Nonmodifiable Risk Factors
As has been reported earlier, several nonmodifiable risk factors appear to be operating in African American women with diabetes. Although gender per se may not be a risk factor for diabetes, there is clear evidence that African American women are more likely to have diabetes than African American men or white Americans of either gender. Although there are some inconsistencies across studies, U.S. data indicate that the prevalence of NIDDM is about 40% higher in women than men among both whites and African Americans (Am erican Diabetes A ssocia tion [ADA], 1996a). Age is a risk factor for diabetes in African Americans, with one in four black women having diabetes by the age o f 55 years (Tull & Roseman, 1995). Genetics has also been identified as a probable risk factor for diabetes (Brancati et al., 1996; Cowie et al., 1993; Rewers & Hamman, 1995; Sacks & M cDonald, 1996). Serving as a surrogate for genetics, family history of diabetes is an established risk factor for diabetes. Individuals having a family m em ber with diabetes have a strikingly increased risk for NIDDM than do people without a family history of diabetes (ADA, 1996a; Harris, 1990). Hypertension is both a risk factor for NIDDM and a major risk for com plications related to diabetes (Brancati et al., 1996; Carter, Pugh, & M onterrosa, 1996; Harris, 1990).