Diabetes in African Americans

In recent years, there has been much concern about the excess frequency and complications from diabetes in minority populations in the United States. In 1986, a Task Force on Black and Minority Health called attention to limitations in knowledge about diabetes in minorities and the need for increased research and intervention to reduce the excess burden of diabetes in these groups1. In this chapter, data on the frequency of diabetes and associated risk factors in the black population of the United States are reviewed and im-plications for this ethnic group are discussed. The African-American population includes many indi-viduals who have immigrated to the United States from other parts of the Americas, particularly the Caribbean, for whom little is known of their diabetes status. Thus, whenever possible, data on diabetes in black Caribbean populations are provided. Epidemiological studies conducted to assess the im-pact of diabetes in black populations have examined a number of syndromes of glucose intolerance, some of which appear to be more common in black than in white Americans. These include NIDDM, the major form of diabetes affecting all populations in the United States, IDDM, impaired glucose tolerance (IGT), gestational diabetes mellitus (GDM), and the malnutrition-related diabetes subtypes described by the World Health Organization (WHO)2 as protein-deficient pancreatic diabetes (PDPD) and fibrocalcu-lus pancreatic diabetes (FCPD). Other atypical diabetes syndromes characterized b