Disclosures: The authors report no relevant financial disclosures.
September 07, 2021
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Diabetes onset occurs earlier in Mexican American, Black adults

Disclosures: The authors report no relevant financial disclosures.
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Mexican American and non-Hispanic Black adults were diagnosed with diabetes at a significantly younger age, 4 to 7 years earlier on average, than non-Hispanic white adults, according to findings published in JAMA Internal Medicine.

The implications are critical, Sadiya S. Khan, MD, MSc, an assistant professor in the division of cardiology at Northwestern University Feinberg School of Medicine, told Healio Primary Care.

Wang MC, et al. JAMA Int Med. 2021;doi:10.1001/jamainternmed.2021.4945.

“The earlier someone develops diabetes, the greater risk for complications related to diabetes and dying at a younger age,” she said.

The earlier age at diabetes onset among Mexican American and non-Hispanic Black adults may also contribute to racial and ethnic disparities in diabetes complications, Khan, Michael C. Wang, BA, an MD candidate in the department of preventive medicine at Northwestern University Feinberg School of Medicine, and colleagues wrote.

Michael C. Wang

For the cross-sectional study, Khan, Wang and colleagues analyzed data from the National Health and Nutrition Examination Survey that were collected from Jan. 1, 2011, to Dec. 31, 2018. The study cohort included 3,022 adults aged 20 years and older who self-reported a history of diabetes and their age at diagnosis. Among this cohort, 1,436 were women, 946 were non-Hispanic white, 805 were non-Hispanic Black, 508 were Mexican American and 339 were non-Hispanic Asian. The mean age was 61.1 years. The primary analysis excluded participants with a likely diagnosis of type 1 diabetes.

Overall, the mean age at the time of a diabetes diagnosis was 49.9 years (95% CI, 49.2-

50.7). Among non-Hispanic white individuals, the mean age at time of diagnosis was 51.8 years (95% CI, 50.8-52.9). Comparatively, Mexican American adults self-reported a mean age of 47.2 years at time of diagnosis (95% CI, 46.1-48.4). Similarly, non-Hispanic Black adults reported a mean age of 44.9 years (95% CI, 43.4-46.4). Non-Hispanic Asian adults had a mean age of 50.5 years (95% CI, 48.4-52.6).

The researchers reported that the “weighted proportion of adults with diabetes diagnosed before age 40 years was greater among Mexican American adults (35%) and non-Hispanic Black adults (25.1%) compared with non-Hispanic white adults (14.4%; P .001).”

The findings were limited by self-reported ages and diagnoses of diabetes, the researchers noted.

“Earlier age at diabetes diagnosis among non-Hispanic Black and Mexican American adults is attributable to a combination of clinical, behavioral, and social factors and may potentially contribute to observed disparities in diabetes-related microvascular and macrovascular complications and premature mortality,” Khan, Wang and colleagues wrote.

Wang suggested that “earlier screening and preventive interventions may be able to identify and care for adults with diabetes earlier in the disease course, with beneficial effects on health equity.”