Type 2 Diabetes Prevention Steps Less Effective Without Degree

Preventing type 2 diabetes mellitus (T2DM) is as simple as following a healthy diet and exercising, right? Not exactly, according to findings from the University of Kansas.

In a study that will surely set off alarms, since the disease is already distinguished by socioeconomic disparities, the key finding of Kansas researcher Kyle Chapman is that those with a college degree gain more benefits from good diets and exercise than those without the same education. Chapman, a doctoral student at Kansas, is set to present his findings at the American Sociological Association annual meeting on Monday.

“Essentially those with a college degree or more education are benefitting more from the positive health behavior of physical activity than other groups,” he said. “That’s going to create more inequality in the future.”

Chapman analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2007-2012 that includes interviews, physical exams, and laboratory tests.

After controlling for diet, body mass index and other social factors, American adults with a college degree who are physically active are 6% less likely to have prediabetic symptoms or elevated glucose levels than college-educated adults who are physically inactive. Among adults with some college, a high school diploma, or those who never finished high school, physical activity only afforded them 1% less likelihood of suffering prediabetic symptoms.

Physical activity reduces the chances of developing full-blown diabetes. But the probably of having the disease was lowest among those with a college degree at 2.5% among those physically active and 4.4% among those physically inactive. Among those without a high school diploma, the chances of diabetes rise significantly: they are 5% for those who are physically active and 7.2% for those who are inactive.

Chapman said his findings are consistent with earlier research that find higher rates of diabetes among lower socioeconomic groups. Possible reasons for such disparities have included more consistent employment, which can lead to better nutrition and less stress, and better neighborhoods among those with higher incomes, which can lead to more opportunities for exercise.

Initiative to prevent and manage diabetes should recognize these realities, Chapman said, because if current practices continue they may help those at least risk of progressing to diabetes while leaving behind the highest-risk groups. “This is real, and if continue down this road, we’re going to be helping the college educated more than we’re helping the less educated,” he said. “The less educated are the people who actually need it more.”

Earlier this year, the CDC and the American Medical Association launched the Prevent Diabetes STAT initiative, which is an effort to identify and screen those with prediabetes who may not be aware that they are at risk of developing full-blown disease. Part of the effort involves identifying barriers to healthy living before the progression occurs.