A new study in The Journal of Clinical Endocrinology & Metabolism has revealed that Black/African Americans are significantly more likely to develop severe insulin-deficient diabetes (SIDD), a more serious form of the disease, compared to White Americans. Using data-driven cluster analysis, a technique widely used within the field of artificial intelligence (AI) and Machine Learning, researchers found that racial background more than lifestyle plays a major role in diabetes subtypes, shedding light on potential disparities in disease severity and treatment outcomes.
Diabetes is not a single condition but a collection of subtypes with different causes and effects on the body. Previous research has identified several distinct clusters of diabetes, but most studies have primarily focused on White populations. This new study, conducted by researchers at the University of Alabama at Birmingham, aimed to analyze diabetes patterns in a more diverse population, particularly in the Deep South.
If Black patients are more likely to develop severe insulin-deficient diabetes, they may require earlier intervention and more aggressive treatment strategies to manage the disease effectively and prevent complications.
The study reviewed electronic health records of 89,875 adults diagnosed with diabetes between 2010 and 2019. Approximately 42% of the study population was Black/African American, allowing researchers to compare how diabetes subtypes vary by race. Researchers used hierarchical cluster analysis to classify patients into different diabetes subtypes based on six key biological markers, including glutamic acid decarboxylase autoantibody levels, hemoglobin A1c, body mass index (BMI), age at diagnosis, and insulin function indicators (HOMA2-B and HOMA2-IR).
The results showed a significant difference in diabetes cluster distribution between Black and White patients. Black Americans were nearly twice as likely to be diagnosed with severe insulin-deficient diabetes (SIDD) — a form of diabetes characterized by impaired insulin production and higher risks for serious complications. Surprisingly, the study found that Black Americans with SIDD had a greater impairment in beta-cell function, which is responsible for producing insulin, despite not being more obese or insulin resistant than White patients. This challenges common assumptions that obesity and insulin resistance are the primary factors driving diabetes severity in Black populations. Additionally, Black Americans with SIDD faced a higher risk of complications, suggesting that the condition may be more aggressive in this group.
These findings highlight the importance of considering racial differences in diabetes diagnosis and treatment. If Black patients are more likely to develop severe insulin-deficient diabetes, they may require earlier intervention and more aggressive treatment strategies to manage the disease effectively and prevent complications.
The study’s lead researchers emphasize the need for personalized treatment approaches rather than a one-size-fits-all method. They also stress the importance of improving access to healthcare and diabetes management resources for Black communities, who already experience higher rates of diabetes-related complications. “Overall, awareness of these different type 2 diabetes clusters and their clinical features should enhance the ability of physicians to tailor diabetes treatment to their individual patients, thereby representing an important step toward precision diabetes,” the authors write in “Data-driven Cluster Analysis Reveals Increased Risk for Severe Insulin-deficient Diabetes in Black/African Americans,” adding, adding that “future studies in different parts of the world will be necessary in order to validate and obtain a global picture of these type 2 diabetes clusters and their implications.”
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