Type 2 diabetes management among African Americans influenced by family experience, study finds

August 5, 2019

Family experience with Type 2 diabetes influences how African Americans perceive the risk of the disease and their approach to managing the illness, according to a small study by researchers at Montana State University and Iowa State University.

The study, published in the journal Global Qualitative Nursing Research found that misconceptions about diabetes — such as the idea that it is primarily caused by sugar — are often passed down through generations and can affect the way patients handle their own diagnosis.


Type 2 diabetes, when the body does not regulate its insulin properly, is a leading cause of death for African Americans, and is more prevalent among black people than white people. This form of diabetes is related to obesity, but genetics and family history are also major risk factors.

Past studies have shown that a strong sense of family and the family’s cultural values, such as the ritual of meals and eating behaviors, can influence how individuals manage their health.


The study’s authors interviewed 20 African American families in Iowa with at least one parent that had Type 2 diabetes, where that parent also had a direct relative with the disease and a child willing to participate in the study interviews. During the interviews, researchers asked families about how family members influenced their understanding of diabetes and management techniques.

“We wanted to get into the meanings and nuances within the family culture to identify some malleable targets we can work with. By understanding the meanings people have around food and nutrition, we might find ways they can make change,” said Tera Jordan, an associate professor of human development and family studies at Iowa State, in a statement.

Jordan was a co-author of the study under her maiden name, Tera Hurt.

The study’s lead author, Brianna Routh, now an assistant professor at Montana State, was involved in the study as a graduate student at Iowa State.


The study was supported by the Iowa State University Intramural Collaborative Seed Grant Program.


Researchers found that, as in many cultures, food plays an important role among African American families. Family recipes handed down for generations may not have the healthiest ingredients, but are an important part of holiday traditions and family gatherings.

Researchers also found that many of the families with a history of diabetes wanted to talk about it with younger generations, to make them aware of the risk factors and encourage them to be healthy.

One grandmother told researchers she talks to her grandchildren about how diabetes has affected her (she lost her vision) and shows them how she checks her blood glucose levels.

“They see all that. They don’t like it, so they are conscious that if they don’t take care of their self, that’s how they could, you know, end up,” researchers quoted the grandmother as saying.

In other instances, talking about diabetes within a family led to a continuation of misinformation, such as the falsity that sugar is the primary cause of diabetes.

(The Philadelphia Department of Health got itself in hot water recently when parents of children with Type 1 diabetes balked at a new healthy eating campaign that linked sugary snacks to diabetes.)

“Even though many recognized that there was more to (Type 2 diabetes) than just simple sugar intake, many still related their experiences, preventive efforts, and beliefs to using sugar, often meaning that carbohydrates, fats, or fibrous foods were not discussed,” the authors wrote.


The study involved a small sample size, which means its findings are not necessarily representative of the general population; however the main themes that emerged from the interviews echoed previous research.


The findings suggest that health care providers could improve their approach to helping African American patients manage diabetes by asking them about their family history with the illness, and what they’ve learned about diabetes from their family, friends, and other influential members of their community.

“I’d tell health care providers to do anything they can to help facilitate communication and build trust, recognizing they might not have done anything personally to violate that trust, but it’s systemic, it’s cultural,” Jordan said in a statement. “We’ve overcome a lot of things culturally and just recognize that it is probably in the room.”



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