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Diabetes
November is Diabetes Awareness Month. Diabetes is a disease in which blood glucose (sugar) levels are above normal. Glucose is the main source of fuel for energy. After eating, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use a hormone call insulin, which is produced by the pancreas, to help convert blood glucose (sugar) to energy needed for daily life. People with diabetes either don’t produce insulin or the body has trouble using insulin.
Approximately 17 million people in the United States have diabetes. However, about 5.9 million people are unaware that they have the disease. Approximately 2.8 million or 13.0% of all African Americans have diabetes and one-third of them do not know they have the disease.1
There are three major types of diabetes:
Type 1 diabetes is an autoimmune disease. An autoimmune disease means the body’s system (immune system) for fighting infections attacks its own body. In this case, the immune system attacks insulin-producing cells in the pancreas and destroys them. Thus the pancreas cannot produce insulin. People with type 1 diabetes take insulin daily. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue.
Type 2 diabetes results from a condition in which the body fails to properly use insulin and the pancreas cannot make enough insulin for the body’s needs. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Being overweight and inactive increases ones chances of developing type 2 diabetes. Approximately 90-95% (16 million) of Americans who are diagnosed with diabetes have type 2 diabetes. Type 2 diabetes is usually treated with exercise and an individual meal plan designed by the patient and his health care provider to help maintain a healthy weight and keep his blood glucose levels in check and avoid complications. If diet and exercise alone does not lower blood glucose levels, diabetes pills, insulin, or both may be needed in addition to diet and exercise.
Symptoms include increased thirst and hunger, fatigue, increased urination (especially at night), weight loss, blurred vision and sores that do not heal. However, many people have no signs or symptoms for type 2 diabetes.
Gestational diabetes - develops only during pregnancy. It occurs more often in African Americans, American Indians, Hispanic Americans, and people with a family history of diabetes. Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases in the United States each year. It usually disappears after delivery; however, the mother is at increased risk of getting type 2 diabetes later in life.
Type 2 Diabetes is the most common diabetes
among African Americans. African Americans are 2 times more likely to
have type 2 diabetes than Whites.
Approximately, 16.9 million or 8.6% ages 20 years or older have diabetes
and one in four African American women over 55 years of age has diabetes.
 A
medical research report, looking ahead from the year 2000, set the
tone for today's high -- and growing -- level of concern about the
increasing diabetes threat: "Diabetes
mellitus has reached epidemic proportions worldwide as we enter
the new millennium. The World Health Organization (WHO) has commented
there is an apparent epidemic of diabetes which is strongly related
to lifestyle and economic change.' Over the next decade the projected
number will exceed 200 million, possibly reaching 250 million
persons. Most will have type 2 diabetes, and all are at risk of
the development of complications." |
African Americans and Diabetes-Related Complications
Complications of Diabetes
|
African Americans experience higher rates of major diabetes-related complications.2
-
Heart disease strikes people with diabetes more than twice as often as it strikes people without diabetes. However, data available suggest that African Americans have a risk similar to that of Whites rather than an increased risk. 3
- Diabetic retinopathy (eye disease) is a term used for all abnormalities of the small blood vessels of the retina caused by diabetes, such as weakening of blood vessel walls or leakage from blood vessels. African Americans are twice as likely to suffer from diabetes-related blindness than Whites. 4
-
Diabetes is the most frequent cause of non-traumatic lower limb amputations. The risk of a leg amputation is 15 to 40 times greater for a person with diabetes. More than 60% of nontraumatic lower-limb amputations in the U.S. occur among people with diabetes. Each year,82,000 people lose their foot or leg to diabetes. Among people with diabetes, African Americans are 1.5 to 2.5 times more likely to suffer from lower limb amputations compared to Whites. 5
-
Diabetes is the leading cause of kidney failure, accounting for 43% of new cases. Ten to 21% of all people with diabetes develop kidney disease. In 1999, 38,160 people with diabetes initiated treatment for kidney failure, and 114,478 people with diabetes underwent dialysis or kidney transplantation. African Americans with diabetes are 2.6 to 5.6 times more likely to suffer from kidney disease with more than 4,000 new cases of end stage renal disease each year compared to Whites. 6
Obesity
Obesity is a major cause of
type 2 diabetes. Several studies have shown that
Obesity and weight gain are associated with an increased risk of diabetes.
Each year an estimated 300,000 US adults die of causes related to obesity.7
Body mass index (BMI) is a measure of body weight relative to height.
The BMI is used to determine whether you are underweight, normal weight,
overweight, or obese. To calculate your BMI, use the following calculator
and check the chart.
BMI
|
What can you do to prevent diabetes?
Studies have shown that changes in one’s lifestyle and eating habits can reduce your chances of developing diabetes. The Diabetes Prevention Program, a federally funded project, showed that moderate diet and exercise resulting in 5-7 % weight loss can delay and possibly prevent type 2 diabetes. People who participated in the Program exercised about 30 minutes a day, 5 days a week (usually by walking) and lowered their intake of fat and calories. They reduced their risk of getting type 2 diabetes by 58%. The average weight loss in the first year of the study was 15 pounds.
Points to Remember
|
Are you at risk for Type 2 Diabetes?
To find out your risk for type 2 diabetes, check each item that applies to you.
-
I am under 65 years of age.
- I am overweight. Use the BMI calculator.
- I have a parent, brother, or sister with diabetes.
- My family background is African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino.
- I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.
- My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure. (If you are not sure, you should check with your healthcare provider)
- My cholesterol levels are not normal. My HDL cholesterol
(“good” cholesterol) is 35 or lower, or my triglyceride
level is 250 or higher.
(If you are not sure, you should check with your healthcare provider) - I am fairly inactive. I exercise fewer than three times
a week.
If you have checked off more than 2, you should see a healthcare professional who can determine if you have diabetes. A checkup with your doctor now could start you on treatment to help prevent or reduce the heart, eye, kidney, and other serious complications diabetes can cause.
1http://www.diabetes.org
2http://www.diabetes.org/info/facts/facts_african.jsp
3 Carter AS, Pugh JA, Monterrosa A.
Non-Insulin Dependent Diabetes Mellitus in Minorities in the United
States. Annals of Internal Medicine 1996:125:221232.
4http://www.diabetes.org/info/facts/facts_african.jsp
5http://diabetes.org/info/facts/facts_african.jsp
6http://diabetes.org/info/facts/facts_african.jsp
7Ford ES, Williamson Df, Liu S. Weight Change
and Diabetes Incidence: Findings From A National Cohort of US Adults.
Am J Epidemiol. 1997;146:214-222.