The Differential Effects of Type II Diabetes Between Ethnicities: A Descriptive Study Comparing Hispanics, African American, and Non-Hispanic White Older Adults with Type II Diabetes

Abstract

Purpose: Type II diabetes mellitus (T2DM) is a significant risk factor for cognitive impairment. Individuals with T2DM have an increased risk for developing depression and depressive episodes. Additionally, T2DM worsens other comorbid conditions such as hypertension and high cholesterol. To gain a better understanding of the etiology and risk factors for the complications of T2DM, it is important to assess how T2DM impacts different ethnic groups. This study aims to explore how T2DM effects Hispanics (H), Non-Hispanic Whites (NHW), and African American (AA) older adults regarding self-reported health and past medical history, objective measures, and clinical blood work.

Methods: Data was collected from 767 (187 AA, 161 NHW, 419 H) participants with T2DM from the Health and Aging Brain Study: Health Disparities, baseline studies. T2DM was defined as an HbA1C of greater than or equal to 6.5 or by self-report. The participants had an average age of 65 years. One-way ANOVAS were run to examine group differences in demographics, physical activity (RAPA), affect (Geriatric Depression Scale: depression; Penn State Worry Questionnaire: worry), blood pressure, and clinical blood work.

Results: ANOVAs demonstrated significant differences in education between H (M = 8.84, SD = 4.51), NHW (M = 15.32, SD = 2.62), AA (M = 14.57, SD = 2.66) groups (F = 246.74, p <0.001). Significant differences in income were also recorded between H (M= 30,530.31, SD = 28,055.79), NHW (M =65,265.45, SD = 53,241.75), AA (M = 61,423.46, SD = 69,393.76) groups (F = 44.63, p < 0.001). Clinically, significant differences in systolic blood pressure were found between H (M = 140.83, SD = 20.98), NHW (M = 137.58, SD = 18.69), AA (M = 136.44, SD = 20.56) groups (F = 3.52, p = 0.03). The cholesterols (total cholesterol, HDL, triglycerides, LDL, HDL ratios, and non-HDL) were all statistically significant between groups (F range 3.35 – 21.13, p range <0.001 – 0.036). ANOVAs also highlighted significant differences in physical activity (RAPA) between H (M = 3.84, SD = 1.49), NHW (M = 4.18, SD = 1.52), AA (M = 4.18, SD = 1.62) groups (F = 4.61, p = 0.01). Lastly, significant differences in affect (GDS) were found between H (M = 7.73, SD = 6.72), NHW (M = 5.84, SD = 6.02), AA (M = 6.81, SD = 5.76) groups (F = 5.42, p = 0.01).

Conclusion: This study demonstrates that Hispanic older adults with T2DM exhibit a greater decline in overall health and wellness compared to their AA and NHW counterparts. Future research should compare type II diabetic Hispanics with non-diabetic Hispanics to determine if Hispanics are already at a baseline risk for potential health complications.