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Diabetes In The African American Community

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Magnitude Of Diabetes Epidemic In Racial And Ethnic Minority Populations

How diabetes disproportionately affects the African American community

The diabetes epidemic continues to grow at an alarming rate. Every 17 seconds, someone in the United States is diagnosed with diabetes. Every day, 230 Americans with diabetes will undergo an amputation, and 120 will develop end-stage renal disease . In addition, about 45% of people with diabetes have some stage of diabetic retinopathy. The toll of this epidemic bludgeons racial and ethnic minorities.

Ways To Prevent Or Improve Your Management Of Diabetes

While factors such as racism and discrimination, as well as access to healthy food, education, and exercise are broader societal issues beyond most individuals direct control, many factors even genetics are not. Diabetes doesnt have to be your destiny, says Ginn-Meadow.

Here are six ways to help reduce your risk of diabetes:

Break With Unhealthy Traditions

In adults with diabetes, the most common causes of death are heart disease and stroke, according to the National Institute of Diabetes and Digestive and Kidney Diseases . And unfortunately, Black Americans have an elevated risk for these diseases, warns the AHA. We all love Sunday dinner, and we know whats on the table, Ginn-Meadow says, but some of our traditions of how we prepare food can negatively impact our heart. Instead of frying your food, Ginn-Meadow recommends baking, broiling, and grilling fish and lean meats, as well as using peanut oil instead of shortening, and cutting back on salt.

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American Indians And Alaska Natives

  • At nearly 16.1%, American Indians and Alaska Natives have the highest age-adjusted prevalence of diabetes among U.S. racial and ethnic groups.

  • In 2004, the rate of death due to diabetes for American Indians and Alaska Natives was three times higher than that of the general U.S. population.

  • The rate of diabetes-related kidney failure is 3.5 times higher in American Indians than in the general U.S. population.

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Diabetes among the African American Community

Introduction

The estimated prevalence of all types of diabetes among the Americans is currently at 26 million, and another approximated 29 million prediabetes almost translating to one-third of the total United State population. The diverse effects of diabetes range from diminishing quality of life to the tremendous economic burden on the current systems of healthcare related to its complications. Such complications include increased amputation, blindness, kidney failures, heart attacks and stroke. A greater prevalence and higher complications are accorded to the African Americans among all the major and minor communities in the U.S.

Research studies have described diabetes to be a group of illnesses having a characteristically unusual increased amount of glucose in the human blood. The disease comes with fatal conditions that can be controlled if certain measures are taken appropriately to reduce the probability of the emergence of further complications. This paper will critically review the significant articles about the general health problems of diabetes among the African Americans while proposing the best strategy towards controlling the effects of the disease.

Literature Review

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One Last Thing About Lowering Your Risk Of Diabetes

Although diabetes is a real threat among Black Americans, you can take steps to stay healthy and avoid the onset of this disease. Work with your healthcare provider to reduce your risk factors. A healthy diet, staying physically active, losing weight, and giving up bad habits like smoking can help keep your blood sugar within a healthy range and keep diabetes at bay.

Additional reporting by Valencia Higuera.

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Fasting Blood Glucose Levels

  • Normal range. Less than 100 milligrams per deciliter .
  • Indicates prediabetes. Between 100125 mg/dL.
  • Indicates diabetes. Higher than 125 mg/dL on two occasions.

An oral glucose tolerance test measures your blood sugar levels over the course of 2 hours after drinking a sugary drink, with results indicating the following:

Diabetes In Black Americans: How To Lower Your Risk

Obesity in the African-American Community

Black Americans are disproportionately affected by diabetes, but education and lifestyle changes can help reduce the risk of the disease.

More than 100 million American adults live with diabetes or prediabetes. But despite the prevalence of these conditions among different racial and ethnic groups, the Black American community is disproportionately affected, according to the Centers for Disease Control and Prevention .

Researchers believe that genetic, environmental, socioeconomic, physiological, and behavioral factors are all contributors to this health disparity, notes the National Institute of Health .

According to a past article, in the United States, the risk of diabetes is 77 percent higher among non-Hispanic Black Americans than it is in non-Hispanic white Americans. The data suggests that Black people tend to experience more diabetes-related complications, like diabetic retinopathy and neuropathy, than non-Hispanic white Americans. Those who are Black are also 2.6 times more likely to have end-stage renal disease caused by diabetes, reports the American Diabetes Association .

While some of the risk factors for type 2 diabetes in Black people can be beyond an individuals control, being educated about the things you can change may help reduce the risk of the disease.

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African Americans Health Focus On Diabetes

If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.

For people with diabetes mellitus, the risks are real, and there can be many complications.

Its important to understand the risks and be proactive about keeping healthy. This is especially important for the African American community, which is affected disproportionately by diabetes.

  • According to the U.S. Department of Health and Human Services, African American adults are 60% more likely than non-Hispanic white adults to be diagnosed with diabetes
  • Non-Hispanic blacks have been 3.5 times more likely than non-Hispanic whites to be diagnosed with end-stage renal disease, often connected with a diabetic condition
  • Non-Hispanic blacks have been 2.3 times more likely than non-Hispanic whites to be hospitalized for lower limb amputationsalso associated with diabetes
  • Nationwide, African Americans have been twice as likely as non-Hispanic whites to die as a result of diabetes

A more dramatic statistic: about 8.3 percent of residents of the District of Columbia are diagnosed with diabetes, similar to the national rate of 8.7 percent. However, the diabetic death rate for blacks in the District can be as much as five times that of whites.

Also at higher risk are people of Hispanic and Asian ancestry. We dont have a detailed understanding of what causes these demographic disparities, although it may well be a combination of genetics, socio-economic factors and access to care.

The Disparate Impact Of Diabetes On Racial/ethnic Minority Populations

Edward A. Chow, MD, is executive director at the Chinese Community Health Care Association in San Francisco, Calif. Henry Foster, MD, is a professor emeritus at Meharry Medical College and a clinical professor of Obstetrics & Gynecology at Vanderbilt University in Nashville, Tenn. Victor Gonzalez, MD, is director of the Valley Retina Institute in McAllen, Tex. LaShawn McIver, MD, MPH, is the national director of public policy and strategic alliances at the American Diabetes Association in Alexandria, Va.

Clin Diabetes

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  • Edward A. Chow, Henry Foster, Victor Gonzalez, LaShawn McIver The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations. Clin Diabetes 1 July 2012 30 : 130133.

    Diabetes is a devastating disease that is affected by interdependent genetic, social, economic, cultural, and historic factors. In the United States, nearly 26 million Americans are living with diabetes, and another 79 million Americans have prediabetes. This means almost one-third of the total U.S. population is affected by diabetes.

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    Inequity Regarding Diet And Exercise

    Age-adjusted obesity is more prevalent among African American people than it is among white American people.

    Some people assume that African American people have a different and less healthy cultural diet than white American people. However, there are other factors that are more likely to cause obesity in African American people than the specific foods they consume.

    Socioeconomic barriers involving food

    The 2019 Census revealed that 17.4% of African American families were living under the poverty line, compared with just 5.5% of non-Hispanic white families.

    Fast food and items of junk food tend to be cheaper than fresher, healthier alternatives. Therefore, the disparate rate at which African American people are living below the poverty line could be a reason that it may be more difficult for African American people to manage their weight.

    Socioeconomic barriers involving exercise

    African American people may find it more difficult to exercise for leisure.

    According to one 2013 study , this could be another effect of residential segregation. For example, there may not be as many safe places for an African American person to exercise in their neighborhood as there are for people living in other neighborhoods.

    The study paper also mentions walkability in towns as a factor that can affect a persons daily exercise. Some neighborhoods give a person less access to supermarkets within walking distance. This also has links to increased body mass index .

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    Can I Prevent Type 2 Diabetes

    Get Well Wednesday: Diabetes 101

    YES! Thats the good news. Even though you may be at greater risk, you can take steps now to reduce that risk. And if you have already been diagnosed with diabetes, there is a lot you can do to keep it in check and prevent complications down the road.

    A Diabetes Prevention Program study by the National Institutes of Health found that overweight adults with higher-than-normal blood glucose levelsincluding African Americanscan delay or prevent type 2 diabetes. With good diabetes management, people in the study were able to lose 5 to 7% of their body weight . And since additional pounds put added pressure on your bodys ability to use insulin, the best way to avoid diabetes, or control it, is to control your weight. Heres what you can do:

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    The Diabetes Epidemic In African Americans

    Type 2 diabetes is a condition that affects the way people process food for energy. But its really more than thatits an epidemic thats affecting the health of our nation. Its one of the leading causes of death and disability in the United States, running up total health care and treatment costs to $174 billion each year.

    This is especially true for African Americans, who are almost twice as likely to have type 2 diabetes than non-Hispanic whites. But rest assured, there is a lot you can do now to controland even preventdiabetes and lower your risk of complications.

    Type 2 diabetes is a disease that causes your blood sugar level to be too high. This happens when the body doesnt make enough insulin or cant use the insulin it makes effectively. You could have symptoms like unusual thirst, frequent urination and infections, or blurred vision. Or, you may have no symptoms at all. Over time, untreated diabetes can affect many parts of your body, such as your kidneys, heart, eyes and feet.

    Type 1 Vs Type 2 Diabetes

    Diabetes is an umbrella term for multiple conditions that cause dysfunction in the bodys ability to metabolize glucose, secrete insulin, or both.

    When you take in glucose from the foods you eat, you need a hormone called insulin. Insulin is released by beta cells from your pancreas. When insulin reaches the cells in your body, it attaches to receptors that help the cells identify and take in glucose from your bloodstream.

    • Type 1 diabetes is an autoimmune condition that most commonly develops in childhood. With type 1 diabetes, the body attacks the beta cells of the pancreas, limiting their ability to produce insulin. Without enough insulin, the cells cannot take in glucose, which, in turn, causes high blood sugar levels.
    • Type 2 diabetes is a type of chronic condition that often starts in adulthood. With type 2 diabetes, it becomes harder for your body to recognize insulin, a condition called insulin resistance. Without an adequate insulin response, it becomes harder for your cells to take up glucose, and as a result, blood sugar levels rise.

    While type 1 diabetes is solely caused by a lack of insulin, type 2 diabetes can be caused by both a sensitivity to insulin and a lack of insulin.

    However, insulin deficiency in type 2 diabetes is not autoimmune. Instead, it happens because the pancreas cannot keep up with the increased demand for insulin due to insulin resistance.

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    How Do You Know If You Have Diabetes

    Regular checkups are one of the best ways to prevent the development of type 2 diabetes. During these checkups, there are several tests your healthcare professional can use to check your blood sugar levels and determine your risk of developing diabetes.

    A fasting blood glucose test measures your blood sugar levels after an 8 to 12 hour fast, with results indicating the following:

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    Kidney Donation in the African American Community

    Type 2 diabetes results from a lapse in body functionality that permits insufficiency in production and utilization of insulin effectively . Robbins articulates that African Americans above the age of 40 are the most common victims. However, the recent research reveals the prevalence has included the younger population. The research can be supported by the increased specific signs of type 2 diabetes that include fatigue and wounds among the victims. This type affects an estimated 95% of the African Americans with diabetes. The final type of diabetes among the African Americans is Gestational diabetes which emerges during pregnancy among women. The victims of gestational diabetes have a high probability of having the type 2 diabetes after ten years. Among the African American women, this type of diabetes has caused scares and worries.

    Diabetic Racial and Health Disparity

    Specific Reasons for Prevalence

    Model Programs and Recommendations

    The final program is company sponsored and aims at providing lectures among the African-Americans on complications like kidney failures and blindness. It is inclusive of those who already have diabetes to give them insights on the best ways of managing its complications and controlling its effects . The companies that aid this project are Baxter and Phizer aiming at full awareness of the specific symptoms of diabetes and ways to address them.

    References

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    Why Dietary Choices Matter When It Comes To Preventing Type 2 Diabetes

    Regardless of race, ethnicity, or sex, achieving or maintaining a healthy body weight matters when it comes to preventing diabetes. According to the American Heart Association , among non-Hispanic Black people ages 20 and older, 63 percent of men and 77 percent of women are overweight or have obesity.

    Excess weight on the body can lead to insulin resistance, which means blood glucose levels will increase, says New York Citybased Dacia Bryant, CDCES, founder of A ONE C LifeBox, a digital coaching and support platform that equips Black and Hispanic people with the tools and information to manage their diabetes more effectively. Insulin resistance can exist alone, but this condition increases the risk for type 2 diabetes, according to an article published in December 2019 in StatPearls.

    While genetics do play a role in weight, for Black Americans, certain unhealthy yet traditional dietary choices may increase the chances of obesity. Our diets tend to be high in carbs like mac and cheese and rice, but low in things that can help control blood sugar and weight, like fiber and green leafy vegetables, Bryant says.

    Understanding what makes for a diabetes-friendly diet and which traditions dont fall under that umbrella may help you achieve a healthy weight, as well as prevent or delay diabetes from progressing.

    RELATED: 7 Healthy Meal Tips for Type 2 Diabetes

    Socioeconomic Status And Other Potential Confounders

    The variables used to estimate SES were total household income in the previous year , highest level of education completed, and type of job held for the longest period of time during the participantâs adult life . We used NamâPowersâBoyd occupational status scores30 for the occupational categories by assigning each category the average of the scores for its individual job examples. In the case of a small number of participants for whom we were unable to code longest-held job with our categories, or for whom this information was missing, we substituted the score for their current occupation.

    Participants self-reported their current weight, their weight at age 21 years, the most they had ever weighed , and their height. Because current weight may reflect weight adjustments after a diagnosis of diabetes,31 we chose to focus on participantsâ reports of the most they had ever weighed and their weight at age 21 years . We calculated body mass index for each of these 2 weight measures we defined overweight as a BMI of 25 kg/m2 or higher, obesity as a BMI of 30 kg/m2 or higher, and extreme obesity as a BMI of 40 kg/m2 or higher32 .

    Participants also reported on leisure time physical activities they had engaged in during their 30s . These activities included both moderate-level sports and vigorous sports .

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