Risk trajectories of type 2 diabetes-related microvascular complications across racial/ethnic groups among older adults

Authors

Kaustubh V. Parab, Advocate Health - MidwestFollow
Xiaotian Gao, Center for Epidemiology and Population Health, Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Neha P. Gothe, Department of Physical Therapy, Human Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA.
Kenneth R. Wilund, School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA.
Harshal P. Mahajan, Department of Health and Kinesiology, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA.
Chelsea R. Singleton, Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA.

Recommended Citation

Parab KV, Gao X, Gothe NP, Wilund KR, Mahajan HP, Singleton CR. Risk Trajectories of Type 2 Diabetes-Related Microvascular Complications Across Racial/Ethnic Groups Among Older Adults. J Racial Ethn Health Disparities. Published online September 9, 2025. doi:10.1007/s40615-025-02625-0

Affiliations

Aurora St. Luke's Medical Center

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) microvascular complications are a major public health issue that disproportionately affects racial/ethnic minorities in the US. We aimed to address the limited understanding of racial/ethnic disparities in the longitudinal natural history of microvascular complications over eight years among older adults with T2DM in the US and Canada.

Methods: From 10,251 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) (2003-2009) trial, we derived 6323 participants. We examined racial/ethnic disparities of composite microvascular complications, nephropathy, neuropathy, and retinopathy outcomes among adults of Black (n = 1099), White (n = 4071), and Other races (n = 1156), over 8 years. We used linear mixed-effects model with random intercept to account for intra-person correlation.

Results: Our linear mixed-effects models displayed that the odds of composite microvascular complications for other race, which primarily consisted of Hispanic adults declined over a period of time [OR: 0.95 (0.93-0.99)]. The odds increased over time for Black [1.06 (1.03-1.09)] and White [1.11 (1.09-1.13)] adults (P < 0.001).

Conclusion: Other race adults had a declining risk of microvascular complications over time. This decline was not observed among Black and White adults.

Document Type

Article

PubMed ID

40926157