Racial discrimination and metabolic control in women with type 2 diabetes

Purpose: 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.