Diabetes Risk in the LGBTQ Community

If you’re a member of the LGBTQ community, you may be at higher risk of developing type 2 diabetes or diabetes-related complications. This is because there are certain diabetes risk factors that may be specific to you.

About 38 million Americans have diabetes, and about 98 million have prediabetes. This includes people who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). About 25% of gay or bisexual men and 14% of lesbian or bisexual women have been diagnosed with diabetes, compared to about 10% of the general population.

If you’re a member of the LGBTQ community, learning about factors that may put you at higher risk of developing type 2 diabetes can help you take charge of your health.

1. Overweight or Obesity

Having overweight or obesity can put you at risk for developing serious health conditions like type 2 diabetes. In fact, nearly 90% of US adults who have diagnosed diabetes are considered to have overweight or obesity. Some research shows that LGBTQ people may be at higher risk for overweight or obesity. For example:

• Lesbian and bisexual women are more likely to have overweight or obesity compared to non-LGBTQ women.
• Transgender men are also more likely to have overweight or obesity compared to cisgender men (those who identify with their gender given at birth).

Overweight and obesity have been linked to long-term stress. The increased levels of stress the LGBTQ community faces may have negative health effects. One possible reason may be that when you’re stressed, your body releases a hormone called cortisol that helps your body deal with that stress. The more you’re stressed, the more cortisol your body releases. High levels of cortisol can have negative effects on your health like high blood pressure and weight gain around the stomach area.

Some research shows that LGBTQ people may also have less healthy sleep patterns. Inconsistent sleep is another potential risk factor that can contribute to weight gain, long-term stress, and developing type 2 diabetes.

While we can’t control outside factors like stressors, making certain lifestyle changes can help. For example, eating well and getting regular physical activity can help you achieve and maintain a healthy weight.

If you don’t have a safe space to be physically active, turn on some music and have yourself a dance party. Or follow a short 10-minute workout video online and build up from there. You can also try swapping some food choices with healthier alternatives, like drinking water instead of a sugary drink. Small changes can have big results over time.

Talk to your doctor to find out what a healthy weight is for you and the best way to get there.

2. Smoking

Smoking can increase your risk for serious health conditions. If you smoke, you’re 30% to 40% more likely to get type 2 diabetes than people who don’t smoke. That’s because smoking affects how well your body makes and uses insulin. Over time, this can lead to prediabetes, type 2 diabetes, and diabetes-related complications. Research shows that:

• Lesbian, gay, or bisexual adults tend to have higher rates of cigarette smoking and use of other commercial tobacco products than non-LGBTQ adults.
• Transgender adults are more likely to currently use a commercial tobacco product than adults who are not transgender (cisgender).

There are many factors that help explain why LGBTQ people experience tobacco-related disparities. For example, the tobacco industry aggressively markets their products to the LGBTQ community. Also, people who face many forms of stress—like financial problems, discrimination, or unsafe neighborhoods—can be more likely to smoke.

People who quit smoking have lower levels of anxiety, depression, and stress, as well as improved positive mood and quality of life. Find healthy ways to combat stress. For example, yoga, meditation, or aromatherapy can help calm your body and mind.

Quitting smoking is one of the most important steps you can take to improve your health.  Remember you don’t have to do it alone. Talk to a doctor about ways to quit, and check out these resources for quitting.

3. Other Health Conditions

Having certain health conditions can increase your diabetes risk or make it harder to manage if you already have it. Although research is limited, there is evidence that LGBTQ adults have higher rates of some chronic health conditions compared to non-LGBTQ adults. For example:

• Gay and bisexual men are more likely to have two or more chronic health conditions, like high blood pressure, heart disease, and kidney disease, compared to non-LGBTQ men.
• Gay and bisexual men and transgender women have higher rates of HIV compared to non-LGBTQ men and cisgender women. Because some HIV medicines can increase insulin resistance, it’s important to have your blood sugar tested to know your diabetes risk.
• Lesbian and bisexual women are more likely to have polycystic ovary syndrome (PCOS), which increases insulin resistance. This means your body can make insulin but can’t use it effectively, increasing your risk for type 2 diabetes. In fact, more than half of women with PCOS develop type 2 diabetes by age 40.

The good news is, if you can prevent or even delay getting type 2 diabetes, you can lower your risk for other conditions too.

4. Gender-Affirming Hormones

While research is limited, some studies show that gender-affirming hormones can cause weight gain, high blood pressure, insulin resistance, and higher levels of triglycerides (a type of fat in the blood) in transgender people. All are risk factors for type 2 diabetes. And if you already have diabetes, these conditions can make it harder to manage.

Talk to your doctor about any concerns or questions you have about hormone therapy and how it can affect your overall health.

5. Your Mental Health

Did you know that experiencing mental distress can also increase your risk for developing type 2 diabetes? And if you have diabetes, experiencing mental distress could make it harder to stick to your diabetes care plan.

Members of the LGBTQ community have worse health outcomes for certain conditions, including mental health, compared to non-LGBTQ people. Feelings of rejection, shame, and low self-esteem that many LGBTQ people experience can impact mental and physical health.

If you’re experiencing mental distress, you’re not alone. Talk to a mental health professional. They can help manage your symptoms. They may suggest medicine, talk therapy, or stress-relieving activities that can help you. Learn more about how to take care of your mental health.

Take Charge of Your Health

If you have any diabetes risk factors, talk to a doctor about your risk. There are a few different blood tests that can check if your blood sugar levels are at the normal, prediabetes, or diabetes range. You can get started by taking this 1-minute prediabetes risk test.

If your blood test results show you have prediabetes, ask your doctor about how the National Diabetes Prevention Program can help you. And if you’re diagnosed with diabetes, ask your doctor for a referral to diabetes self-management education and support services to help manage it.

Now that you’re in the know, take charge of your health to prevent or delay type 2 diabetes and its complications.