Nonheterosexual Youth May Be at Greater Diabetes Risk

Miriam E. Tucker
July 30, 2018

Nonheterosexual adolescents may be at greater risk for developing type 2 diabetes compared with heterosexual teens, new research suggests.

The findings were published online July 13 in Pediatric Diabetes by Lauren B. Beach, JD/PhD, a research fellow at Northwestern University's Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, Illinois, and colleagues.

The study was based on national data for 350,673 high school students aged 14–18 years who participated in the Youth Risk Behavior Survey (YRBS) during 2009–2015. Overall, youth who self-identified as lesbian, gay, bisexual, or questioning (LGBQ) had higher rates of obesity and sedentary activity and lower rates of physical activity compared with those who identified as heterosexual.

"Elevated diabetes risk among sexual minority youth and youth unsure of their sexual orientation is a serious concern. Sexual minority youth already face unique health disparities that may compound with diabetes risk factors to pose an additional significant health risk in an already vulnerable population," Beach and colleagues write.

Sexual minorities should be considered a priority population in special need of health screening, along with "patient-centered, culturally sensitive methods for identifying sexual minority youth to ensure these screenings occur," the authors say.

Findings Highlight Risks Among LGBQ Youth

Overall, 88% of the students identified as heterosexual, 2% as gay or lesbian, 6% as bisexual, and 4% as unsure, or "questioning".

After adjustment for age, race/ethnicity, body mass index, and survey year, all nonheterosexual youth except for lesbian females reported significantly fewer days of physical activity — by about 1 day per week — compared with heterosexual students of the same age. They were also 38% to 53% less likely to meet physical activity guidelines than heterosexual students.

Sexual identity was not associated with hours of sedentary behavior among males or lesbian females, but females who identified as bisexual or unsure reported significantly more hours of sedentary behavior per school day than their heterosexual counterparts.

Among females, the proportions who were overweight were 26% for lesbians compared with 18% of bisexual, 16% of uncertain, and 15% of heterosexuals, with an adjusted odds ratio of 1.85 for lesbians compared with heterosexual women.

In contrast, nonheterosexual identity was not associated with overweight among males.

Black and Hispanic students also had higher rates of the risk factors studied.

Is Stress a Factor?

These findings may be explained in part by "minority stress," Beach said in a statement. "Many of these youth might be taking part in sedentary activities — like playing video games — to escape the daily stress tied to being lesbian, gay, bisexual, or questioning...Our findings show that minority stress actually has a very broad-ranging and physical impact."

But she also noted that the findings represent an opportunity for intervention. "Teachers, parents, and physicians should work together to ensure these youth have the tools they need to stay healthy...Family support and identity affirmation — developing positive feelings and a strong attachment to a group — have been consistently linked to better health among LGBQ youth."

The study was funded by the National Institute on Alcohol Abuse and Alcoholism. The authors have reported no relevant financial relationships.

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SOURCE: Medscape, July 30, 2018. Pediatr Diabetes. Published online July 13, 2018.

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