UMMS study examines disparity in diabetes rate among women

Evidence shows majority of cases are preventable among all ethnicities/races

By Lisa M. Larson

UMass Medical School Communications

July 25, 2012
   Yunsheng Ma, MD, PhD (left) and Judith Ockene, PhD, MEd, MA

Most cases of diabetes in American women over age 50 are preventable with diet and exercise, no matter their ethnicity or race, according to a new study by researchers at UMass Medical School published today in Diabetes Care, a journal of the American Diabetes Association. The researchers investigated disparities among different ethnicities and races, such as blacks,  Hispanics and Asians, who have a higher risk of developing diabetes.

“The high rate of diabetes among certain minorities has been well documented, but few studies have looked at that disparity in relation to lifestyle factors in aggregate to estimate the proportion of diabetes that might be avoided by adopting a pattern of low-risk behaviors,” said Yunsheng Ma, MD, PhD, primary investigator on the study. “Our work shows that among numerous race/ethnicities, the women with both high body mass index and low levels of physical activity are far more likely to develop diabetes. A healthier diet and adequate levels of physical activity could significantly lower that risk for most women.”

Dr. Ma and colleagues used data from the Women’s Health Initiative (WHI) to examine determinants of racial/ethnic differences in diabetes incidence among more than 150,000 postmenopausal women who were followed for more than 10 years. They collected data on race/ethnicity, educational attainment, baseline diabetes and development of new onset diabetes as well as weight, height, waist size, smoking status, diet and physical activity.

The results showed that blacks were two to three times more likely than whites to develop diabetes; Hispanics and Asians were about two times more likely than whites. Those differences were explained in large part by modifiable lifestyle factors that included diet, physical activity and smoking.

Asians had the highest inherent risk of diabetes, and may need to achieve even greater weight loss to have the same low risk of diabetes as non-overweight whites. Researchers also found that blacks and Hispanics may be more sensitive to lifestyle modifications and weight loss for diabetes risk, and this is corroborated by a previous UMMS lifestyle intervention study of a Hispanic population in Lawrence. In addition, adjustment for educational attainment resulted in the largest decrease in diabetes incidence in Hispanics; the study found that if Hispanics had achieved the same education levels as whites, their risk of diabetes could decrease by 14 percent.

Although determinants of the disparities varied by race/ethnicity, the study found that women of all four groups could potentially experience a large reduction in diabetes risk by maintaining a healthy body weight, healthy diet and physically active lifestyle. Maintaining a body mass index of less than 25 appeared to be particularly important, the study showed.

“Once again, the WHI has provided important insights regarding factors that affect diabetes risk. Although genetics does matter in terms of pre-disposing individuals to diabetes, the primary differences are explained by lifestyle factors, particularly obesity and physical activity.” said Judith Ockene, PhD, MEd, MA, professor of medicine ,and a co-researcher on the study. “It shows prevention and behavior matter.”

Related links on UMassMedNow:
Diabetes intervention proves effective in Lawrence
Statin use associated with increased diabetes risk in women