Diabetes in Black Americans: How to Lower Your Risk

While some of the risk factors for type 2 diabetes in Black people can be beyond an individual’s control, it's important to know what you can do to lower your overall risk.

Why Lifestyle Choices Matter When It Comes to Preventing Type 2 Diabetes

Body weight, body mass index, and waist circumference are key indicators of your metabolic health and, in turn, your risk of diabetes, says Marjorie A. Pennant, MD, an endocrinologist at the University of Maryland Center for Diabetes and Endocrinology and an assistant professor of medicine at the university’s medical school in Baltimore.

“If you’re overweight, losing 5 to 15 percent of your body weight will help in preventing diabetes,” says Dr. Pennant. And improvements in nutrition, physical activity, and metabolic health are beneficial even when weight loss is modest.

Understanding what makes for a diabetes-friendly diet — and which eating patterns don’t fall under that umbrella — may help you achieve a healthy weight, as well as prevent the onset of diabetes or delay its progression.

Start by limiting your intake of sugar-sweetened drinks, processed packaged foods, and red meat, and instead focusing on prioritizing whole grains, healthy fats, and plant-based protein, suggests Pennant.

How Access, Discrimination, and Stress Play a Role

Poor (or no) physician support, as well as a perception that the condition isn't serious and a lack of knowledge of how to treat diabetes, all contribute to higher rates of poor disease management.

“A lot of the answers point to social determinants of health as contributors to the disease,” says Tiffany Gary-Webb, PhD, a professor of epidemiology and the associate director of the Center for Health Equity at the University of Pittsburgh.

“For example, aspects of residential environment, particularly in neighborhoods with more poverty, contribute to these disparities through lack of access to healthy food,” she says. “[These] ‘food deserts’ and ‘food swamps’ are places saturated with fast food, convenience stores, and unhealthy foods.” Poor access to exercise facilities or safe outdoor areas to exercise may also be contributing factors.

“African Americans experience increased stress due to discrimination, institutional racism, and many other factors,” says Dr. Gary-Webb. “Researchers are studying what this increased stress does to the body — for example, whether it leads to higher levels of the stress hormone cortisol or accelerated cellular aging.”

6 Ways to Reduce Your Risk of Diabetes

While factors such as racism and discrimination, as well as access to healthy food, education, and exercise are broader societal issues beyond most individuals’ direct control, many factors are not.

“Even with genetics and a family history of diabetes, you still have control through lifestyle intervention,” says Pennant.

Here are six ways to reduce your risk of diabetes.

1. Get Screened

“Typically, if you have a parent or a sibling with diabetes, you are [considered] at risk,” says Omar El Kawkgi, MBBCh, an endocrinologist at Mayo Clinic Health System in Eau Claire, Wisconsin. He advises those in this group who are older than 35 to get screened.

2. Practice Heart-Healthy Habits

3. Watch Your Sugar Intake

“A key message I tell patients is to watch their sugar intake, because it’s one of the biggest drivers of heart disease, diabetes, and weight gain,” says Pennant.

4. Get Moving

If you’re new to exercise, Pennant recommends starting small. You don’t have to go to the gym to get a lot of movement. Simple lifestyle changes like going on a brisk 30-minute daily walk or taking the stairs instead of the elevator can make a big difference in increasing your physical activity, she says.

5. Don’t Smoke, or Quit if You Do

If you do develop type 2 diabetes, continuing to smoke can further elevate your risk of diabetes complications such as stroke and heart disease.

6. Seek Preventive Care

Although accessing quality medical care and forming a positive doctor-patient relationship is challenging for many Black Americans, Pennant says that, if possible, regular checkups with your primary care physician, eye doctor, dentist, and foot doctor can all help you spot warning signs sooner, reduce your risk of diabetes, and increase your chances of getting the right treatment if you end up receiving a diagnosis.

Pennant recommends asking your doctor for a referral to a specialist, particularly if you’re having a hard time losing weight,

“These [symptoms] may be signs that your body is making a lot of insulin to keep your blood sugar normal,” says Pennant. They could be indications of diabetes, prediabetes, or the need for continued monitoring.

The Takeaway

• Black Americans are 24 percent more likely to develop diabetes than other groups and experience higher rates of complications due to a mix of genetic, behavioral, environmental, and socioeconomic factors.
• Societal determinants of health, such as institutional racism, discrimination-induced stress, and lack of neighborhood access to healthy foods and exercise facilities, significantly contribute to these elevated risk levels and poorer disease management.
• Maintaining a healthy body weight through regular exercise and adopting a heart-healthy diet that limits sugar-sweetened drinks, processed foods, and red meat can significantly lower your risk of insulin resistance and type 2 diabetes.
• Individuals can further reduce their risk by quitting smoking, seeking routine medical screenings starting at age 35, and utilizing alternative tests like fasting or glucose tolerance tests if standard A1C results are inaccurate.

Additional reporting by Valencia Higuera and Carmen Chai.