Assessing the Risks and Cultural Relativity of Diabetes in Black Individuals of African Caribbean Ancestry (ACB) Aged 18-39 Years in Toronto.

Abstract

Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18-39 and to assess the sensitivity of glycated hemoglobin (HbA1c) compared to an oral glucose tolerance test (OGTT) to diagnose diabetes. Methods: In this mixed-methods study, maximum variation sampling was used to recruit 272 ACB participants from fourteen African and five Caribbean countries from Toronto. Participants' height, weight, waist circumference, HbA1c, OGTT, demographic, and behavioural data were collected. SPSS was used to analyze the quantitative data. This study used descriptive statistics for frequency distribution and cross-tabulation while inferential statistics (regression, ANOVA, factor analysis, etc.) were used for relational analysis. Because of the small sample size, qualitative data were analyzed manually using the charting technique. Results: This study found that 1.5% of participants had diabetes, 9.2% had prediabetes, and 44.9% were at risk of developing diabetes. The mean value of HbA1c, FBS, and 2hPG was 5.5%, 4.8 mmol/L, and 5.7 mmol/L, respectively. The mean BMI was 28.2 kg/m², and the waist circumference was 85.8 cm. This study found a correlation between glucose intolerance and increasing body mass index (BMI) and waist circumference (WC). Dietary habits, physical inactivity, and mental health challenges were risk factors among the participants. HbA1c was found to be a more sensitive and culturally acceptable screening measure than OGTT in diagnosing diabetes. Conclusions: ACB individuals are at high risk of having diabetes, requiring culturally tailored peer-based health promotion strategies to reduce diabetes prevalence and risk. HbA1c is a culturally acceptable and statistically more capable measure than OGTT in identifying individuals with prediabetes. Further longitudinal research is needed.