Table of ContentsView AllTable of ContentsHigh Blood PressureStrokeCoronary Artery DiseaseNerve DamageEye DamageKidney DamageKetoacidosis & Diabetic ComaFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
High Blood Pressure
Stroke
Coronary Artery Disease
Nerve Damage
Eye Damage
Kidney Damage
Ketoacidosis & Diabetic Coma
Frequently Asked Questions
This article is part ofHealth Divide: Type 2 Diabetes in People of Color, a destination in our Health Divide series.
Several factors contribute to the differences in type 2 diabetes diagnoses and outcomes seen in people of color, including socioeconomics, environment, and access to care due to geography, language, or education barriers. In addition, people of color may experience discrimination, racism, and negative attitudes that affect the care they receive.
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Managing symptomsof type 2 diabetes reduces the risk of complications, like heart disease, nerve damage, kidney disease, and foot and eye problems.This article discusses common type 2 diabetes complications that impact people of color.
People with diabetes are twice as likely to havehigh blood pressurethan those who don’t since it can damage the blood vessels.Approximately 74% of adults with diabetes also have or develop high blood pressure.High blood pressure and diabetes put people at higher risk forheart diseaseand stroke.
A healthy diet and physical activity can help prevent andtreat high blood pressure. However, environmental and socioeconomic conditions can make it difficult to adopt these healthy behaviors. People of color may be less likely to have access to healthy foods and safe outdoor spaces to exercise, which can contribute to the risk of diabetes and hypertension.
Diabetes causesdyslipidemia(an imbalance oflipids[fats] in the blood) andhyperlipidemia(high levels of fat in the blood). High blood pressure, atherosclerosis, dyslipidemia, and hyperlipidemia increase the risk of stroke.
According to the American Heart Association, stroke risk factors like high blood pressure and diabetes impact people of various races differently. High blood pressure has a more significant effect on stroke in African American men than in women or White people. Diabetes impacts African American men at a rate of 17.2% compared to White men at 10.5%.
These findings highlight the need for culturally-sensitive health care and tailored education to address higher stroke risk among people of color who have diabetes and hypertension.
Coronary artery diseaseis a type of heart disease that affects the arteries that bring blood to the heart. High blood pressure, fat build-up or imbalance in the blood, and plaque build-up in the arteries are risk factors for coronary artery disease.
African American adults are more likely to haveuncontrolled blood pressureand die from heart disease than non-Hispanic White adults. Poverty, unemployment, and barriers to receiving proper health care contribute to the high rate of this complication among people of color.
According to the U.S. Census Bureau, 21.2% of non-Hispanic Black people live in poverty compared to 9% of non-Hispanic White people. The unemployment rate is twofold among non-Hispanic Black people, who are less likely to have private health insurance, more likely to rely onMedicaidor publichealth insurance, and more likely to be uninsured than non-Hispanic White people.
Uncontrolled diabetescan affect the nerves and lead to a condition calleddiabetic neuropathy. The most common type of nerve damage occurs in the feet, legs, hands, and arms. This type of nerve damage affects about one-third to one-half of people with diabetes.
Neuropathy can also cause problems with:
A 2015 study surveyed adults in the United States with diabetic neuropathy symptoms. The researchers found differences in how people with diabetic neuropathy experienced and perceived pain and interacted with healthcare providers.African American and Hispanic people reported experiencing lower pain severity and fewer symptoms than White people.
The difference in perceived pain may contribute to fewer African American and Hispanic people receiving a diagnosis and discussing their pain symptoms with their healthcare providers, resulting in delayed diagnosis and treatment and worse outcomes.
Foot Problems
Nerve damage in thefeetcan cause tingling, pain, and a loss of feeling, leading to unnoticed cuts and sores. Diabetes can decrease blood flow to the feet, making it hard for sores and infections to heal. An estimated 34% of individuals with diabetes develop diabetic foot problems.
Higher Rates of AmputationAfrican American and Hispanic people experience higher rates of diabetic foot problems and amputation. African American people are two to three times more likely to have a diabetic-related amputation than non-Hispanic White people. One study found that the risk of major amputation was 33% and 44% higher for Hispanic and African American people than for White people.
Higher Rates of Amputation
African American and Hispanic people experience higher rates of diabetic foot problems and amputation. African American people are two to three times more likely to have a diabetic-related amputation than non-Hispanic White people. One study found that the risk of major amputation was 33% and 44% higher for Hispanic and African American people than for White people.
Socioeconomic status, access to health insurance, and income level may contribute to the disparities in amputation rates among African American and Hispanic people compared to White people. When nerve damage progresses and is left untreated, irreversible complications and amputation are more likely.
Type 2 diabetes is the leading cause of blindness. Over time, uncontrolled high blood sugar can cause damage to the blood vessels in the eyes (diabetic retinopathy). High blood sugar can also cause swelling (diabetic macular edema) leading to blurry vision.
People of color are more likely to experience eye damage due to diabetes.Screeningto detect eye damage early is important to preventing blindness. Studies have shown that people of color may undergo screening less often than their White counterparts.
Barriers to screening include:
Another serious complication of high blood sugar iskidney disease. Type 2 diabetes is the leading cause of end-stagerenal diseaseand 1 in 3 adults with diabetes also has kidney disease.
In 2017, non-Hispanic Black people were 3.2 times more likely to be diagnosed with diabetes-relatedend-stage kidney disease. In addition, Hispanic people were twice as likely to be hospitalized for diabetes-related end-stage kidney disease than non-Hispanic White people.
Current literature suggests that access to quality health care and other environmental factors may contribute to the racial difference in developing diabetes-related kidney disease.
Individuals with type 2 diabetes can developketoacidosiswhen the body doesn’t have enough insulin. Diabetic ketoacidosis can be life-threatening and lead todiabetic coma.
Studies looking at diabetes-related deaths have found that non-Hispanic Black people have more than twice the risk of death compared to non-Hispanic White people. Poverty and segregation contribute to the difference in outcomes and lack of access to healthy food and quality health care in underserved communities.
Summary
People of color experiencedisparitiesin outcomes of type 2 diabetes. Socioeconomic status, environment, language and cultural barriers, distrust of healthcare providers, and discomfort in discussing symptoms and pain can contribute to delayed screening, diagnosis, and treatment of diabetes. This can lead to progressive damage to nerves and blood vessels and put people of color at a higher risk for developing severediabetes-related complications.
A Word From Verywell
Learning to identify common signs and symptoms, seeking translation services if language is a barrier, and adoptinghealthy lifestyle changescan reduce the risk of type 2 diabetes complications in people of color. If health care costs prevent you from getting care, your local social services provider can refer you to free or low-cost clinics in your area. Find atrusted healthcare providerand discuss options to manage your blood sugar, blood pressure, and lipid levels.
Common complications of type 2 diabetes among people of color include high blood pressure, stroke, heart disease, nerve damage, kidney disease, foot problems, eye damage, ketoacidosis, and diabetic coma.Learn MoreCould You Have Undiagnosed Diabetes?
Common complications of type 2 diabetes among people of color include high blood pressure, stroke, heart disease, nerve damage, kidney disease, foot problems, eye damage, ketoacidosis, and diabetic coma.
Learn MoreCould You Have Undiagnosed Diabetes?
Uncontrolled blood sugar levels cause complications for individuals with type 2 diabetes.Learn MoreUncontrolled Diabetes Symptoms
Uncontrolled blood sugar levels cause complications for individuals with type 2 diabetes.
Learn MoreUncontrolled Diabetes Symptoms
Learn MoreManaging and Preventing Complications of Diabetes
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.National diabetes statistics report.Department of Health and Human Services Office of Minority Health.Diabetes and Hispanic Americans.Department of Health and Human Services Office of Minority Health.Diabetes and African Americans.Hill-Briggs F, Adler NE, Berkowitz SA, et al.Social determinants of health and diabetes: a scientific review.Diabetes Care. 2021;44:258–279. doi:10.2337/dci20-0053American Diabetes Association.Diabetes complications.Petrie JR, Guzik TJ, Touyz RM.Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms.Can J Cardiol. 2018;34(5):575-584. doi:10.1016/j.cjca.2017.12.005National Heart, Lung, Blood Institute.What is a stroke?.Pikula A, Howard BV, Seshadri S.Stroke and diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018.American Heart Association.Race and gender may tip the scales on traditional stroke risk factors.Centers for Disease Control and Prevention.Coronary artery disease.Department of Health and Human Services Office of Minority Health.Profile: Black/African Americans.National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic neuropathy.Eichholz M, Alexander AH, Cappelleri JC, et al.Perspectives on the impact of painful diabetic peripheral neuropathy in a multicultural population.Clin Diabetes Endocrinol. 2017;3:12. doi:10.1186/s40842-017-0051-2National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes and foot problems.Tan TW, Shih CD, Concha-Moore KC, et al.Disparities in outcomes of patients admitted with diabetic foot infections.PLoS One. 2019;14(2):e0211481. doi:10.1371/journal.pone.0211481National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.Barsegian A, Kotlyar B, Lee J, Salifu MO, McFarlane SI.Diabetic retinopathy: rocus on minority populations.Int J Clin Endocrinol Metab.2017;3(1):034-045. doi:10.17352/ijcem.000027National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.Dias JP, Shardell M, Golden SH, Ahima RS, Crews DC.Racial/ethnic trends in prevalence of diabetic kidney disease in the United States.Kidney Int Rep. 2018;4(2):334-337. doi:10.1016/j.ekir.2018.10.018Centers for Disease Control and Prevention.Diabetic ketoacidosis.Beydoun MA, Beydoun HA, Mode N, et al.Racial disparities in adult all-cause and cause-specific mortality among US adults: mediating and moderating factors.BMC Public Health. 2016;16:1113. doi:10.1186/s12889-016-3744-z
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.National diabetes statistics report.Department of Health and Human Services Office of Minority Health.Diabetes and Hispanic Americans.Department of Health and Human Services Office of Minority Health.Diabetes and African Americans.Hill-Briggs F, Adler NE, Berkowitz SA, et al.Social determinants of health and diabetes: a scientific review.Diabetes Care. 2021;44:258–279. doi:10.2337/dci20-0053American Diabetes Association.Diabetes complications.Petrie JR, Guzik TJ, Touyz RM.Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms.Can J Cardiol. 2018;34(5):575-584. doi:10.1016/j.cjca.2017.12.005National Heart, Lung, Blood Institute.What is a stroke?.Pikula A, Howard BV, Seshadri S.Stroke and diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018.American Heart Association.Race and gender may tip the scales on traditional stroke risk factors.Centers for Disease Control and Prevention.Coronary artery disease.Department of Health and Human Services Office of Minority Health.Profile: Black/African Americans.National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic neuropathy.Eichholz M, Alexander AH, Cappelleri JC, et al.Perspectives on the impact of painful diabetic peripheral neuropathy in a multicultural population.Clin Diabetes Endocrinol. 2017;3:12. doi:10.1186/s40842-017-0051-2National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes and foot problems.Tan TW, Shih CD, Concha-Moore KC, et al.Disparities in outcomes of patients admitted with diabetic foot infections.PLoS One. 2019;14(2):e0211481. doi:10.1371/journal.pone.0211481National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.Barsegian A, Kotlyar B, Lee J, Salifu MO, McFarlane SI.Diabetic retinopathy: rocus on minority populations.Int J Clin Endocrinol Metab.2017;3(1):034-045. doi:10.17352/ijcem.000027National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.Dias JP, Shardell M, Golden SH, Ahima RS, Crews DC.Racial/ethnic trends in prevalence of diabetic kidney disease in the United States.Kidney Int Rep. 2018;4(2):334-337. doi:10.1016/j.ekir.2018.10.018Centers for Disease Control and Prevention.Diabetic ketoacidosis.Beydoun MA, Beydoun HA, Mode N, et al.Racial disparities in adult all-cause and cause-specific mortality among US adults: mediating and moderating factors.BMC Public Health. 2016;16:1113. doi:10.1186/s12889-016-3744-z
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.National diabetes statistics report.Department of Health and Human Services Office of Minority Health.Diabetes and Hispanic Americans.Department of Health and Human Services Office of Minority Health.Diabetes and African Americans.Hill-Briggs F, Adler NE, Berkowitz SA, et al.Social determinants of health and diabetes: a scientific review.Diabetes Care. 2021;44:258–279. doi:10.2337/dci20-0053American Diabetes Association.Diabetes complications.Petrie JR, Guzik TJ, Touyz RM.Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms.Can J Cardiol. 2018;34(5):575-584. doi:10.1016/j.cjca.2017.12.005National Heart, Lung, Blood Institute.What is a stroke?.Pikula A, Howard BV, Seshadri S.Stroke and diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018.American Heart Association.Race and gender may tip the scales on traditional stroke risk factors.Centers for Disease Control and Prevention.Coronary artery disease.Department of Health and Human Services Office of Minority Health.Profile: Black/African Americans.National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic neuropathy.Eichholz M, Alexander AH, Cappelleri JC, et al.Perspectives on the impact of painful diabetic peripheral neuropathy in a multicultural population.Clin Diabetes Endocrinol. 2017;3:12. doi:10.1186/s40842-017-0051-2National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes and foot problems.Tan TW, Shih CD, Concha-Moore KC, et al.Disparities in outcomes of patients admitted with diabetic foot infections.PLoS One. 2019;14(2):e0211481. doi:10.1371/journal.pone.0211481National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.Barsegian A, Kotlyar B, Lee J, Salifu MO, McFarlane SI.Diabetic retinopathy: rocus on minority populations.Int J Clin Endocrinol Metab.2017;3(1):034-045. doi:10.17352/ijcem.000027National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.Dias JP, Shardell M, Golden SH, Ahima RS, Crews DC.Racial/ethnic trends in prevalence of diabetic kidney disease in the United States.Kidney Int Rep. 2018;4(2):334-337. doi:10.1016/j.ekir.2018.10.018Centers for Disease Control and Prevention.Diabetic ketoacidosis.Beydoun MA, Beydoun HA, Mode N, et al.Racial disparities in adult all-cause and cause-specific mortality among US adults: mediating and moderating factors.BMC Public Health. 2016;16:1113. doi:10.1186/s12889-016-3744-z
Centers for Disease Control and Prevention.National diabetes statistics report.
Department of Health and Human Services Office of Minority Health.Diabetes and Hispanic Americans.
Department of Health and Human Services Office of Minority Health.Diabetes and African Americans.
Hill-Briggs F, Adler NE, Berkowitz SA, et al.Social determinants of health and diabetes: a scientific review.Diabetes Care. 2021;44:258–279. doi:10.2337/dci20-0053
American Diabetes Association.Diabetes complications.
Petrie JR, Guzik TJ, Touyz RM.Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms.Can J Cardiol. 2018;34(5):575-584. doi:10.1016/j.cjca.2017.12.005
National Heart, Lung, Blood Institute.What is a stroke?.
Pikula A, Howard BV, Seshadri S.Stroke and diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018.
American Heart Association.Race and gender may tip the scales on traditional stroke risk factors.
Centers for Disease Control and Prevention.Coronary artery disease.
Department of Health and Human Services Office of Minority Health.Profile: Black/African Americans.
National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic neuropathy.
Eichholz M, Alexander AH, Cappelleri JC, et al.Perspectives on the impact of painful diabetic peripheral neuropathy in a multicultural population.Clin Diabetes Endocrinol. 2017;3:12. doi:10.1186/s40842-017-0051-2
National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes and foot problems.
Tan TW, Shih CD, Concha-Moore KC, et al.Disparities in outcomes of patients admitted with diabetic foot infections.PLoS One. 2019;14(2):e0211481. doi:10.1371/journal.pone.0211481
National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.
Barsegian A, Kotlyar B, Lee J, Salifu MO, McFarlane SI.Diabetic retinopathy: rocus on minority populations.Int J Clin Endocrinol Metab.2017;3(1):034-045. doi:10.17352/ijcem.000027
National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.
Dias JP, Shardell M, Golden SH, Ahima RS, Crews DC.Racial/ethnic trends in prevalence of diabetic kidney disease in the United States.Kidney Int Rep. 2018;4(2):334-337. doi:10.1016/j.ekir.2018.10.018
Centers for Disease Control and Prevention.Diabetic ketoacidosis.
Beydoun MA, Beydoun HA, Mode N, et al.Racial disparities in adult all-cause and cause-specific mortality among US adults: mediating and moderating factors.BMC Public Health. 2016;16:1113. doi:10.1186/s12889-016-3744-z
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