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American Journal of Epidemiology Advance Access published online on July 11, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm187
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Invited Commentary: Untangling the Web of Diabetes Causality in African Americans

Richard W. Grant1,2

1 Division of General Medicine, Massachusetts General Hospital, Boston, MA
2 Harvard Medical School, Boston, MA

Correspondence to Dr. Richard W. Grant, Division of General Medicine, Massachusetts General Hospital, 50-9 Staniford Street, Boston, MA 02114 (e-mail: Rgrant{at}partners.org).

Received for publication March 23, 2007. Accepted for publication April 4, 2007.

Diabetes is more prevalent and its consequences more severe in African Americans than in Whites. Efforts to understand and eliminate the root causes of disparities in the prediabetic state offer the potential to reduce the tremendous "downstream" costs of diabetes for patients and society. The accompanying study by Schootman et al. (Am J Epidemiol 2007;166:000–00) presents provocative new data on the apparently significant role of an individual's own housing condition in the odds of subsequent diabetes development. Despite methodological limitations in measurement and adjustment for confounding, this paper offers new insights into potential mediators of diabetes development. Efforts to effectively address the problem of disparities in the prediabetic state will require greater interdisciplinary collaboration between unfamiliar disciplines and wider implementation of the randomized clinical trial design.

African Americans; diabetes mellitus; genetics; housing; prediabetic state; questionnaires; residence characteristics


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M. Schootman, E. M. Andresen, F. D. Wolinsky, T. K. Malmstrom, J. P. Miller, Y. Yan, and D. K. Miller
Schootman et al. Respond to "Diabetes Causality in African Americans"
Am. J. Epidemiol., August 15, 2007; 166(4): 391 - 392.
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