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Self-Reported Discrimination, Diabetes Distress, and Continuous Blood Glucose in Women with Type 2 Diabetes

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Abstract

We investigated whether self-reported racial discrimination was associated with continuous glucose levels and variability in individuals with diabetes, and whether diabetes distress mediated these associations. Seventy-four Black and White women with type 2 diabetes completed the Experience of Discrimination scale, a measure of lifetime racial discrimination, and the Problem Areas in Diabetes, a measure of diabetes distress. Participants wore a continuous glucose monitor for 24 h after 8 h of fasting, a standard meal, and a 4-h run in period. Higher discrimination predicted higher continuous mean glucose and higher standard deviation of glucose. For both mean and standard deviation of glucose, a race × discrimination interaction indicated a stronger relationship between discrimination and glucose for Whites than for Blacks. Diabetes distress mediated the discrimination–mean glucose relationship. Whites who report discrimination may be uniquely sensitive to distress. These preliminary findings suggest that racial discrimination adversely affects glucose control in women with diabetes, and does so indirectly through diabetes distress. Diabetes distress may be an important therapeutic target to reduce the ill effects of racial discrimination in persons with diabetes.

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Acknowledgments

This study was supported by a Grant from the National Institute of Diabetes, Digestive, and Kidney Diseases to Dr. Wagner 5R21DK074468. Dr. Osborn is supported by NIDDK K01DK087894.

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Authors and Affiliations

  1. Division of Behavioral Sciences and Community Health, MC3910, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT, 06030, USA

    Julie A. Wagner

  2. Department of Community Medicine, University of Connecticut Health Center, Farmington, CT, USA

    Howard Tennen

  3. Quinnipiac University, Hamden, CT, USA

    Richard Feinn

  4. Departments of Medicine and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA

    Chandra Y. Osborn

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  1. Julie A. Wagner
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  2. Howard Tennen
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  3. Richard Feinn
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  4. Chandra Y. Osborn
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Correspondence to Julie A. Wagner.

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Wagner, J.A., Tennen, H., Feinn, R. et al. Self-Reported Discrimination, Diabetes Distress, and Continuous Blood Glucose in Women with Type 2 Diabetes. J Immigrant Minority Health 17, 566–573 (2015). https://doi.org/10.1007/s10903-013-9948-8

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  • DOI: https://doi.org/10.1007/s10903-013-9948-8

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