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. 

Sources:

  1. 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.
  2. 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.
  3. 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.
  4. Daniel MJ. Lipid management in patients with type 2 diabetesAm Health Drug Benefits. 2011;4:312-322.
  5. Murchison AP, Hark L, Pizzi LT, et al. Non-adherence to eye care in people with diabetesBMJ Open Diabetes Res Care. 2017;5(1):e000333.
  6. 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 iconN Engl J Med. 2001;345:851-860.
  7. Geiss LS, Li Y, Hora I, et al. Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult US populationDiabetes Care. 2019;42(1):50-54.

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