Health and Racial Disparities in Diabetes Mellitus Prevalence, Management, Policies, and Outcomes in the United States

Diabetes Mellitus (DM) is a severe and chronic metabolic disorder characterized by hyperglycaemia and various complications, including cardiovascular disease. It is diagnosed when fasting plasma glucose (FPG) level is126 mg/dL (7.0 mmol/L) or higher 1. Notable differences in DM prevalence are evident among populations in the United States. While DM affects 13% of the general adult population, specific groups, including American Indians/Alaska Natives (14.7%), Hispanics (12.5%), and non-Hispanic Blacks (11.7%), experience disproportionately higher rates. Conversely, lower prevalence rates are observed among non-Hispanic Asians (9.2%) and non-Hispanic Whites (7.5%). Black Americans are twice as likely to succumb to diabetes-related mortality compared to Whites 2. The overall objective of this review article is to comprehensively address racial disparities in DM within the United States, emphasizing prevalence rates, management strategies, and health outcomes across diverse ethnic groups. To achieve this objective, we conducted a systematic review and meta-analysis utilizing data from nationally representative surveys, healthcare databases, and published literature spanning from 2014 to 2023. Our findings highlight significant racial disparities in DM prevalence, with minority populations, including African Americans, Hispanics, and Native Americans, consistently exhibiting higher rates than their Caucasian counterparts. Beyond prevalence, disparities extend to access to healthcare resources, diabetes education, and preventive measures. Additionally, challenges in DM management, including access to optimal treatment modalities, medication adherence, and diabetes self-management education, are identified among minority populations. Socioeconomic factors, particularly income and education, significantly contribute to these disparities. This review article contributes to the growing body of evidence guiding policymakers, healthcare professionals, and researchers in developing targeted strategies to achieve health equity in diabetes management and prevention. Addressing these disparities is crucial for fostering an inclusive and practical approach to DM care within diverse ethnic populations.