Diabetes Prevalence by Racial Subgroups

The rates of diabetes among Hispanic and Asian American subpopulations are unclear. A cross-sectional study examined the rates of diabetes among adults aged 20 years and older in these groups.

The study included 2011 to 2016 data from the National Health and Nutrition Examination Surveys, representative of the non-institutionalized, civilian population in the United States. Diabetes was either self-reported during interviews or established through measurements of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and two-hour plasma glucose (2hPG). The study’s exposures were race/ethnicity groups non-Hispanic white, non-Hispanic black, Hispanic and Hispanic subgroups (Mexican, Puerto Rican, Cuban/Dominican, Central American, and South American), non-Hispanic Asian and non-Hispanic Asian subgroups (East, South, and Southeast Asian), and non-Hispanic other. The main outcome measure was total diabetes, defined as diagnosed (self-reported diagnosis) or undiagnosed diabetes (no reported diagnosis but with an HbA1c of 6.5% or greater, FPG of 126 mg/dL or greater, or 2hPG of 200 mg/dL or greater.

Final analysis included 7,575 patients (mean age, 47.5 years; 52% were female). The racial breakdown of the study population was 65% non-Hispanic white (n=2,866), 11% non-Hispanic black (n=1,636), 15% Hispanic (n=1,952), 6% non-Hispanic Asian (n=909), and 3% non-Hispanic other (n= 12). Most patients (n=2,266) had diagnosed diabetes, and 377 had undiagnosed diabetes. Weighted age- and sex-adjusted prevalence of total diabetes by race was 12.1% non-Hispanic white (95% confidence interval [CI], 11.0-13.4), 20.4% non-Hispanic black (95% CI, 18.8-22.1), 22.1% Hispanic (95% CI, 19.6-24.7), and 19.1% non-Hispanic Asian (95% CI, 16.0-22.1; P<0.001 for all). The prevalence of total diabetes for Hispanic adults by subgroup was 24.6% Mexican (95% CI, 21.6-27.6), 21.7% Puerto Rican (95% CI, 14.6-28.8), 20.5% Cuban/Dominican (95% CI, 13.7-27.3), 19.3% Central American (95% CI, 12.4-26.1), and 12.3% South American (95% CI, 8.5-16.2; P<0.001 for all). The prevalence of total diabetes for non-Hispanic Asian adults by subgroup was 14.0% East Asian (95% CI, 9.5-18.4), 23.3% South Asian (95% CI, 15.6-30.9), and 22.4% Southeast Asian (95% CI, 15.9-28.9; P=0.02 for all). Undiagnosed diabetes differed among racial groups, at 3.9% among non-Hispanic whites (95% CI, 3.0-4.8), 5.2% among non-Hispanic blacks (95% CI, 3.9-6.4), 7.5% among Hispanics (95% CI, 5.9-9.1), and 7.5% among non-Hispanic Asians (95% CI, 4.9-10.0; P<0.001 for all).