Diabetes in African Americans: Understanding Risks, Impacts, and Prevention

Explore the complexities of diabetes in African Americans, including prevalence, risk factors, prevention, diagnosis, and support resources.

By Medha deb

Created on Sep 25, 2025

Explore the complexities of diabetes in African Americans, including prevalence, risk factors, prevention, diagnosis, and support resources.

Diabetes is a serious and chronic condition affecting over 34 million people in the United States. While it impacts all racial and ethnic groups, African Americans face significantly higher risks of developing diabetes—and its associated complications—compared to non-Hispanic white peers. Understanding these disparities, including their causes, impacts, and paths to prevention, is crucial for reducing the burden of diabetes on Black communities.

Facts About Diabetes and Race
Type 1 vs. Type 2 Diabetes
Diabetes in Black Americans: Prevalence and Impact
Diagnosis and Barriers to Care
Prevention: Lowering Your Risk
Resources for Support
Frequently Asked Questions

Facts About Diabetes and Race

While diabetes knows no boundaries, evidence shows that race and ethnicity play a major role in both risk and outcomes:

Non-Hispanic Black Americans have a diabetes prevalence of approximately 11.7%, markedly higher than the 7.5% observed in non-Hispanic whites.
Asian Americans follow with a rate of 9.2%.
Hispanic (12.5%) and American Indian/Alaskan Native (14.7%) communities experience the highest prevalence.
Among Black Americans in 2018, prevalence rates were 13.4% for men and 12.7% for women.

The data highlight a sobering reality: Black Americans not only face a higher likelihood of developing diabetes but are also more vulnerable to life-altering complications including kidney failure, vision loss, and even premature death.

**Prevalence of Diagnosed Diabetes by Race/Ethnicity**
Group	Prevalence (%)
Non-Hispanic Black Americans	11.7 – 13.4
Non-Hispanic White Americans	7.2 – 7.5
Asian Americans	9.2
Hispanics	12.5
American Indian/Alaskan Natives	14.7

Black Americans are also more likely to:

Experience diabetic retinopathy, with rates approximately 46% higher than whites.
Progress to end-stage renal disease (ESRD) due to diabetes at a rate 2.6–3 times higher than non-Hispanic whites.
Face hospitalization and death from diabetes at significantly elevated rates.

Type 1 vs. Type 2 Diabetes

Two main forms of diabetes exist, but they differ substantially in causes and demographics:

Type 1 Diabetes is an autoimmune condition where the body attacks its own insulin-producing cells, commonly diagnosed in children and young adults. It is less linked to lifestyle, and much less common than type 2 diabetes.
Type 2 Diabetes is driven by a combination of genetic, lifestyle, and environmental factors and accounts for the vast majority of cases (especially among adults). It involves insulin resistance, where the body either doesn’t produce enough insulin or cannot use it efficiently.

Type 2 diabetes is strongly associated with higher rates in Black Americans, while type 1 diabetes remains comparatively rare.

Diabetes in Black Americans: Prevalence and Impact

Statistics make clear that Black Americans are 60% more likely to be diagnosed with diabetes than non-Hispanic whites. This elevated risk is observed in men and women, with some reports noting higher rates among Black women compared to men. Notably, the increased risk does not stop at diagnosis; it extends to severe complications and mortality rates.

Differences by Gender

**Gender-Based Prevalence among Non-Hispanic Black Adults (2019–2021)**
Gender	Prevalence (%)
Men	11.5
Women	12.5

Complication Risks

Black individuals with diabetes are markedly more likely to suffer from end-stage kidney disease (sometimes as much as 2.6–3 times more than their white counterparts).
Rates of diabetic retinopathy, a major cause of vision loss, are nearly 50% higher among African Americans.
Hospitalizations for uncontrolled diabetes and diabetes-related deaths are also substantially more frequent in Black communities.

Underlying Causes of Disparities

Several intersecting factors help explain these health inequities:

Socioeconomic status (SES): Lower average SES can hinder access to healthy foods, preventive care, and diabetes management resources.
Environmental factors: Lack of access to safe spaces for exercise, neighborhood food deserts, stressful environments, and poorer healthcare infrastructure can all contribute to increased diabetes risk.
Genetics and physiology: Some research indicates genetic predispositions can influence insulin resistance and obesity risk, albeit not the sole explanation.
Healthcare biases and barriers: Experiences of discrimination, lower diagnosis rates, language barriers, and mistrust in medical systems reduce both preventive care and disease management among Black Americans.

Diagnosis and Barriers to Care

Timely and accurate diagnosis is critical for effective management of diabetes, yet Black Americans encounter numerous obstacles to care:

Underdiagnosis: Socioeconomic inequality and reduced access to routine screening can delay diagnosis and treatment.
Limited awareness: Several studies indicate that many Black Americans may be unaware of prediabetes or early-stage symptoms.
Insurance gaps: Health insurance status greatly affects access to preventive care, screenings, and essential medications.

Screening and Diagnostic Tools

A1C Test: Measures average blood glucose over approximately three months.
Fasting Plasma Glucose: Checks fasting blood sugar levels after an overnight fast.
Oral Glucose Tolerance Test (OGTT): Evaluates the body’s response to sugar over several hours.
Random Blood Sugar Test: Measures current blood sugar levels, though less commonly used for diagnosis.

Regular health checkups and early screening are the cornerstone of effective diabetes management and prevention in high-risk populations.

Prevention: Lowering Your Risk

Despite elevated risk, type 2 diabetes is largely preventable through proactive lifestyle and health management:

Maintain a healthy body weight: Obesity is one of the most significant risk factors for type 2 diabetes. Aim for a BMI in the healthy range.
Eat a balanced diet: Favor fresh vegetables, whole grains, lean proteins, and minimize processed foods and excess sugar intake. Traditional eating patterns, such as the “soul food” diet, can be adapted for health by using healthy fats, reducing salt and sugar, and choosing grilled rather than fried proteins.
Engage in regular physical activity: The CDC recommends at least 150 minutes per week of moderate-intensity exercise, such as brisk walking, biking, or swimming.
Routine health screenings: Early identification of prediabetes or diabetes is possible with regular checkups and blood tests, especially for those with family history or other risk factors.
Manage blood pressure and cholesterol: Cardiovascular health is tightly linked to diabetes risk, so monitoring these factors is important.

Healthcare providers, community leaders, and families can play a pivotal role in both education and empowerment around diabetes prevention.

Resources for Support

Receiving a diagnosis of diabetes can be overwhelming, but there are many organizations and community resources available to provide support and guidance:

American Diabetes Association: Offers up-to-date educational materials on prevention, management, and living well with diabetes.
Office of Minority Health (OMH): Develops culturally sensitive materials and leads initiatives targeted at minority health disparities.
Local churches, health clinics, and community groups: Often provide outreach programs, diabetes screenings, and peer support for African Americans living with the disease.
Certified Diabetes Educators (CDEs): Specialists in diabetes management, nutrition, and lifestyle support.

Proactively seeking out information and building a network of support can ease both the physical and emotional challenges of diabetes.

Frequently Asked Questions (FAQs)

Q: Why is diabetes more common in African Americans?

A complex mix of factors—including genetics, systemic inequalities, neighborhood environments, traditions around food, lower average access to healthcare, and economic barriers—all contribute to a higher prevalence of diabetes in Black populations.

Q: Is type 1 diabetes also more common among African Americans?

No, type 1 diabetes does not show the same racial or ethnic disparities. The increased prevalence in African Americans almost entirely reflects type 2 diabetes.

Q: What complications are African Americans with diabetes most at risk for?

Diabetic retinopathy (leading to blindness), kidney failure (end-stage renal disease), heart disease, nerve damage, hospitalizations, and a higher risk of diabetes-related deaths.

Q: What are the best ways to reduce my risk?

Adopt a healthy lifestyle that includes a balanced diet, physical activity, regular screenings, weight management, and good control of blood pressure and cholesterol. Seek medical advice and community support as needed.

Q: What should I do if I think I am at risk or have symptoms?

Speak with a healthcare provider as soon as possible. Early screening and intervention can greatly improve long-term outcomes.

Bottom Line

Diabetes remains a threat to the health and well-being of African American communities, as a result of interwoven socio-economic, genetic, and environmental forces. With sustained focus on prevention, early diagnosis, better access to healthcare, and culturally relevant support, it is possible to reduce these disparities and improve lives. Staying informed, making healthy choices, and connecting with support networks are critical steps toward a healthier future.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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