Non-insulin-dependent diabetes mellitus in minorities in the United States.
OBJECTIVE
To review the available information on prevalence, complications, and mortality of non-insulin-dependent diabetes mellitus and primary and secondary prevention activities in black persons, Hispanic persons, Native Americans, and Asians and Pacific Islanders in the United States.


METHODS
MEDLINE search from 1976 to 1994 through the PlusNet search system.


METHODS
Use of the key words non-insulin-dependent diabetes mellitus, the names of each specific minority group, socioeconomic status, acculturation, genetics, diet, complications, mortality, treatment, and intervention (lifestyle or medication) produced 290 unduplicated articles. Additional articles cited in the original articles were also included.


METHODS
Risk factors, incidence, prevalence, complications, and mortality of non-insulin-dependent diabetes mellitus.


RESULTS
All minorities, except natives of Alaska, have a prevalence of non-insulin-dependent diabetes mellitus that is two to six times greater than that of white persons. Most studies show an increased prevalence of nephropathy that can be as much as six times higher than that of white persons. Retinopathy has variably higher rates in black persons, Hispanic persons, and Native Americans. Amputations are done more frequently among black persons than among white persons (9.0 per 1000 compared with 6.3 per 1000), and Pima Indians have 3.7 times more amputations than do white persons. Diabetes-related mortality is higher for minorities than for white persons, and the rate is increasing. The relative importance of genetic heritage, diet, exercise, socioeconomic status, culture, language, and access to health care in the prevalence, incidence, and mortality of diabetes is not clear. Studies of interventions in minority populations are in progress.


CONCLUSIONS
Diabetes should be treated as a public health problem for minority populations.
Carter
J S
JS
University of New Mexico School of Medicine, Albuquerque, USA.
Pugh
J A
JA
Monterrosa
A
A
D001741:Black or African American / Q000706:statistics & numerical data; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D003469:Culture; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D017719:Diabetic Foot / Q000601:surgery; D015444:Exercise; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data; D008913:Minority Groups / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data