Risks for Black, Hispanic and Asian Americans start at lower weights and younger ages than risks for white people
Rahul Aggarwal was in medical school when he got the surprising news that his mother—a fit woman in her 40s—had been diagnosed with type 2 diabetes. “I always thought of diabetes as a disease of people at higher weights and with certain lifestyle practices,” he recalls, “but my mom was an Indian American woman with a healthy weight and good diet and exercise practices.
In a second analysis, the investigators looked at diabetes prevalence by age and concluded that to match the efficacy of screening white people at 35, providers would need to screen Hispanic Americans at 25, Asian Americans at 23 and Black Americans at 21. Medicine has been eliminating race-based scoring that made some tests, such as an assessment of kidney function, less sensitive to disease in Black people.
Ngo-Metzger, who was the USPSTF's scientific director from 2012 to 2019, notes that “most studies of diabetes were done in middle-aged white individuals,” and that's what screening standards were based on. She argues that they should be revised. “The study found that you would miss so many Blacks, Hispanics and Asians when you use these guidelines. I think it's a disservice.”
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