ClearMed
BriefingsDrug & Biomarker IndexSaved (0)
All Endocrinology BriefingsDiabetes Care
EndocrinologyReal-World Cohort3 min read

Reactions to Race[ism]: The Relationship Between Differential Treatment Based on Race and Diagnosed Diabetes Status in U.S. Adults

We analyzed 2022-2023 Behavioral Risk Factor Surveillance System data from 328,056 adults completing the Reactions to Race module and reporting diabetes status.

Published in Diabetes CareObservational cohort study
3/5 Observational
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

Source

Study Cohort

328,056 adults

Experiences of racial discrimination were common among U.S. adults and were reported more frequently by adults with diabetes.

What Changes?

Endocrinology · Real-World Cohort

Current Standard

In both groups, discrimination was associated with race and ethnicity, age, sex, employment, poor mental health, and current smoking.

New Finding

Because discrimination can contribute to chronic stress, reduced access to high-quality care, and barriers to diabetes self-management, consideration of racism-related exposures is important in efforts to understand and address diabetes disparities.

3 Key Takeaways

Plain English Summary
  1. 01Core Finding

    Experiences of racial discrimination at work, in health care, or elsewhere, and related physical symptoms, were categorized as any versus none.

  2. 02Study Evidence

    Tested in a study (328,056 adults) at the real-world stage.

  3. 03Practical Meaning

    findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.

What This Means for You

Experiences of racial discrimination were common among U.S. adults and were reported more frequently by adults with diabetes. Because discrimination can contribute to chronic stress, reduced access to high-quality care, and barriers to diabetes self-management, consideration of racism-related exposures is important in efforts to understand and address diabetes disparities.

The Discovery

To examine associations between diabetes status and self-reported discrimination based on race among U.S. adults with and without diabetes. We analyzed 2022-2023 Behavioral Risk Factor Surveillance System data from 328,056 adults completing the Reactions to Race module and reporting diabetes status. Experiences of racial discrimination at work, in health care, or elsewhere, and related physical symptoms, were categorized as any versus none. Weighted and multivariable logistic regression were stratified by diabetes status. Discrimination based on race was reported by 14.2% of adults with diabetes and 12.5% without diabetes. Patterns were similar across age, metropolitan status, and employment subgroups. In both groups, discrimination was associated with race and ethnicity, age, sex, employment, poor mental health, and current smoking.

How It Works, Simply

This endocrinology research focuses on hormonal, glycemic & metabolic receptor signaling. Researchers evaluated it using an observational cohort study (328,056 adults) at the real-world cohort stage of medical research.

3 Key Takeaways

Clinical Takeaways
  1. 01Core Finding

    Experiences of racial discrimination at work, in health care, or elsewhere, and related physical symptoms, were categorized as any versus none.

  2. 02Study Evidence

    Tested in a study (328,056 adults) at the real-world stage.

  3. 03Practical Meaning

    findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.

01

Biological Mechanism & Study Design

Study Design & Cohort

Observational cohort study

Observational cohort study (328,056 adults) · Real-World Cohort

Biological Pathway & Modality

Hormonal, glycemic & metabolic receptor signaling

Intervention: Reactions to Race[ism]: The Relationship Between Differential Treatment Based on

02

Experimental Findings & Endpoints

To examine associations between diabetes status and self-reported discrimination based on race among U.S. adults with and without diabetes.

We analyzed 2022-2023 Behavioral Risk Factor Surveillance System data from 328,056 adults completing the Reactions to Race module and reporting diabetes status. Experiences of racial discrimination at work, in health care, or elsewhere, and related physical symptoms, were categorized as any versus none.

Weighted and multivariable logistic regression were stratified by diabetes status. Discrimination based on race was reported by 14.2% of adults with diabetes and 12.5% without diabetes.

Patterns were similar across age, metropolitan status, and employment subgroups. In both groups, discrimination was associated with race and ethnicity, age, sex, employment, poor mental health, and current smoking.

03

Clinical Translation & Practice Context

Experiences of racial discrimination were common among U.S. adults and were reported more frequently by adults with diabetes.

Because discrimination can contribute to chronic stress, reduced access to high-quality care, and barriers to diabetes self-management, consideration of racism-related exposures is important in efforts to understand and address diabetes disparities.

03

The Bottom Line · Clinical Pearl

“Experiences of racial discrimination were common among U.S. adults and were reported more frequently by adults with diabetes.”

Published in Diabetes Care · Current Stage: Real-World Cohort

Practical Next Step

Questions for Your Next Doctor Visit

  1. 1Based on my health history, do these endocrinology findings (adults with and without diabetes) apply to my situation?
  2. 2How do the potential benefits of this approach compare with the standard care I'm currently using?
  3. 3Given the study's key limitation (observational cohort findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.), what risks or follow-up steps should we watch for?
Endocrinology · Real-World Cohort
Study Type
Observational cohort study

Observational cohort study (328,056 adults)

Evidence Score
3/5 · Real-World Observation
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

Who It Applies To
Adults with and without diabetes
Intervention & Mechanism
Reactions to Race[ism]: The Relationship Between Differential Treatment Based on

Hormonal, glycemic & metabolic receptor signaling

Key Limitation
Observational cohort findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.

Translational Stage

LEVEL 2 · Real-World Cohort

Classified as Observational cohort study along the clinical evidence continuum

  1. Lab & Discovery
  2. Early Trials
  3. Human Evidence
  4. 4Real-World CohortActive

Original Publication & AMA Citation

Reactions to Race[ism]: The Relationship Between Differential Treatment Based on Race and Diagnosed Diabetes Status in U.S. Adults. Diabetes Care. Published 2026;Oct 29. Accessed November 15, 2026. https://pubmed.ncbi.nlm.nih.gov/42955026/

Diabetes Care

https://pubmed.ncbi.nlm.nih.gov/42955026/

Read Original Paper

Continue Reading

Related in Endocrinology

View all Endocrinology briefings →
ENDOCRINOLOGY · CLINICAL PRACTICE

Ozempic in Pregnancy: Diabetes, Not Drug, Linked to Early Births?

The reason you're taking Ozempic or Wegovy matters during pregnancy, with underlying diabetes potentially posing a greater risk than the medication itself. This study challenges the previously held, often generalized, assumption that GLP-1 medications alone are responsible for pregnancy complications.

3/5 Observational
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

1 min readScienceDaily
ENDOCRINOLOGY · REAL-WORLD COHORT

Clinical Guidance for Disease-Modifying Immunotherapy in Children and Adolescents With New-Onset (Stage 3) Type 1 Diabetes

Teplizumab-specific recommendations are identified, with broader principles framed for adaptation across health systems. This article addresses who should lead care, how to approach eligibility and timing, how to assess β-cell reserve and infection risk, how to sequence treatment with diabetic ketoacidosis recovery and early education, and how to monitor treatment safely.

3/5 Observational
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

1 min readDiabetes Care
ENDOCRINOLOGY · REAL-WORLD COHORT

Transient Cognitive Vulnerability After Hypoglycemia in Adults With Type 1 Diabetes: Evidence From Continuous Glucose Monitoring and Cognitive Ecologic Momentary Assessment

Hypoglycemia was associated with a transient period of cognitive vulnerability largely confined to the hour after an event, with little evidence of delayed effects. Findings support avoiding or exercising caution during cognitively demanding tasks for up to an hour after a hypoglycemic event.

3/5 Observational
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

1 min readDiabetes Care