By Merdies Hayes
Diabetes is one of the most serious and life-changing diseases among Americans today. With November serving as National Diabetes Month, physicians nationwide urge the public to take action against the disease which, according to a 2012 report from the Centers For Disease Control and Prevention, affects 8.3 percent of the U.S. population (or 25.8 million people).
Diabetes, particularly the “type 2” form of the disease, hits African Americans especially hard with approximately 5 million (or 18.7 percent of the non-Hispanic Black population) people living with the disease. Among all races, half of the people showing symptoms of diabetes don’t even know they have it—a startling revelation from a 2011 report from the National Diabetes Education Program.
According to the African American Community Health Advisory Committee, the disease is diagnosed in several forms—“type 1,” which is an autoimmune disease in which the body does not produce any insulin. It occurs most often in children and young adults. People with type 1 diabetes require daily insulin injections to live. About five to 10 percent of people with diabetes have this form. The symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision and extreme fatigue.
“Type 2,” the most common form, is a metabolic disorder resulting from the body’s inability to make enough—or properly use—insulin, requiring the person to begin immediate treatment. These symptoms include: feeling tired or ill, unusual thirst, frequent need to urinate (especially at night), weight loss, blurred vision, frequent infections and slow-healing wounds. Once called “adult onset diabetes,” the name was changed to encompass the increasing numbers of children and youth diagnosed with the disease.
According to a 2011 report from the African American Community Health Advisory Committee, African Americans are 1.7 times as likely to develop type 2 diabetes as the general population.
Type 2 diabetes can also develop in people who are thin. This is more common in the elderly.
Gestational diabetes develops in 2 to 5 percent of all pregnancies, but disappears when the pregnancy is over. However, women who have gestational diabetes have a 30- to 60-percent chance of developing type 2 diabetes within 10 to 20 years following diagnosis.
If there is a family history of diabetes, there is a possibility that your pancreas cannot keep up with the increased insulin demand during pregnancy, consequently blood glucose levels may rise too high, resulting in gestational diabetes.
According to the Mayo Clinic, for most women, gestational diabetes doesn’t cause noticeable signs or symptoms. Rarely, it may cause excessive thirst or increased urination.
Other forms of diabetes can result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illness. African Americans experience higher rates of at least three of the complications of the disease, including diabetic retinopathy (blindness) which occurs when the small blood vessels in the eye are weakened by diabetes. Blacks are twice as likely to have diabetes-related blindness; this complication is what caused Dodgers great Jackie Robinson to lose his sight.
A second complication comes when an excess of glucose builds up in the blood thereby causing failure of the lower extremities. African Americans are 1.5 to 2.5 times more likely to have a lower limb amputated, and are 2.5 to 5.6 times more like to suffer from kidney disease with more than 4,000 new cases annually of renal disease requiring a kidney transplant or regular dialysis.
The American Diabetes Association (ADA) announced this summer that, when people develop type 2 diabetes, they almost always have “pre-diabetes,” or blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes.
There are no clear symptoms of pre-diabetes—a reason why so many persons are unaware they are living with the disease. The ADA recommends testing begin no later than age 20 and then a doctor visit every one to two years to keep abreast of your health, particularly if the disease is common within your family. You don’t develop type 2 diabetes auto automatically, if you have pre-diabetes; ADA research has demonstrated that early treatment can return blood glucose levels to the normal range.
The ADA this month announced that besides the nearly 26 million children and adults who have diabetes, another 79 million Americans have pre-diabetes. The organization found that recent estimates project that as many as one in three American adults will have diabetes by 2050 unless steps are taken to stem the tide of cases. Two out of three people with diabetes die from heart disease or stroke. Diabetes is also the leading cause of kidney failure, the leading cause of new cases of blindness among adults, and the rate of amputation for people with diabetes is 10 times higher than for people without the disease. Also, about 60 to 70 percent of persons with diabetes have mild to severe forms of nerve damage that could result in pain in the feet or hands, slowed digestion, sexual dysfunction and other nerve problems.
The majority of the time, diabetes is classified as a “pre-existing” condition with the cost of diagnosed cases in excess of $245 billion annually, including direct medical payments ($176 billion). The average medical expenditure among people with diabetes is 2.3 times higher than those who do not have it. Indirect costs (disability, work loss, and premature death) amount to $69 billion every year. With the national discussion focusing on reducing the rising cost of healthcare—primarily through the federal Affordable Care Act—the ADA found that one in 10 healthcare dollars is spent treating diabetes and its complications, while one in five healthcare dollars is spent caring for people with the disease.
The research also shows that a person can lower their risk for type 2 diabetes by 58 percent by losing just seven percent of body weight (or 15 pounds if you weigh 200 pounds), and by regular, moderate exercise (a brisk 30-minute walk daily). Even if you can’t reach your ideal body weight, losing 10 to 15 pounds can make a big difference in warding off the disease.
“Diabetes is prevalent because of our diet, lifestyle and the way we cook food,” said Hutson Morris-Irvin, director of marketing and communications for the Los Angeles office of the ADA. She said that although a definitive answer for the cause remains years away, there are actionable methods available to each person to lower their risk of diabetes. “There are hereditary components for sure,” Morris-Irvin said, “but a healthy lifestyle is the best way to prevent type 2 diabetes. If you have type 2 diabetes, work with your physician. Pre-diabetes responds to medical suggestions. It’s not always weight because even fit persons should be checked for diabetes. Look at your diet; cut down on fried, fatty food; cook vegetables without meat (ex: collard greens sans ham hocks) and walk or jog more. A balanced diet and regular exercise are the best ways to prevent type 2 diabetes.”
According to a 2011 report from the National Diabetes Education Program (NDEP), type 2 diabetes accounts for 90 to 95 percent of all diagnosed cases of diabetes in adults. You are more likely to develop type 2 diabetes if:
• you have a family history of the disease;
• are a member of an ethnic group;
• are overweight or obese;
• are 45 years or older;
• had diabetes while pregnant;
• have pre-diabetes
• have high blood pressure
• have abnormal cholesterol (lipid) levels;
• are not getting enough physical activity;
• have polycystuic ovary syndrome;
• have blood vessel problems affecting the heart,
brain or legs;
• or have dark, thick and velvety patches of skin
around the neck and armpits (called acanthusis
Dr. James R. Gavin III, chair of the ADA’s African American Program, says diabetes can be controlled and even prevented with a proactive regimen of exercise, a balanced diet and education. “By keeping fit, eating right and getting regular exercise, we can decrease our risk for diabetes quite substantially,” Gavin explained. “This is a disease about which we can do a great deal, but only when those affected are informed and empowered to take control of this disease is this possible,” Gavin admitted that the medical profession still does now know why diabetes (and a range of other maladies including heart disease, breast cancer in women, high blood pressure) strike the Black community in such disproportionate numbers, but he does point to ADA statistics gathered from the past 50 years showing that number of African Americans with diabetes has tripled, leading to a near epidemic in a community already twice as likely than the general population to have the disease. “We have looked and looked and, unfortunately, what we don’t know is why our community is such a primary target.”
Although the medical profession cannot yet pinpoint why Blacks are so susceptible to diabetes, part of the answer may trace back to the traditional diet of African Americans. Centuries ago, many Black families dined on heavy, fat-laden fare such as chitterlings, hog maws, ham hocks, pig’s feet, fat back, neck bones, ox tales etc.