels from the past 2 to 3 months, with results indicating the following:

A1C test results

  • Normal range. Less than 5.7 percent.
  • Indicates prediabetes. Between 5.7 and 6.4 percent.
  • Indicates diabetes. Higher than 6.4 percent.
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If your blood sugar levels are within the prediabetes range, your doctor will likely recommend making certain lifestyle changes to reduce your risk of developing diabetes.

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

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

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

Some of these changes include:

  • Weight management. Although weight isn’t the sole indicator of health status, being overweight can increase your risk of developing type 2 diabetes. If you carry excess weight, even losing 5 to 10 percent of your body weight can reduce your risk of diabetes.
  • Dietary changes. Eating a balanced, well-rounded diet can help lower your risk of developing diabetes. Filling your plate with whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats can help with weight and blood sugar management. Try to avoid high fat, high calorie foods.
  • Regular exercise. Exercising regularly can help reduce the risk of many chronic conditions, including type 2 diabetes. Experts recommend getting at least 150 minutes of physical activity a week. You can break this down into 30 minutes of physical activity at least 5 days each week, or 22 minutes of exercise each day.
  • Stress management. Research suggests that chronic stress can have a negative impact on health and increase the risk of many health conditions. Activities like mindfulness, meditation, and gentle exercise are just a few ways to reduce your stress, both short-term and long-term.
  • Regular checkups. If you’re at a higher risk of developing type 2 diabetes, it’s important to schedule regular checkups with a doctor. Your doctor can work with you to identify lifestyle changes that may 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 live with your condition. The following resources may be especially helpful.

Diabetes resources

  • The Association of Diabetes Care & Education SpecialistsTools and Resources page provides information on resources for accessibility, peer support, and more.
  • The Alliance to Reduce Disparities in DiabetesResources for African Americans with Diabetes page shares information on the different diabetes resources available online.
  • The Office of Minority Health’s OMH Resource Center provides information on health conditions in minority populations, for both patients and healthcare professionals.
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Diabetes is more prevalent in certain racial and ethnic groups, including Indigenous, Hispanic, and Black Americans. A variety of genetic, health, and social factors contribute to higher diabetes rates in Black Americans.

Research suggests that the biggest impact comes from a higher rate of obesity among Black men and women.

If you’re concerned about your risk of developing diabetes, reach out to a healthcare professional to discuss your concerns and explore the steps you can take to reduce your risk.