Session Ia | Healthcare Disparities: Type 2 Diabetes & Breast Cancer

Type 2 diabetes mellitus (diabetes) is more prevalent among African Americans (AAs) compared to nonHispanic whites (NHWs). Recent trends indicate that diabetes incidence has plateaued among NHWs, but continues to rise among AAs. Thus, examining potential diabetes prevention strategies in AA populations is of paramount importance. The two strategies that will be explored are modifiable lifestyle factors and the renin-angiotensin-aldosterone system. Modifiable lifestyle factors such as physical activity, sedentary behaviors, dietary intake and smoking are well described in NHWs, but evidence on the role of modifiable risk factors in diabetes prevention in AA populations is lacking. In the Multi-Ethnic Study of Atherosclerosis, attainment of ideal cardiovascular health components (total cholesterol, blood pressure, dietary intake, tobacco use, physical activity and body mass index) was associated with a greater magnitude of risk lowering among NHWs compared to AAs. Thus, we performed two further analyses evaluating: 1) the role of modifiable lifestyle factors (exercise, diet, smoking, TV watching, and sleep-disordered breathing burden) and 2) the role of ideal cardiovascular health in the development of diabetes among AAs in the Jackson Heart Study. Our work shows that modifiable lifestyle factors play a role in the development of diabetes in AAs but there are significant racial/ethnic differences. Thus, it is critical to understand novel biological mechanisms underpinning diabetes among AAs. We have been investigating the role of the reninangiotensin-aldosterone system in diabetes, which may provide a potential targeted strategy for prevention of diabetes among AAs.