In the United States, Hispanic, non-Hispanic Black, Asian American, and American Indian/Alaska Native adults all develop type 2 diabetes at significantly higher rates than non-Hispanic white adults. The gap is substantial: adjusted for age and sex, about 22% of Hispanic adults and 20% of Black adults have diabetes, compared to roughly 12% of white adults. These differences stem from a combination of genetics, body composition, socioeconomic conditions, and unequal access to healthcare.
Prevalence Rates by Race and Ethnicity
A large national analysis covering 2011 through 2016 calculated diabetes prevalence after adjusting for age and sex differences between groups. Hispanic adults had the highest overall prevalence at 22.1%, followed closely by non-Hispanic Black adults at 20.4% and non-Hispanic Asian adults at 19.1%. Non-Hispanic white adults had a prevalence of 12.1%. That means Hispanic and Black adults are roughly twice as likely to have diabetes as white adults.
American Indian and Alaska Native populations face especially high risk. Federal data from 2024 shows that AI/AN adults are 36% more likely than the general U.S. adult population to have diagnosed diabetes, with a prevalence of 13.6% compared to 10.0% overall. Some tribal communities have rates far above even that national average.
Differences Within Racial Groups
Broad racial categories can mask important variation. Among Hispanic and Latino adults, diabetes rates range from about 10% in South Americans to over 18% in people of Mexican, Puerto Rican, and Dominican heritage. Central Americans fall in between at roughly 17.7%. Cuban Americans have a prevalence of about 13.4%. These differences likely reflect distinct genetic backgrounds, dietary patterns, and migration histories within the broader Latino population.
Asian Americans are similarly diverse. The standard BMI threshold used to screen for diabetes (25 or above) was developed using data from predominantly white populations and misses many Asian Americans who develop diabetes at lower body weights. The American Diabetes Association now recommends screening Asian American adults at a BMI of 23 or above, recognizing that this group accumulates metabolically harmful fat at smaller body sizes. South Asians in particular face elevated risk, with some guidelines suggesting a screening threshold as low as 24.
Why Body Fat Matters Differently Across Groups
Where your body stores fat matters as much as how much you carry. Visceral fat, the deep abdominal fat surrounding your organs, is strongly linked to insulin resistance and type 2 diabetes. But the strength of that link varies by race and sex.
In a study comparing fat distribution across racial groups, visceral fat was a strong predictor of diabetes in white and Hispanic women but a much weaker predictor in Black women. Black women with the same amount of visceral fat as white or Hispanic women had a notably lower associated diabetes risk. This suggests that other biological pathways, possibly related to how fat tissue interacts with insulin signaling, play a larger role in diabetes development for Black women. The finding also helps explain why BMI alone is an imperfect screening tool: two people with identical BMIs can carry fat very differently and face very different metabolic risks.
Gestational Diabetes and Long-Term Risk
About 8% of pregnancies in the U.S. involve gestational diabetes, but the condition hits communities of color harder, and so do its long-term consequences. Within eight years of a pregnancy complicated by gestational diabetes, roughly 1 in 5 Black patients will develop type 2 diabetes. For South and Southeast Asian patients, it’s about 1 in 6. For Hispanic patients, approximately 1 in 7. For non-Hispanic white patients, the figure drops to about 1 in 20.
Relative to white individuals, Black patients face a fourfold increased risk of progressing from gestational diabetes to type 2, while Hispanic and South/Southeast Asian patients face about a threefold increase. These transitions represent a critical window where early intervention could prevent a lifelong condition, yet follow-up screening rates after pregnancy remain low across all groups.
Complications Are Not Equally Distributed
Having diabetes is one thing. How it progresses is another, and here too, racial disparities are stark. Black and Hispanic adults with diabetes have higher rates of kidney damage, eye disease, and poor blood sugar control compared to white adults. While overall rates of serious complications like heart attacks, strokes, and amputations have declined since 1990, minority patients still experience them more often.
Kidney failure is a particularly concerning example. In one study of over 62,000 insured patients with diabetes, Black patients developed end-stage kidney disease at roughly twice the rate of white patients. Hispanic and Asian patients also had elevated rates. The decline in early-stage kidney damage observed over recent decades was limited to white patients, with no significant improvement seen in other groups.
Lower-limb amputations follow a similar pattern. Black and Hispanic patients with diabetes are 30% to 40% more likely to undergo a major amputation than white patients, even after accounting for other factors. Asian patients, interestingly, have the lowest amputation rates of any group.
The Role of Socioeconomic Factors
Biology alone doesn’t explain these gaps. The CDC estimates that social determinants of health, the conditions where people live, work, eat, and access care, account for 50% to 60% of health outcomes. Racial and ethnic minority groups in the U.S. are disproportionately affected by food insecurity, limited access to safe places for physical activity, lower incomes, and fewer nearby healthcare providers.
These factors cluster geographically. A large portion of Appalachia, for instance, is known as the “diabetes belt” because of its extraordinarily high rates, yet residents there often have significantly less access to healthcare than people in other parts of the country. Similarly, urban neighborhoods with predominantly Black or Hispanic populations often have fewer grocery stores carrying fresh produce and more fast-food outlets, a pattern that shapes dietary habits across generations. The racial disparities in diabetes prevalence have persisted for decades, and the CDC notes that this gap has not substantially narrowed despite broad improvements in diabetes care overall.
None of this means diabetes is inevitable for any individual based on their race. But it does mean that some groups face steeper odds from the start, a combination of genetic susceptibility, body composition differences, and environments that make prevention harder. Understanding where you fall on that spectrum of risk is the first step toward doing something about it.