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Cited by 713Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchRacial and Ethnic Identity Research

Prevalence of Diabetes by Race and Ethnicity in the United States, 2011-2016

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Cheng, Yiling J., Kanaya, Alka M., Araneta, Maria Rosario G., Saydah, Sharon H., Kahn, Henry S., Gregg, Edward W., Fujimoto, Wilfred Y., Imperatore, Giuseppina·2019·JAMA
DOI 10.1001/jama.2019.19365PMC PMC6990660
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Abstract

Importance: The prevalence of diabetes among Hispanic and Asian American subpopulations in the United States is unknown. Objective: To estimate racial/ethnic differences in the prevalence of diabetes among US adults 20 years or older by major race/ethnicity groups and selected Hispanic and non-Hispanic Asian subpopulations. Design, Setting, and Participants: National Health and Nutrition Examination Surveys, 2011-2016, cross-sectional samples representing the noninstitutionalized, civilian, US population. The sample included adults 20 years or older who had self-reported diagnosed diabetes during the interview or measurements of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and 2-hour plasma glucose (2hPG). Exposures: Race/ethnicity groups: non-Hispanic white, non-Hispanic black, Hispanic and Hispanic subgroups (Mexican, Puerto Rican, Cuban/Dominican, Central American, and South American), non-Hispanic Asian and non-Hispanic Asian subgroups (East, South, and Southeast Asian), and non-Hispanic other. Main Outcomes and Measures: Diagnosed diabetes was based on self-reported prior diagnosis. Undiagnosed diabetes was defined as HbA1c 6.5% or greater, FPG 126 mg/dL or greater, or 2hPG 200 mg/dL or greater in participants without diagnosed diabetes. Total diabetes was defined as diagnosed or undiagnosed diabetes. Results: The study sample included 7575 US adults (mean age, 47.5 years; 52% women; 2866 [65%] non-Hispanic white, 1636 [11%] non-Hispanic black, 1952 [15%] Hispanic, 909 [6%] non-Hispanic Asian, and 212 [3%] non-Hispanic other). A total of 2266 individuals had diagnosed diabetes; 377 had undiagnosed diabetes. Weighted age- and sex-adjusted prevalence of total diabetes was 12.1% (95% CI, 11.0%-13.4%) for non-Hispanic white, 20.4% (95% CI, 18.8%-22.1%) for non-Hispanic black, 22.1% (95% CI, 19.6%-24.7%) for Hispanic, and 19.1% (95% CI, 16.0%-22.1%) for non-Hispanic Asian adults (overall P < .001). Among Hispanic adults, the prevalence of total diabetes was 24.6% (95% CI, 21.6%-27.6%) for Mexican, 21.7% (95% CI, 14.6%-28.8%) for Puerto Rican, 20.5% (95% CI, 13.7%-27.3%) for Cuban/Dominican, 19.3% (95% CI, 12.4%-26.1%) for Central American, and 12.3% (95% CI, 8.5%-16.2%) for South American subgroups (overall P < .001). Among non-Hispanic Asian adults, the prevalence of total diabetes was 14.0% (95% CI, 9.5%-18.4%) for East Asian, 23.3% (95% CI, 15.6%-30.9%) for South Asian, and 22.4% (95% CI, 15.9%-28.9%) for Southeast Asian subgroups (overall P = .02). The prevalence of undiagnosed diabetes was 3.9% (95% CI, 3.0%-4.8%) for non-Hispanic white, 5.2% (95% CI, 3.9%-6.4%) for non-Hispanic black, 7.5% (95% CI, 5.9%-9.1%) for Hispanic, and 7.5% (95% CI, 4.9%-10.0%) for non-Hispanic Asian adults (overall P < .001). Conclusions and Relevance: In this nationally representative survey of US adults from 2011 to 2016, the prevalence of diabetes and undiagnosed diabetes varied by race/ethnicity and among subgroups identified within the Hispanic and non-Hispanic Asian populations.

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  • Racial and ethnic minority groups experience higher rates of type 2 diabetes-related morbidity and mortality.

    “Given that racial and ethnic minority groups experience higher rates of type 2 diabetes-related morbidity and mortality, examining these disparities is important [18].”

    From Racial and ethnic disparities in the uptake of SGLT2is and GLP-1RAs among Medicare beneficiaries with type 2 diabetes and heart failure, atherosclerotic cardiovascular disease and chronic kidney disease, 2013–2019 (2025) · cites this paper as [18]

    The Discussion reports higher diabetes prevalence among Hispanic, non-Hispanic Black, and non-Hispanic Asian adults than among non-Hispanic White adults. That supports a racial and ethnic disparity in diabetes prevalence, but the paper does not establish higher rates of type 2 diabetes-related morbidity or mortality. (LLM, conf=0.76)

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  • Risk factors for type 2 diabetes include overweight and obesity, physical inactivity, age, family history, race and ethnicity, history of gestational diabetes, and presence of other conditions (eg, hypertension, dyslipidemia, cardiovascular disease).

    “Risk factors for type 2 diabetes include overweight and obesity, physical inactivity, age, family history, race and ethnicity, history of gestational diabetes, and presence of other conditions (eg, hypertension, dyslipidemia, cardiovascular disease).9–14”

    From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [11]

    The Discussion reports an association between BMI and diabetes and differences in diabetes prevalence by race and ethnicity. It does not substantiate the rest of the listed risk factors—physical inactivity, age, family history, gestational diabetes, hypertension, dyslipidemia, or cardiovascular disease. Page numbers are not available in our copy. (LLM, conf=0.88)

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  • In individuals with prediabetes, type 2 diabetes can be prevented or delayed with changes in health behaviors that lead to weight loss or pharmacotherapy.

    “In individuals with prediabetes, type 2 diabetes can be prevented or delayed with changes in health behaviors that lead to weight loss or pharmacotherapy.8”

    From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [8]

    The Methods (page unavailable) define prediabetes, and the Results report its prevalence, but neither addresses whether type 2 diabetes can be prevented or delayed. Searches for weight loss, lifestyle intervention, and pharmacotherapy found no passage supporting the attributed claim. (LLM, conf=0.76)

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Authors
Cheng, Y. J., Kanaya, A. M., Araneta, M. R. G., Saydah, S. H., Kahn, H. S., Gregg, E. W., Fujimoto, W. Y., & Imperatore, G.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • University of California, San Francisco (US)
  • University of California San Diego (US)
  • Emory University (US)
  • Imperial College London (GB)
  • University of Washington (US)
Corresponding author
Cheng, Yiling J.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2019-12-24
Volume
322
Issue
24
Pages
2389
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2019.19365
PMC
PMC6990660
OpenAlex
W2995605526
Cited by
713
References
23
Citations by year
2026: 62 · 2025: 142 · 2024: 128 · 2023: 119 · 2022: 122 · 2021: 97 · 2020: 42 · 2019: 1
FWCI
53.15
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute (K24HL112827)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK098722, P30DK092924)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Keywords
diabetes prevalence, racial and ethnic disparities, Hispanic subgroups, Asian American subgroups, undiagnosed diabetes, diabetes diagnosis, HbA1c, fasting blood glucose, 2-hour plasma glucose, Mexican Americans, Puerto Ricans, East Asian Americans, South Asian Americans, Southeast Asian Americans, non-Hispanic Black adults
MeSH terms
Adult, Asian, Cross-Sectional Studies, Diabetes Mellitus, Ethnicity, Female, Hispanic or Latino, Humans, Male, Nutrition Surveys, Socioeconomic Factors, United States, Prevalence, Racial Groups

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