Racial differences in symptoms and complications in adults with type 2 diabetes mellitus

Objective. To compare the frequency of common symptoms and complications between African- and white American adults with type 2 diabetes mellitus in a primary care setting, and to examine associations of these conditions with glycemic control. Design. Three hundred and four adults with type 2 diabetes participated in this cross-sectional analysis; 142 of whom were African-Americans. Patients were recruited from a family practice ambulatory care unit and a community health center. Results. Both male and female African-Americans had higher mean diastolic blood pressure and poorer metabolic control than their white counterparts. After adjustment for diabetes duration, glycosylated hemoglobin and diastolic blood pressure, African-American females were significantly more likely to experience constipation and hypertension but less likely to experience chest pain, claudication, peripheral neuropathy or have peripheral vascular disease. Among male subjects, African-Americans were significantly more likely to experience blurred vision and hypertension but less likely to have peripheral atherosclerotic disease. Poor glycemic control was more strongly associated with the occurrence of common diabetic symptoms in African-American subjects. Conclusions. Both African- and white Americans with type 2 diabetes are likely to experience a wide variety of symptoms and vascular complications. African-American subjects appear more likely than whites to experience symptoms related to glycemic control but less likely to have, or experience symptoms and complications of, cardiovascular disease. That nearly half of these subjects seen in a primary care setting had microalbuminuria suggests that vascular complications are likely to be present in the majority of adults with type 2 diabetes, even in these currently asymptomatic. These findings may have implications for screening and preventive strategies for the treatment of this disease.