Risk Trajectories of Type 2 Diabetes-Related Microvascular Complications Across Racial/Ethnic Groups Among Older...

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Public Health

Background:

• Microvascular complications of type 2 diabetes mellitus (T2DM) represent a significant public health concern.
• Racial and ethnic minorities in the US experience disproportionately higher rates of these complications.
• Understanding longitudinal disparities in T2DM microvascular complications is crucial for targeted interventions.

Purpose of the Study:

• To investigate racial and ethnic disparities in the eight-year progression of microvascular complications among older adults with T2DM.
• To analyze the natural history of composite microvascular complications, nephropathy, neuropathy, and retinopathy across different racial groups.

Main Methods:

• Analysis of 6323 participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (2003-2009).
• Examination of racial/ethnic differences (Black, White, Other) in microvascular outcomes over an 8-year period.
• Utilized linear mixed-effects models with random intercepts to account for within-person correlations.

Main Results:

• The odds of composite microvascular complications declined over time for adults of "Other" race (primarily Hispanic) [OR: 0.95 (0.93-0.99)].
• Conversely, the odds of these complications increased over the study period for Black [1.06 (1.03-1.09)] and White [1.11 (1.09-1.13)] adults (P < 0.001).

Conclusions:

• A significant trend of declining microvascular complication risk was observed in "Other" race adults with T2DM.
• This protective trend was notably absent in Black and White adults, highlighting persistent racial disparities in T2DM management and outcomes.