Diabetes in Black Americans

 

Diabetes in Black Americans

What is Diabetes?

     Diabetes Mellitus is a chronic disease that exists in three different forms: Type 1, Type 2, and gestational diabetes (Olaniyan, 2023). In Type 1 Diabetes, the pancreas stops producing sufficient insulin; in Type 2 Diabetes, the body progressively becomes unable to effectively use the insulin being produced by the pancreas (in a process called insulin resistance), leading to an inability to regulate blood glucose levels (Olaniyan, 2023). Gestational diabetes is a form of the condition that develops where a rise in circulating placental hormones causes increased insulin resistance during pregnancy (Kunarathnam et al., 2025). The most common form of diabetes in adults is the Type 2 variant (Olaniyan, 2023).

Who Does It impact?

     According to data from the U.S. Centers for Disease Control and Prevention (CDC), in 2021, 38.4 million people, or roughly 11.6% of the United States population had diabetes (CDC, 2024). There were 38.1 million American adults living with the disease, or roughly 14.7% of all adults in the country; of those, 5.4 million were Black (CDC, 2024). Black American adults show a greater burden of Type 2 Diabetes when compared to White adults (Glover et al., 2023). The National Institutes of Health (NIH) report that while Type 2 Diabetes can occur at any age, it is more likely to develop in those that are age 45 and older, those who have a family history of diabetes, and those that are overweight or obese (NIH, 2018).

Demographic Trends

     Per the U.S. Department of Health and Human Services Office of Minority Health (OMH), among all racial and ethnic groups in the United States, Black Americans are second only to American Indians and Alaskan Natives for the lowest life expectancy at birth (OMH, 2025). In 2023, Diabetes ranked among the top five leading causes of death for non-Hispanic Black Americans (OMH, 2025). In 2022, non-Hispanic Black Americans died from Diabetes complications at a rate 78% higher than the total population, and in 2024, non-Hispanic Black adults were diagnosed with Diabetes 24% more frequently than the total American adult population (OMH, 2025).  Below is a map representing Black Americans as a percentage of the population state by state.

Figure 1.

Black/African American Population Map

From Black/African American Health, 2025, OMH.

 Table 1.

Estimated number of adults aged 18 years or older with diagnosed diabetes, undiagnosed diabetes, and total diabetes, United States, 2021

From National Diabetes Statistics Report, 2024, CDC.

What puts one at higher for developing it?

     Factors such as a family history of Diabetes, hypertension, cigarette smoking, physical inactivity, consumption of sodas and other sugary drinks and food insecurity are all associated with greater risk for the development of Type 2 Diabetes (Rodriguez et al., 2022). Of American adults diagnosed with Diabetes, 89.8% were overweight with 47.1% being obese, 80.6% had some form of high blood pressure, and 31.9% were physically inactive (defined as getting less than 10 minutes per week of moderate to vigorous physical activity in work, leisure time, or transportation (CDC, 2024). Of note, 14.6% were current smokers, while 22.1% were tobacco users, with 36% having quit smoking but with a history of smoking 100 cigarettes or more during their lifetime (CDC, 2024).

How it is treated

     The American Diabetes Association (ADA) emphasizes that insulin is essential for Type 1 Diabetes as the disease is defined by a lack of insulin production by the pancreas (ADA, 2026). For adults with Type 2 Diabetes, the ADA stresses the importance of a person-centered approach to any medication regimen (ADA, 2026). Because Type 2 Diabetes often presents along with other comorbidities such as obesity, hypertension and hypercholesterolemia, their plan of treatment should include medications aimed at reducing their risk of a cardiac event (ADA, 2026). Weight reduction strategies for those that are overweight or obese should also be incorporated (ADA, 2026).

References

American Diabetes Association Professional Practice Committee for Diabetes. (2026). Pharmacologic approaches to glycemic treatment: Standards of care in Diabetes—2026. Diabetes Care, 49(1). https://doi.org/10.2337/dc26-S009

Factors contributing to higher incidence of diabetes for black Americans. (2018, January 9). National Institutes of Health. https://www.nih.gov/news-events/nih-research-matters/factors-contributing-higher-incidence-diabetes-black-americans

Glover, L. M., Martin, C. L., Green-Howard, A., Adatorwovar, R., Loehr, L., Staley-Salil, B., North, K. E., & Sims, M. (2023). Cumulative socioeconomic status and incident type 2 diabetes among African American adults from the Jackson heart study. SSM- Population Health, 22. https://doi.org/10.1016/j.ssmph.2023.101389

Kunarathnam, V., Vadakekut, E. S., & Mahdy, H. (2025, September 15). Gestational Diabetes. StatPearls Publishing.  https://www.ncbi.nlm.nih.gov/books/NBK545196/

McLaurin, N., Tabibi, D., Wang, T., Alhalimi, T., Lehrer, H. M., Harrison Jr., L., Tanaka, H., & Steinhardt, M. A. (2024). Coping with discrimination among African Americans with Type 2 Diabetes: Factor structure and associations with diabetes control, mental distress, and psychosocial resources. Preventing Chronic Disease: Public Health Research, Practice and Policy, 21. https://dx.doi.org/10.5888/pcd21.230189

Olaniyan, A. C. (2023). Diabetes statistics and health needs among African Americans. Biomedical Journal of Scientific & Technical Research, 54(1). https://doi.org/10.26717/BJSTR.2023.54.008493

Rodriguez, L. A., Thomas, T. W., Finertie, H., Turner, C. D., Heisler, M., & Schmittdiel, J. A. (2022). Psychosocial and diabetes risk factors among racially/ethnically diverse adults with prediabetes. Preventive Medicine Reports, 27. https://doi.org/10.1016/j.pmedr.2022.101821

U.S. Centers for Disease Control. (2024, May 15). National Diabetes Statistics Report. https://www.cdc.gov/diabetes/php/data-research/index.html

U.S. Department of Health and Human Services Office of Minority Health. (2025, September 15). Black/African American Health. https://minorityhealth.hhs.gov/blackafrican-american-health