Skin deep: Enhanced variable may help explain racial disparities in type 2 diabetes and prediabetes




Lo, Celia C.
Lara, Joanna
Cheng, Tyrone C.

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Introduction: The study refined definitions of type 2 diabetes and prediabetes (Pre-/T2D) via its four-category outcome variable. Respondents were identified as Pre-/T2D on the basis of (a) doctor’s diagnosis only (i.e., managed Pre-/T2D); (b) biomarker only (i.e., undiagnosed Pre-/T2D); or (c) both diagnosis and biomarker (i.e., unmanaged Pre-/T2D). The reference was Pre-/T2D not indicated. We linked the outcome to social structural and social support factors, health care-related factors, mental disorder, and lifestyle variables, for each racial/ethnic group.

Methods: We used the 2011–2012 and 2013–2014 National Health and Nutrition Examination Surveys to measure the four-category outcome and examine race/ethnicity’s role in explaining the outcome.

Results: We found Pre-/T2D to be associated with age, BMI, physical activity, income, education, receiving health services, and other factors. A moderating role for race/ethnicity was also confirmed.

Conclusion: The racial disparities observed in our three main categories generally resulted from high levels of undiagnosed Pre-/T2D and high levels of diagnosed but unmanaged Pre-T2D. Race/ethnicity’s moderating role generally indicated that, through the factors BMI, age, and receiving health services, minority status (with its attendant disadvantages) could facilitate undiagnosed Pre-/T2D as well as Pre-/T2D indicated concurrently by diagnosis and biomarker.


Article originally published in Diabetes Therapy, 8(4), 837–850. English. Published online 2017.


Biomarker, Multiple disadvantage model, Racial disparities, Type 2 diabetes and prediabetes (Pre-/T2D), Undiagnosed Pre-/T2D, Unmanaged Pre-/T2D


This is the published version of an article that is available at Recommended citation: Lo, C. C., Lara, J., & Cheng, T. C. (2017). Skin deep: Enhanced variable may help explain racial disparities in type 2 diabetes and prediabetes. Diabetes Therapy, 8(4), 837–850. This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.