What is the prevalence of Diabetes in minority populations?
In the US, 2.3 million African Americans have been diagnosed with diabetes.
There has been a 33% increase in the diabetic African American population
between 1980 and 1994. The actual number of African Americans with diabetes
is even higher since for every person with a diagnosis of diabetes there
is at least one undiagnosed case.
The Latino
population is the fastest growing minority population in the United States.
There are 2.5 million Latinos in the United States with diabetes. About
one-third of Latino Americans do not know they have diabetes.
How is diabetes affecting the African American and
Latino Community? The
prevalence of diabetes is 1.4 to 2.3 times as frequent in African Americans
as compared to Caucasians. One in four black women, 55 years of age or
older has diabetes.
25% of African
Americans between the ages of 65 and 74 have diabetes
African Americans
have higher in-hospital mortality and higher rates of sudden death. Diabetes
is the third leading cause of death from disease among Black women.
African Americans
are more likely to develop the long term complications of diabetes which
include: blindness (40% higher), kidney failure (2.5 to 5.5 times more
frequent) and amputation (African Americans are 72% more likely to develop
diabetes related amputations).
30% of Latinos
older than 50 years of age have either diagnosed or undiagnosed diabetes
Latino men
and women have a higher rate of angina, heart attacks and strokes than
Caucasians.
12% of Latina
women develop type 2 diabetes after pregnancy
Latinos have
a two-fold higher rate of diabetic retinopathy, and a higher rate of kidney
disease than Caucasians
What is diabetes? Diabetes is a disease which can affect all the parts of the
body. It is due to a lack of or resistance to the insulin that comes from
the pancreas. When insulin from the pancreas is insufficient or doesn't
work, it causes the blood sugar to rise. This is called "hyperglycemia".
It is the high blood sugar that causes the long term complications.
What is the difference between type 1 and type 2
diabetes? Most minority populations have type 2 or non-insulin dependent
diabetes. Type 2 diabetes accounts for 90% of all diagnosed cases of diabetes.
Type 2 diabetes usually develops after the age of 40. In the Latino and
African American community we are now seeing a high prevalence of type
2 diabetes in children. Type 2 and can be treated with diet, exercise
and oral medications. There are some people with type 2 diabetes that
require the use of injected insulin.
Type 1 diabetes
usually develops before age 20. Type 1 diabetes is usually seen in children
and was previously called insulin-dependent diabetes or juvenile onset
diabetes. Type 1 diabetes accounts for 5-10% of all diagnosed cases of
diabetes. Type 1 diabetes must be treated with injected insulin.
Can you inherit diabetes? There
is a strong genetic link in diabetes. Diabetes usually runs in families.
Many Blacks have inherited a "thrifty gene". When in their native
land this gene allowed them to use food more efficiently to get through
periods of famine. Now that we live in a society were food is abundant
and easily accessible, obesity has become a problem in both the African
American and Latino community.
Is
obesity a problem in minority populations? The
National Health and Nutrition Survey showed that the rate of obesity is
higher in both Latinos and African Americans. African American women have
the highest rate of obesity compared to any other ethnic group. 80% of
African American women are overweight.
The location
of the excess weight is also important. Upper body obesity (waistline)
is a risk factor for type 2 diabetes. One of the reasons for the increased
obesity seen in Blacks stems from their diet ("Soul Food") and
lack of physical activity.
Latino men
and women also have higher rates of obesity and lack of physical activity.
Approximately 80% of Latino men and women are overweight.
What are the other risk factors that contribute to the development of
diabetes? Prior
history
diabetes during pregnancy (gestational diabetes)
Old age
Impaired glucose tolerance (high blood sugars after meals)
Physical inactivity
Can
diabetes be prevented? If
you have a family history of diabetes it is very important that you watch
what you eat and keep your weight under control. Once diabetes has been
diagnosed, the first step in the treatment is to start a diet and exercise
program. It is very important to keep blood sugar near normal levels at
all times. (Note: normal levels of blood sugar are 60-110mg/dL). All people
with diabetes need to receive nutritional counseling from a registered
dietician. If you need to lose weight, the first steps are to decrease
your portions and decrease the amount of fatty foods that are eaten. Daily
physical activity is very important and has been shown to delay the onset
of type 2 diabetes.
Type 1 diabetes -
People with type 1 diabetes must use insulin to control their blood sugar.
Treatment generally requires careful meal planning and calculation of
sugar (carbohydrate) intake, planned physical activity, home blood glucose
monitoring at least twice a day and multiple daily injections of insulin.
Type
2 diabetes -
Treatment usually requires careful meal planning, home blood glucose monitoring
(especially after you eat), oral medications and/or insulin injections.
Approximately 40% of people with type 2 diabetes need to take insulin
to control their blood sugar.
When your
physician prescribes a medication for you, it needs to be taken every
day as prescribed. If the medication is causing side effects, the physician
should be notified.
Why
should I monitor my blood sugar at home? Home
blood glucose monitoring (HMGM) is one of the most important advances
in diabetes management that has happened in the last 20 years. By monitoring
your blood sugar at home you are able to see the effect of food, exercise
and medications on your blood sugar. HBGM allows you to check your diabetes
control. By keeping your blood sugar under control you prevent or delay
the long term complications of diabetes. You should check your blood sugar
daily especially if you are taking oral medications or insulin.
What
should my blood sugar levels and my Hemoglobin A1C be if I am in "good"
control?
70 - 120mg/dL
before meals and less than 140mg/dL after meals
HbA1c - less than 8%
Blindness - due to eye disease (retinopathy)
-
Each year 12,000 to 24,000 people with diabetes lose their eyesight.
Kidney
Disease -due to nephropathy -
Minority populations are especially prone to developing kidney disease
due to the higher incidence of high blood pressure.
Heart
Disease and Stroke -
minority populations have a 2-4 times
increase prevalence of heart disease and stroke.
Nerve
Disease and Amputations -
70% of people with diabetes have some form of nerve damage. When the nerves
and blood supply are severely affected than lower limb amputations can
occur.
Impotence
-
Due to the lack of blood supply to the penis and nerve damage, many men
with diabetes have problem with sexual performance. Control of blood sugar
and blood pressure can help diabetes induced impotence
What type of diet should I eat? It is important to eat three well balanced meals a day. You
should eat food from the four main groups which include:
Fruits
and vegetables
Whole
grains
Dairy
products
Meats,
fish, poultry, eggs, dried beans, and nuts
Tips
for healthy eating:
Choose
lean cuts of meat
Eat fish,
chicken and turkey
Use canola
oil
Drink low-fat or skim milk
Watch
your portion sizes
You
should avoid the following foods:
Simple sugars found in candy, cakes, cookies, syrup
Fats found in red meat, whole milk, ice cream, cream cheese, salad
dressing
Can diabetes
be cured? There
are many research studies being conducted to find a cure for people with
diabetes. There have been several areas of research to find a cure for
diabetes, most of which involve the pancreas (organ that produces insulin).
These include:
Pancreas
transplantation
Islet
cell transplantation
Artificial
pancreas
Genetic
engineering
There is
still a great deal of research that must be done in these areas. There
have been pancreas transplants that have been successful.