African Americans and Diabetes

Diabetes is a killing disease in the African American community, but a disease that may be controlled, according to James R. Gavin III, MD, chair of the American Diabetes Association's African-American Program. "By keeping fit, eating right and getting regular exercise, we can decrease our risk for diabetes quite substantially," he said. "This is a disease about which we can do a great deal, but only when those affected are informed and empowered to take the kind of control of this disease that is now possible.

"Unfortunately, what we don't know right now is why our community is such a primary target." Since the 1960s, the 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, according to the American Diabetes Association.

Diabetes currently is the fourth-leading cause of death by disease among African-Americans and is the leading cause of blindness, kidney failure and amputation. While diabetes affects nearly 3 million African- Americans — half of those with the disease don't know it. Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes is unknown, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

DIFFERENT TYPES OF DIABETES

	Type 1 diabetes 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 5 to 10 percent of people with diabetes have this form.
	Type 2 diabetes, the most common, is a metabolic disorder resulting from the body's inability to make enough, or properly use, insulin. It occurs most often in older people. African-Americans are 1.7 times as likely to have type 2 diabetes as the general population. An estimated 2.3 million African-Americans, or almost 11 percent, have diabetes.
	Gestational diabetes develops in 2 to 5 percent of all pregnancies, but disappears when the pregnancy is over. However, women who have gestational diabetes are more likely to develop type 2 diabetes.
	Other types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illness.

COMPLICATIONS

African-Americans experience higher rates of at least three of the complications of diabetes:

	Diabetic retinopathy is what happens when the small blood vessels in the eye are weakened by diabetes. African-Americans are twice as likely to have diabetes-related blindness.
	Diabetes is the most frequent cause of leg amputations not resulting from accidents. Among people with diabetes, African-Americans are 1.5 to 2.5 times more likely to suffer from lower limb amputations.
	African-Americans are 2.5 to 5.6 times more likely to suffer from kidney disease with more than 4,000 new cases annually of renal disease requiring a kidney transplant or regular dialysis.

WARNING SIGNS

Type 1

	Frequent urination
	Unusual thirst
	Extreme hunger
	Extreme fatigue
	Irritability

Type 2

	Any of the type 1 symptoms
	Frequent infections
	Blurred vision
	Cuts/bruises that are slow to heal
	Tingling/numbness in hands or feet
	Recurring skin, gum or bladder infections

WHAT TO DO

	Patient education is critical.
	People with diabetes, with the help of their health care providers, should set a goal for better control of blood sugar levels.
	Education of your health care team — your physician, nurses, other caregivers, and yourself — is vital.