Risk Trajectories of Type 2 Diabetes–Related Microvascular Complications Across Racial/Ethnic Groups Among Older Adults

Introduction: Type 2 diabetes mellitus (T2DM) microvascular complications are a major public health issue that disproportionately affects racial/ethnic minorities in the US. We aimed to address the limited understanding of racial/ethnic disparities in the longitudinal natural history of microvascular complications over eight years among older adults with T2DM in the US and Canada. Methods: From 10,251 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) (2003–2009) trial, we derived 6323 participants. We examined racial/ethnic disparities of composite microvascular complications, nephropathy, neuropathy, and retinopathy outcomes among adults of Black (n = 1099), White (n = 4071), and Other races (n = 1156), over 8 years. We used linear mixed-effects model with random intercept to account for intra-person correlation. Results: Our linear mixed-effects models displayed that the odds of composite microvascular complications for other race, which primarily consisted of Hispanic adults declined over a period of time [OR: 0.95 (0.93–0.99)]. The odds increased over time for Black [1.06 (1.03–1.09)] and White [1.11 (1.09–1.13)] adults (P < 0.001). Conclusion: Other race adults had a declining risk of microvascular complications over time. This decline was not observed among Black and White adults.