Type 2 Diabetes Health Indicators
The clinical focus for this DRIVE Toolkit is to help build equity for type 2 diabetes health outcomes in communities of color.
Impact from Type 2 Diabetes in Communities of Color
Type 2 diabetes accounts for 90% to 95% of all diabetes cases. Communities of color are disproportionately affected by type 2 diabetes. According to the Centers For Disease Control (CDC)’s 2017 Diabetes Report Card:
- American Indian/Alaska Native Patients account for 15.1% of all diabetic patients
- Asian Americans account for 8.0% of all diabetic patients
- Hispanic Americans account for 12.7% of all diabetic patients
- Black, non-Hispanic Americans account for 12.1% of all diabetic patients
- White, non-Hispanic Americans account for 7.4% of all diabetic patients
Likewise, new information from the 2017 Diabetes Report Card shows the following:
- In the past decade, the annual rate of new cases of diabetes among US adults has been going down overall
- Diabetes-related complications have increased among young adults aged 18 to 44 years and among middle-aged adults aged 45 to 64 years
- The rate of new cases of diabetes among children and adolescents continues to grow
- Nearly 1 in 5 adolescents aged 12 to 18 years and 1 in 4 young adults aged 19 to 34 years have prediabetes
Though it is still unclear who specifically can face serious complications from developing type 2 diabetes, research shows:
- Blood sugar management can reduce the risk of eye disease, kidney disease, and nerve disease by 40%
- Blood pressure management can reduce the risk of heart disease and stroke by 33% to 50%, and decline in kidney function by 30% to 70%
- Cholesterol management can reduce cardiovascular complications by 20% to 50%
- Regular eye exams and timely treatment could prevent up to 90% of type 2 diabetes-related blindness
- Regular foot exams and patient education could prevent up to 85% of type 2 diabetes-related amputations
Racial Disparities Exist in Type 2 Diabetes Health Outcomes
People of color experience chronic diseases at a higher rate than their white counterparts, such as heart disease (6x more likely in Black patients), respiratory illness, type 2 diabetes (10x more likely in Hispanic patients), hypertension, heart disease, and obesity. These comorbidities increase the risk of severe illness, complications and death from type 2 diabetes in these populations. Patient education and vaccination against infectious diseases can protect higher risk type 2 diabetes patients from severe outcomes. However, there are significant racial disparities in type 2 diabetes health outcomes, health literacy, patient education, care and management practices, and affordable education access. Namely, a report indicates that 50% of patients do not take their type 2 diabetes medications as prescribed. Anecdotally, patients have described that high medication costs as a main driver of nonadherence.
Since management of type 2 diabetes via medication is essential for some patients, especially patients of color, it is critical to ensure access to medications or communities of color.
Diabetes Self-Management Education and Support (DSMES) Works to Help Manage Type 2 Diabetes
According to the CDC, DSMES is important because:
- Patients with education and support are healthier than those without
- Controlling type 2 diabetes saves time and money, and reduces emergency room visits and hospitalizations
- Education on medication adherence, blood sugar monitoring, and lifestyle changes helps patients improve type 2 diabetes management
- Managing type 2 diabetes properly helps curtail or delay serious health complications
Unacceptable racial disparities and inequities in type 2 diabetes health outcomes require immediate action and collaboration between public health, medical, and community systems.
The DRIVE Toolkit is a framework that can be utilized to help improve type 2 diabetes health outcomes in communities of color.
- Centers for Disease Control and Prevention. (2019, April 15). Addressing Health Disparities in Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/disparities.html. Accessed July 21, 2021.
- Centers for Disease Control and Prevention. (2021, January 4). Diabetes Report Card 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/reports/reportcard.html. Accessed July 21, 2021.
- National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, MD: National Heart, Lung, and Blood Institute; 2004. Accessed July 21, 2021.
- Daniel MJ. Lipid management in patients with type 2 diabetes. Am Health Drug Benefits. 2011;4:312-322.
- Murchison AP, Hark L, Pizzi LT, et al. Non-adherence to eye care in people with diabetes. BMJ Open Diabetes Res Care. 2017;5(1):e000333.
- Lewis EJ, Hunsicker LG, Clarke WR, et al; Collaborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetesexternal icon. N Engl J Med. 2001;345:851-860.
- Geiss LS, Li Y, Hora I, et al. Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult US population. Diabetes Care. 2019;42(1):50-54.