title: Racial discrimination and metabolic control in women with type 2 diabetes.
abstract: OBJECTIVE
  We investigated whether self-reported racial discrimination was associated with insulin resistance (IR) and glycosylated hemoglobin (A1c) in women with type 2 diabetes in the United States, after controlling for covariates.
  
  
  METHODS
  Seventy-seven Black and White women with type 2 diabetes completed the Experiences of Discrimination Scale, which assesses self-reported lifetime frequency of racially motivated discrimination. Participants provided fasting blood samples for assessment of glucose and insulin for determination of IR and A1c. Covariates included age, education, waist circumference, diabetes distress, and stressful life events.
  
  
  RESULTS
  In unadjusted regression analysis discrimination was significantly associated with IR. There was a trend for a race by discrimination interaction, with a weaker effect for Blacks than Whites. Follow up analysis showed that discrimination was significantly associated with IR in both Blacks and Whites, even after adjustment, as was waist circumference. In unadjusted regression analysis, discrimination was significantly associated with A1c. There was a significant race by discrimination interaction. Follow up analysis showed that discrimination was not significantly associated with A1c among Blacks, but was among Whites, even after adjustment, as was diabetes distress and insulin use.
  
  
  CONCLUSIONS
  Racial discrimination is associated with insulin resistance in Black and White women with diabetes, and with A1c in White women with diabetes.
authors.affiliation: Division of Behavioral Sciences and Community Health MC3910, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06410, USA. juwagner@uchc.edu
authors.forename: Julie A
authors.initials: JA
authors.lastname: Wagner
authors.affiliation: Division of Behavioral Sciences and Community Health MC3910, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06410, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Tennen
authors.affiliation: Quinnipiac University School of Medicine, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Feinn
authors.affiliation: Johns Hopkins University School of Medicine, USA.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Finan
mesh_terms: D001741:Black or African American; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D063505:Racism; D014481:United States; D055105:Waist Circumference; D044465:White People
chemical_list: D006442:Glycated Hemoglobin