Perceived Discrimination: Influencing Behavior in Diabetics

Approximately 13.2 % of adults who have type 2 diabetes mellitus (T2DM) are non-Hispanic blacks. Compared to others, people from ethnic minorities tend to have higher prevalence, risk of complications, and mortality related to T2DM. Racial disparities in health care are well documented. Researchers from the Medical University of South Carolina recently asked the question, “Is perceived discrimination a stressor for patients who have T2DM?” Their study, published in the June 2015 issue of Endocrine Practice, indicates that perceived discrimination influences health behavior.

Using a large sample size of black and white patients with T2DM (N=602 adults), the researchers queried perceived racial discrimination and measured glycemic control, blood pressure, and LDL cholesterol. They also examined health behaviors known to improve diabetes outcomes. They looked at diet in two ways: (1) general diet, or ability to follow a healthy diet, and (2) specific diet, or consumption of fruits and fat.

All patients received care at adult primary care clinics in either a local Veterans Administration medical center or an academic medical center in the southeastern United States.

Patients’ average age was 61 years. Almost 65% identified as non-Hispanic black, and 41.6 % reported incomes of less than $20,000 annually.

Perceived discrimination significantly reduced the mental component of quality of life. In addition, patients who had perceived discrimination had poorer and specific general diets.

Non-Hispanic black patients who reported perceived discrimination were significantly more likely to have higher systolic blood pressure.

Whites who had perceived discrimination were also more likely to have general and specific diet deficits, and they were less likely to adhere to blood glucose testing recommendations.

Patients reporting income between $10,000 and $14,999 seemed to be disproportionately (negatively) affected.

The researchers urge clinicians to tailor diabetes education programs to reflect patients’ cultures and consider psychosocial factors including perceived discrimination.