Diabetes is complex. Many factors influence your risk of developing diabetes, including race. The way race is associated with diabetes risk may change the way physicians screen patients for the disease.
Being overweight has been identified as a factor in diabetes, and may serve as a cue for screening. The United States Preventive Services Task Force — the governmental agency charged with finding the best evidential ways to prevent disease — recommends that patients aged 35-70 be screened for diabetes if they have a BMI of 25 or over, which categorizes that person as “overweight.” [1, 2].
Let’s break this down. First, what’s the BMI scale?
The Body Mass Index (BMI) is a number based on dividing your weight by the square of your height. [Here’s a link to calculate your BMI.] Medical professionals use it as one quick screening tool for assessing a person’s risk for illnesses related to weight/height ratios. While the CDC says that the BMI number “does not diagnose the body fatness or health of an individual,” the resulting number categorizes a person as being in one of four ranges:
Chart from Centers for Disease Control
Your ethnicity also impacts your risk of diabetes. Native Americans, Alaska Natives, Asians, Blacks, and Hispanics all have higher incidences of diabetes by percentage of the population when compared with White Americans.
Chart from the Centers for Disease Control
What is the connection between race and size for diabetes risk? Researchers at Beth Israel Deaconess Medical Center and Harvard Medical School knew that certain ethnic groups were at a higher risk of getting diabetes. For the average white adult, a BMI of 25 and up (“overweight’) triggers a diabetes screening. But what if you’re not average? Shouldn’t people in higher risk groups be screened for diabetes at a different BMI? If so, what should those numbers be? The researchers sought to determine at what number a member of a different group would be facing the same risks as a 35 year old white person with a BMI of 25. 
In the study, they recommended the following thresholds for these groups:
|Asians||BMI of 20 (range, under 18.5 to 23)|
|Black Americans||BMI of less than 18.5 (range, under 18.5 to 23)|
|Hispanic Americans||BMI of 18.5 kg/m2 (range, under 18.5 to 24)|
Note that for all Asians, Black Americans, and Hispanic Americans between 35 and 70, testing should be triggered even if the person is “underweight” or at “healthy weight” by BMI standards. While the study did not include them, Native Americans are the group at the highest risk of all for diabetes, so it is likely that a lower BMI could also apply here.
This is just one study’s recommendation. The important information to take away is that your ethnicity influences your risk of developing diabetes. It is important to be aware that ethnicity affects your relative risk and to talk with your doctor about what this means for you specifically.
Image by Gerd Altmann from Pixabay