Multi-Ethnic Study Finds Diabetes Complications Differ Across Minority Groups

Previous research on this topic has been limited to white populations

Asian, Hispanic, and Black people with diabetes differ in their development of complications like kidney failure and heart disease depending on their disease profile, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Disparities in diabetes research, treatment, and prevention for Asian, Hispanic, and Black people contribute to worse outcomes for these individuals. Defining new subgroups of diabetes and how they vary by race/ethnicity could help clinicians better understand diabetes risks and complications among minorities and lead to better health outcomes.

“Prior research on diabetes subgroups has shown that some subgroups have different risks for diabetes complications but has largely been limited to white study populations,” says study author Michael Bancks, PhD, MPH, of the Wake Forest School of Medicine in Winston-Salem, N.C. “The topic of diabetes subgroups is an important research question, and our work expanded the study population to include South Asians, non-Hispanic whites, Chinese, Hispanic, and Black people to make this area of research more applicable to a broader population.”

The authors identified five diabetes subgroups among 1,293 participants from two multi-ethnic U.S. study populations: older age at diabetes onset, younger age at onset, severe hyperglycemia, severe obesity, and individuals requiring insulin medication use.

The most common subgroup was older onset for all race/ethnicities except for South Asians where the severe hyperglycemia subgroup was most likely. These five diabetes subgroups differed in their development of complications like kidney failure and heart disease, with some subgroups having lower risk for complications than others, even after accounting for racial/ethnic disparities in risk for these complications.

Other authors of the study include: Alain Bertoni, Haiying Chen, and David Herrington of the Wake Forest School of Medicine; Mercedes Carnethon and Namratha Kandula of the Northwestern University Feinberg School of Medicine in Chicago, Ill.; Mary Frances Cotch of the National Eye Institute of the National Institutes of Health in Bethesda, Md.; Unjali Gujral of the Emory University Rollins School of Public Health in Atlanta, Ga.; Alka Kanaya of the University of California San Francisco in San Fransisco, Calif.; Moyses Szklo of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Md.; and Dhananjay Vaidya of the Johns Hopkins University School of Medicine in Baltimore, Md.

The manuscript received funding from the National Institutes of Health and the National Center for Advancing Translational Sciences.

The manuscript, “Association of Diabetes Subgroups with Race/Ethnicity, Risk Factor Burden and Complications: the MASALA and MESA Studies,” was published online, ahead of print.