Causes and Risk Factors of Type 2 Diabetes in People of Color

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This article is part of Health Divide: Type 2 Diabetes in People of Color, a destination in our Health Divide series.

Type 2 diabetes is a disease characterized by high blood sugar (glucose) levels in the body. While it's estimated that more than 30 million adults in the United States have type 2 diabetes, this condition disproportionately affects certain populations more than others. Data show that 14.5% of Indigenous, 12.1% of Black, 11.8% of Latinx, and 9.5% of Asian American adults have type 2 diabetes, compared to 7.4% of White Americans.

The reasons behind these differences (known as health disparities) are complex. In addition to common type 2 diabetes risk factors, like having excess body weight or a family history of the disease, the systemic discrimination that Black and Brown communities face play a big role in elevating risk.

This article discusses the increased risk of type 2 diabetes in Black and Brown people as well as potential causes and risk factors.

Diabetes Diagnosis Rates by Ethnicity in the U.S. : Bar graph showing the data (14.5% American Indians and Alaska natives, 12.1% Non-Hispanic Blacks, 11.8% Hispanics, 9.5% Non-Hispanic Asians, 7.4% Non-Hispanic Whites)

Verywell / Zoe Hansen

Common Causes

Type 2 diabetes develops when your blood sugar levels get too high because the body isn't able to process insulin (a hormone that regulates blood sugar use) normally.

Anyone can develop type 2 diabetes, regardless of age or background. However, certain factors may increase this risk, including:

  • Body weight: Having excess weight in the abdomen is linked to developing type 2 diabetes.
  • Physical activity level: Getting less than the recommended 150 minutes of physical activity per week is another risk factor, as exercise can help the body's use of glucose.
  • Age: People who are aged 45 and older may be at a greater risk for developing type 2 diabetes, as aging affects the body’s ability to respond to insulin (known as insulin sensitivity).
  • Genetics and family history: Researchers have found many different genes that are likely linked to diabetes risk. If you have a parent or sibling with the disease, you’re more likely to develop type 2 diabetes.

Along with these common causes, additional factors increase the risk of type 2 diabetes in people within Black, Latinx, Indigenous, and Asian American communities.

The Centers for Disease Control and Prevention (CDC) notes that socioeconomic and systemic factors (outside influences from our home, work, school, and community) are responsible for more than half of a person's health outcomes. For example:

  • Social determinants of health: The conditions and circumstances of our environment, such as income, education, housing, and access to healthy food, medical care, and other resources, profoundly impact our health. Lower socioeconomic status has contributed to higher rates of chronic diseases like type 2 diabetes in historically marginalized communities in the United States.
  • Systemic racism: Long-standing policies, practices, and procedures that have pervaded global institutions and systems of power is a root cause of the health inequities that Black and Brown people face today. In addition, the stress of repeated exposure to racism and other forms of discrimination have been linked to the biological aging of the body's cells, leading to health declines and reduced quality of life among Black and Brown people with type 2 diabetes.

Common Type 2 Diabetes Symptoms

Type 2 diabetes symptoms may not always be obvious, however, common signs include: 

  • Excessive thirst or hunger
  • Frequent urination
  • Extreme fatigue
  • Neuropathy (nerve tingling)
  • Blurry vision

Genetics

Together with lifestyle and environmental factors, the genes that are passed down to you from your parents play a role in determining whether you may be more likely to develop type 2 diabetes.

So far, experts have found more than 150 gene variations that may be linked to type 2 diabetes. Having a close family member (parent or sibling) with the disease increases the likelihood that you will develop it, too.

But genetics is only one part of the equation. External factors can also trigger the development of type 2 diabetes, which means that genetics isn't the sole explanation for disparities.

To Keep in Mind

Much more research is needed on the genetic components of type 2 diabetes in racial and ethnic subgroups. Initial studies suggest that different ancestral genes are responsible for type 2 diabetes risk across many racial and ethnic subgroups.

Lifestyle Risk Factors

What we do (or don’t do) in our daily lives can contribute to the development of type 2 diabetes.

For example, unhealthy eating patterns, lack of exercise, and smoking are known to add to a person's type 2 diabetes risk. Experts call these lifestyle risk factors. Together with your genetics, they contribute to the development of type 2 diabetes.

It's important to understand how these lifestyle factors play out in Black and Brown communities. For example:

  • Diet: Unhealthy eating patterns are often highlighted as contributing to type 2 diabetes, as certain foods like carbohydrates directly impact blood sugar levels. But whether you're able to physically access and afford healthier food options will depend greatly on where you live and other socioeconomic factors. In addition, for some Black and Brown communities (particularly those with immigrant ties), changing their culture's traditional diet to assimilate to a standard "American" diet full of carbohydrate-heavy and processed foods can elevate risk even more.
  • Exercise: Becoming more physically active can help reduce the risk of type 2 diabetes. But this may not be a feasible option for communities that lack recreational options, such as safe access to sidewalks, grassy areas, or fitness facilities. Unlike many suburban neighborhoods, this is more likely to be the case in urban and rural environments.
  • Smoking: People who smoke are up to 40% more likely to develop type 2 diabetes due to inflammation and damage from the chemicals in cigarettes.
  • Medical care: Regularly seeing a healthcare provider is helpful for maintaining good health. Still, many Black and Brown people face financial, physical, language, and cultural barriers to accessing the necessary care, testing, and medications required for preventing and treating type 2 diabetes. In addition, not all available type 2 diabetes treatment options have been tailored to or routinely tested in Black, Latinx, Indigenous, and Asian populations, despite these groups having the highest prevalence of the disease.

For Black and Brown people, common lifestyle risk factors are often amplified by the systemic racism these populations face. Experts are just beginning to scratch the surface in addressing type 2 diabetes disparities by suggesting solutions for expanded access to care and economic stability in Black and Brown communities.

Type 2 Diabetes Treatment Options

Managing type 2 diabetes will likely require a combination of individualized treatment options that work well for you. For example, a culturally competent treatment plan may include:

  • Weight loss and dietary changes
  • Regular exercise
  • Quitting smoking
  • Prescription medications
  • Blood glucose monitoring
  • Support from family, friends, and community members

Summary

Type 2 diabetes is a condition in which the body is unable to properly process insulin, resulting in high blood sugar levels. Black, Latinx, Indigenous, and Asian American adults experience disproportionately high rates of type 2 diabetes than White American adults due to systemic racism.

Research shows that this disparity is driven by socioeconomic factors that place Black and Brown people at an increased risk for chronic diseases like type 2 diabetes. These factors include income, education, access to medical care, healthy foods, and other resources. Genetics and lifestyle factors, such as smoking, lack of exercise, and poor diet, also play a role in determining a person's chances of developing type 2 diabetes.

A Word From Verywell

It's very likely you know someone who's been diagnosed with diabetes or will be in the near future. In fact, the CDC predicts that one in five U.S. adults will have diabetes by the year 2025. We can all do our part to make sure this statistic doesn't become a reality. Know that there are resources and programs available to help support you and your loved ones in your health journey. Consider looking into Diabetes Self-Management Education and Support (DSMES) services to find care and educational resources in your local area.

Frequently Asked Questions

  • What are the three main causes of type 2 diabetes in people of color?

    In people of all backgrounds, type 2 diabetes is caused by a combination of genetic and lifestyle factors. In Black and Brown communities, there are additional socioeconomic factors that disproportionately increase type 2 diabetes risk due to systemic racism. This includes factors like income, education, and access to medical care and healthy foods, which research shows contribute greatly to a person's health outcomes.

  • How do genetics affect type 2 diabetes risk in Black and Brown people?

    While genes do play a role in the likelihood of type 2 diabetes development, it's not an explanation for why Black and Brown people have a higher risk of developing the disease. Studies suggest that there are likely genetic variants linked to type 2 diabetes across all racial and ethnic groups. Systemic racism is what is linked to the elevated rates seen in Black and Brown people, not genetics.

  • How important is nutrition for lowering type 2 diabetes risk?

    Having access to healthy, nutritional foods is a key part of type 2 diabetes prevention. Research shows that minimizing processed and carbohydrate-rich foods in favor of whole grains, lean protein, vegetables, fruits, and healthy fats is linked to a lower risk of developing type 2 diabetes.

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By Cristina Mutchler
Cristina Mutchler is an award-winning journalist with more than a decade of experience in national media, specializing in health and wellness content.