Addressing Diabetes-associated Health Disparities: A Wake-up Call Amidst the COVID-19 Pandemic

EAST GREENSBORO, N.C. (Dec. 22, 2020) – According to the Centers for Disease Control, adults living with diabetes are at an increased risk of experiencing severe illness or complications when exposed to COVID-19. The disease is the seventh leading cause of death in the country and disproportionately affects minority ethnic groups and economically disadvantaged populations. Type 2 diabetes is driven by the obesity crisis. Obesity prevalence is especially pronounced in many Southeastern states, including North Carolina.

The North Carolina Diabetes Research Center (NCDRC), a consortium comprised of Wake Forest University, UNC-Chapel Hill, North Carolina Agricultural and Technical State University and Duke University, hosted a successful virtual workshop for faculty members from academic research institutions in North Carolina and surrounding states during Diabetes Awareness Month. The focus of this year’s workshop was “Addressing Diabetes-related Health Disparities in Light of the COVID-19 Pandemic.” N.C. A&T leads the NCDRC Enrichment Program, which organized the workshop.

The NCDRC is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health and seeks to enhance diabetes research in North Carolina by providing access to cutting-edge research facilities, building regional collaborations and mentoring trainees and early career investigators.

The workshop featured two keynote speakers. Eliseo J. Perez-Stable, M.D., director of the National Institute on Minority Health Disparities (NIMHD), delivered the first keynote addressed titled, “Health Disparities Research in Multiple Chronic Diseases.” Perez-Stable comprehensively outlined challenges and opportunities in health disparities research, and addressed the public health crisis presented by diabetes, highlighting several key factors in diabetes-related health disparities, such as social determinants of health, health literacy, patient-clinician communication and obesity. 

He also addressed the COVID-19 pandemic. Data show the severity and death rates for COVID-19 are higher among African Americans and Latinos. Additionally, chronic diseases such as diabetes and hypertension contribute to the severity and mortality rates associated with COVID-19 infections. Perez-Stable emphasized the need to implement prevention and healthcare strategies aligned with the needs of minority communities in order to address effects of the pandemic and to mitigate underlying inequities. As part of the NIH, the NIMHD seeks to advance the science of minority health and health disparities research through research, training, research capacity development, public education, research and dissemination of information.  

 Ayotunde Dokun, M.D., director of the Division of Endocrinology, Diabetes, and Metabolism at the University of Iowa Hospitals and Clinics delivered the second keynote address, “MicroRNA Regulation of Ischemic Adaption in Diabetes.” Dokun’s NIH-funded research seeks to understand the mechanisms that regulate damage to blood vessels, leading to tissue damage and amputations of limbs. 

The Ignite Talks highlighted research on a variety of topics. The workshop also featured talks from North Carolina researchers engaged in various aspects of diabetes research, including behavioral, basic and translational research. 

Featured researchers included Cheryl Woods-Giscombe, Ph.D., a Distinguished Term Associate Professor, at UNC Chapel Hill School of Nursing, whose talk focused on “Psychological Stress and Diabetes: Implementing Culturally-Congruent Interventions to Enhance Well-Being, Quality of Life, and Health Equity” and “Ignite Talks” by four early career investigators from regional Minority Serving Institutions (MSIs).

• Diabetes Self-Management for African American Adults in Faith-Based Settings” by Pandora Goode, Ph.D., DNP assistant professor of Nursing at Winston-Salem State University;
• “The Ca²⁺-Sensing Receptor as a Potential Target for Hypertension and Diabetes Therapy” by Emmanuel M. Awumey, Ph.D., associate professor of Biological and Biomedical Sciences at North Carolina Central University; "Impacts of Race, Psychosocial Distress, and Neighborhood Context on Disease Risk" by Adrienne Aiken Morgan, Ph.D., assistant professor of psychology at North Carolina A&T
• “Promoting Physical Activity among Latinos Living with Diabetes: Building Evidence to Address Social, Community and Technological Barriers” by Sandra Echeverria, Ph.D., MPH, associate professor of Public Health Education at UNC Greensboro.

In addition to the keynote addresses and research talks, two sessions focused on faculty mentoring. Susan Girdler, Ph.D., FABMR, a professor of psychiatry, vice chair for Faculty Development; and director of the Stress & Health Research Program, presented information about “The PROMISE Research Study,” a project funded by the NIH to determine the unique and additional contributions that psychosocial mentoring makes to skills-focused mentoring for underrepresented biomedical researchers within a facilitated, peer group mentoring model. The study was funded in response to the 2011 Ginther study, demonstrating that African American researchers are at least 10% less likely to receive federal grant funding than other races after controlling for educational background, country of origin, training, previous research awards, publication record, and employer characteristics. Faculty interested in participating in the promise study can contact Susan at susan_girdler@med.unc.edu. Likewise, Winnie Martinez, M.S., program officer at the NIDDK discussed the NIDDK-sponsored Network for Minority Health Research Investigators (NMRI) program. NMRI creates networking and mentoring opportunities for health investigators from minority ethnic groups to advance their research careers.

Diabetes is a complex disease with complications that include kidney disease, cardiovascular disease, blindness, nerve damage and impaired wound healing (often resulting in amputations). Diabetes is also associated with neurodegenerative diseases such as Alzheimer’s disease. Diabetes lowers the quality of life for patients and their families, costing the nation $327 billion yearly in medical costs and lost work and wages for patients. 

Health disparities research and community engagement are priority areas for N.C. A&T demonstrated in the university's strategic plan "A&T Preeminence: Taking the Momentum to 2023." Building regional partnerships in research and community engagement accelerates our efforts and is key to attaining health equity in North Carolina.

Additional activities sponsored by the NCDRC Enrichment Core include organizing an annual diabetes research symposium, a diabetes seminar series, facilitating year-round mentoring for junior investigators, and engaging T32 supported and K12 trainees in the state of North Carolina.

For more information about the NCDRC, visit the website. If you have any questions, contact Elimelda Ongeri, Ph.D. (eongeri@ncat.edu) or Brittney Jackson (britjack@wakehealth.edu).