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The Diabetes Epidemic Among African Americans

Black folks are more likely to be diagnosed with diabetes. In fact, there’s a diabetes epidemic among us.

What is diabetes?
Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications. Diabetes is one of the leading causes of death and disability in the United States. Total health care and related costs for the treatment of diabetes run about $174 billion annually.

What are the different types of diabetes?
Type 1 diabetes (formerly called juvenile diabetes) results when the body’s immune system attacks and destroys its own insulin-producing beta cells in the pancreas. People with type 1 diabetes must have insulin delivered by injection or a pump. Symptoms of type 1 diabetes—increased thirst and urination, constant hunger, weight loss, blurred vision and extreme fatigue—usually develop over a short period of time. If type 1 diabetes is not diagnosed and treated, a person can lapse into a life-threatening coma. Type 1 diabetes accounts for approximately 5 percent of all diagnosed cases of diabetes in adults.

Type 2 diabetes (formerly called adult-onset diabetes) occurs when the body does not make enough insulin or cannot use the insulin it makes effectively. This form of diabetes usually develops in adults over the age of 40 but is becoming more prevalent in younger age groups—including children and adolescents. The symptoms of type 2 diabetes—feeling tired or ill, unusual thirst, frequent urination (especially at night), weight loss, blurred vision, frequent infections, and slow-healing wounds—may develop gradually and may not be as noticeable as in type 1 diabetes. Some people have no symptoms.

Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. A person is more likely to develop type 2 diabetes if they:

  • have a family history of diabetes
  • are a member of an ethnic group like African Americans
  • are overweight or obese
  • are 45 year old or older
  • had diabetes while pregnant (gestational diabetes)
  • have pre-diabetes (glucose levels are elevated but not high enough to be
    diagnosed as diabetes)
  • have high blood pressure
  • have abnormal cholesterol (lipid) levels
  • are not getting enough physical activity
  • have polycystic ovary syndrome (PCOS)
  • have blood vessel problems affecting the heart, brain or legs
  • have dark, thick and velvety patches of skin around the neck and armpits (This is
    called acanthosis nigricans.)

Gestational diabetes develops during pregnancy. Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes, mostly type 2, in the next 10 to 20 years.

How many African Americans have diagnosed and undiagnosed diabetes?

  • An estimated 4.9 million, or 18.7 percent, of all non-Hispanic blacks ages 20 and older have diagnosed and undiagnosed diabetes.
  • Roughly 12.6 percent had diagnosed diabetes according to age adjusted 2004-2006 national survey data.

What is the link between cardiovascular disease and diabetes?
Cardiovascular disease is the leading cause of death for people with diabetes—about two out of three people with diabetes die of heart disease or stroke. Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. The risk for stroke is two to four times higher among people with diabetes. About 67 percent of adults with diabetes also have high blood pressure. Smoking doubles the risk for heart disease in people with diabetes.

What can African Americans do to prevent heart disease or stroke and other diabetes complications/
Diabetes is a self-managed disease. People with diabetes must take responsibility for their day-to-day care. The chances of having diabetes complications can be reduced or delayed significantly by keeping blood glucose (blood sugar), blood pressure and cholesterol levels (called the ABCs of Diabetes) in the target range.

The National Diabetes Education Program recommends the following targets for reducing the risk of heart disease and stroke for most people with diabetes:

  • A1C (blood glucose): less than 7 percent (check at least twice a year)
  • Blood pressure: less than 130/80 mmHg (check every doctor’s visit)
  • Cholesterol (LDL): .ess than 100 mg/dl (check once a year)

Targets should be individualized—less stringent targets may be advised with severe hypoglycemia, limited life expectancy, other medical conditions or longstanding diabetes. People with diabetes can manage their disease by eating healthy foods, being physically active, taking diabetes medicine as prescribed and testing blood glucose levels.

Community education and support programs can help people with diabetes and their families to manage their diabetes.

Can type 2 diabetes be prevented?
Yes. The Diabetes Prevention Program, an important trial sponsored by the National Institutes of Health, and the DPPOS, the 10-year follow up study to the DPP, showed that type 2 diabetes can be delayed or prevented in overweight adults with pre-diabetes, including African Americans. Pre-diabetes is a condition where blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes.

Risk factors for prediabetes are the same as those listed for type 2 diabetes. To prevent diabetes, the people who participated in the DPP study:

  • Lost 5 to 7 percent of their body weight (that is 10 to 14 pounds for a person who weighs 200
  • Were physically active for 30 minutes a day, 5 days a week. Most participants chose brisk
  • Made healthier food choices and limited the amount of calories and fat in their diet.

Where can I go for more information?
For more information about preventing and controlling diabetes, call 1-888-693-NDEP (1-888-693-6337) or visit the National Diabetes Education Program.


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