Lesbian and bisexual women are at greater risk of developing type 2 diabetes compared to heterosexual women, according to a new study published in the journal Diabetes Care.
The findings show that lesbian and bisexual (LB) women are more likely to develop type 2 diabetes at younger ages than heterosexual women, and that a higher body mass index in lesbian and bisexual women may play a role in these disparities.
In addition, LB women tend to have higher levels of stress, particularly in relation to discrimination, violence victimization and psychological distress, and this may contribute to higher rates of poor health conditions, such as diabetes, suggest the researchers.
For the study, the research team analyzed survey results dating back to 1989 from 94,250 women participating in the Nurses’ Health Study II, which is one of the largest investigations into the risk factors for major chronic diseases in women.
All women were between the ages 24 to 44 at the start of the study and were assessed for a diagnosis of type 2 diabetes every other year to identify incidence, from 1989 to 2013. The women self-identified their sexual orientation: A total of 1,267 identified as lesbian or bisexual and 92,983 identified as heterosexual. Diabetes was assessed by self-reported clinician diagnosis.
The study, led by Dr. Heather L. Corliss, a professor at San Diego State University’s Graduate School of Public Health, found that lesbian and bisexual women had a 27 percent higher risk of developing type 2 diabetes than heterosexual women. In 2013, the findings show that 6,399 women had developed type 2 diabetes with lesbian and bisexual women having a 22 percent greater risk of developing the condition.
The findings also show that lesbian and bisexual women developed type 2 diabetes at younger ages than heterosexual women, and that a higher body mass index in lesbian and bisexual women was an important contributor to disparities found.
“Given the significantly higher risk of developing type 2 diabetes before age 50 years among LB women, and their potentially longer duration of living with type 2 diabetes, LB women may also be more likely to experience complications compared with heterosexual women,” the researchers wrote in the paper.
Corliss explained that her team conducted the analysis because previous research on the risk of type 2 diabetes among lesbian and bisexual women has been inconclusive — some studies found differences between heterosexual and lesbian and bisexual women, while other studies found no differences.
“Despite inconclusive findings, there is a reason to suspect that LB women may have disparities in chronic physical health conditions, including type 2 diabetes, because they are more likely than heterosexual women to have risk factors such as obesity, tobacco smoking, heavy alcohol drinking and stress-related exposures,” write the researchers.
Stress, in particular, is an important consideration in this case. The researchers noted that stress related to discrimination, violence victimization and psychological distress, were reportedly higher for lesbian and bisexual women, and these factors may contribute to higher rates of health-related issues for those women.
“Although it is important to address behavioral factors such as physical activity, sedentary behavior and dietary intake, focusing on these factors alone may not be sufficient to eliminate LB women’s disparities in chronic disease,” the team explained.
The researchers emphasize that greater public health and clinical efforts to prevent, detect and manage obesity and type 2 diabetes among lesbian and bisexual women — along with improved access to care — are crucial needs.
The team is also calling for expanded research into sexual orientation-related differences in disease management and on the overall health of lesbian and bisexual women.
Source: San Diego State University