Tracking Diabetes Risk in African Americans

Predictive models of type 2 diabetes risk may not work as well in assessing African American patients, a study found.

Do current predictive models of type 2 diabetes risk work as well in African Americans? That’s the question a team at Brown University’s School of Public Health in Providence, R.I., sought to answer in an analysis using data from the Coronary Artery Risk Development Study in Young Adults (CARDIA) study.

The American Diabetes Association (ADA) added hemoglobin A1c (HbA1c) measurements to their guidelines for diagnosing type 2 diabetes in 2010. However, the models used to predict a person’s risk of developing diabetes were created before this addition.

The team, led by Mary E. Lacy, a doctoral candidate in the Department of Epidemiology, examined data from 2,456 white and African-American adults without diabetes beginning in 2005-2006 and followed for 5 years to see how well the Atherosclerosis Risk in Communities diabetes risk prediction model and similar existing models worked before and after the additon of the baseline HbA1c. They also evaluated whether there were racial differences in how well the models worked.

Overall, the team wrote, the model resulted in good discrimination for prediction of 5-year diabetes risk; adding HbA1c as a predictor improved it. However, when stratified for race, all of the models worked significantly better in white participants than African American participants. The study was published online ahead of print on December 1, 2015 and in print in the February issue of Diabetes Care.