Diabetes is having a devastating effect on the African American community. Diabetes is the fifth leading cause of death in African Americans and their death rates are twenty seven percent higher than whites.Over 2.8 million African Americans have diabetes and one third of them don’t know they have the disease. In addition, twenty five percent of African Americans between the ages of 65 – 74 have diabetes and one in four African American women, over the age of 55, have been diagnosed with the diseaseThe cause of diabetes is a mystery, but researchers believe that both genetics and environmental factors play roles in who will develop the disease.HeredityResearchers believe that African Americans and African Immigrants are predisposed to developing diabetes. Research suggests that African Americans and recent African immigrants have inherited a “thrifty gene” from their African ancestors.This gene may have enabled Africans to use food energy more efficiently during cycles of feast and famine. Now, with fewer cycles of feast and famine, this gene may make weight control more difficult for African Americans and African Immigrants.This genetic predisposition, coupled with impaired glucose tolerance, is often associated with the genetic tendency toward high blood pressure. People with impaired glucose tolerance have higher than normal blood glucose levels and are at a higher risk for developing diabetes.What is Diabetes?Diabetes, commonly know as “sugar diabetes”, is a condition that occurs when the body is unable to properly produce or use insulin. Insulin is needed by the body to process sugar, starches and other foods into energy. Diabetes is a chronic condition for which there is no known cure; diabetes is a serious disease and should not be ignored.Diabetics often suffer from low glucose levels (sugar) in their blood. Low blood sugar levels can make you disorientated, dizzy, sweaty, hungry, have headaches, have sudden mood swings, have difficulty paying attention, or have tingling sensations around the mouth.Types of DiabetesPre-diabetes is a condition that occurs when a person’s blood glucose levels is higher than normal but not high enough for a diagnosis of type II diabetes. Pre-diabetes can cause damage to the heart and circulatory system, but pre-diabetes can often be controlled by controlling blood glucose levels. By controlling pre-diabetes you can often prevent or delay the onset of Type II diabetes.Type I or juvenile-onset diabetes usually strikes people under the age of 20, but can strike at any age. Five to ten percent of African Americans who are diagnosed with diabetes are diagnosed with this type of the disease. Type I diabetes is an autoimmune disease where the body produces little or no insulin and this type of diabetes must be treated with daily insulin injections.Type II or adult onset diabetes is responsible for ninety to ninety-five percent of diagnosed diabetes cases in African Americans. Type II results from a condition where the body fails to properly use insulin. According to the American Diabetes Association, “Type II is usually found in people over 45, who have diabetes in their family, who are overweight, who don’t exercise and who have cholesterol problems.” In the early stages it can often be controlled with lifestyle changes, but in the later stages diabetic pills or insulin injections are often needed.Pregnancy related diabetes or gestational diabetes can occur in pregnant women. Gestational diabetes is often associated with high glucose blood levels or hyperglycemia. Gestational diabetes affects about four percent of all pregnant women. The disease usually goes away after delivery, but women who suffer from gestational diabetes are at a higher risk for developing diabetes later in life.Symptoms of DiabetesThe most common symptoms of diabetes include:excessive urination including frequent trips to the bathroomincreased thirstincreased appetiteblurred visionunusual weight lossincreased fatigueirritabilityComplications from DiabetesDiabetes can lead to many disabling and life threatening complications. Strokes, blindness, kidney failure, heart disease, and amputations are common complications that effect African Americans who have diabetesKidney Disease”Diabetes is the second leading cause of end stage kidney disease in African Americans, accounting for about thirty percent of the new cases each year,” says the National Kidney Foundation of Illinois. Up to twenty-one percent of people who develop diabetes will develop kidney disease.AmputationsDiabetes is the leading cause of non-traumatic lower-limb amputations in the United States. More than sixty percent of non-traumatic lower-limb amputations in America occur among people with diabetes and African Americans are almost three times more likely to have a lower limb amputated due to diabetes than whites. According to Center for Disease Control (CDC), about 82,000 non-traumatic lower-limb amputations were performed among people with diabetes in 2001.BlindnessAfrican Americans are twice as likely to suffer from diabetes related blindness. Diabetics can develop a condition called “Diabetic Retinopathy”, a disease affecting the blood vessels of the eye, which can lead to impaired vision and blindness. Diabetes is the leading cause of new cases of blindness in people from 20 – 74 years of age and up to 24,000 people loose their sight each year because of diabetes.Heart DiseasePeople with diabetes are up to four times more likely to develop heart disease as people who don’t have diabetes. Atherosclerosis (hardening of the arteries) is more common in diabetics and can lead to increased risk of heart attacks, stroke, and poor circulation throughout the body.Diabetes Risk FactorsYou have a greater risk for developing diabetes if you have any of the following:ObesityFamily history of diabetesPre-diabetesLow physical activityAge greater than 45 yearsHigh blood pressureHigh blood levels of triglyceridesHDL cholesterol of less than 35Previous diabetes during pregnancy or baby weighing more than 9 poundsDiabetes has had a devastating effect on the African American community; it is the fifth leading cause of death and second leading cause of end stage kidney disease in African Americans.African Americans suffer from complications from diabetes at a much higher rate than the rest of the population. African Americans are three times more likely to have a lower limb amputated because of diabetes and twice as likely to suffer from diabetes related blindness.If you have any of the diabetes risk factors you should contact your physician and have a blood glucose test. Also discuss with your physician lifestyle changes you can take to lower your chances of developing diabetes.
INTRODUCTIONAccording to the World Health Organization, a few decades back diabetes was an uncommon disease, in both developed and developing countries. Today, the story is different. It is currently estimated that over 143million people worldwide are affected by the disease. This figure is ever increasing, by 2020 over 220million people are expected to be living with diabetes, if the current trend continues.In the United States alone, there are 18.2 million people (6.3% of the population) living with diabetes. While another 13million people have been diagnosed with diabetes. Unfortunately, 5.2milion (or nearly one third) are unaware that they have the disease.The figure for Nigeria is not readily available, but it is estimated that over 1.5million people have diabetes in Nigeria.In developed countries, most patients of diabetes are over sixty, but in developing countries, diabetes is found to affect people in their prime.WHAT IS DIABETES?Diabetes Mellitus (or simply diabetes) is derived from the Greek word ‘Diabeinein’, meaning ‘To pass through’ describing copious urination, and Mellitus from the Latin word meaning ‘Sweetened with honey’. These two words signify sweetened urine or sugar in urine.Diabetes is a disease in which the body does not produce or properly use Insulin. Insulin is a hormone that is needed, in the body, to control the rate at which sugar, starch and other food are converted into glucose required as energy for daily life. The hormone is produced and released
into the blood by an organ called ‘Pancreas’. This insulin help to maintain the blood glucose level within a normal range. The World Health Organization (WHO) puts this normal range between
60 – 100mg/dl (Before taking any food for the day, hence this value is called Fasting Blood Glucose). In health, despite several demands for glucose in different situations, the blood glucose rarely exceeds this value.After a meal the liver stores the glucose from the meal as glycogen and releases it into the blood in between meals. The role of insulin is the control of this storage and release of glucose. It ensures that the amount of glucose in the blood at every particular time does not go beyond or below the normal range.TYPES OF DIABETES.According to the World Health Organization (WHO), five classes of diabetes are recognized, these are; Insulin Dependent Diabetes Mellitus (IDDM) or Type I Diabetes, Non Insulin Dependent Diabetes Mellitus (NIDDM) or Type II Diabetes, Gestational Diabetes, Diabetes Insipidus and Bronze Diabetes.INSULIN DEPENDENT/TYPE I DIABETES: This type of diabetes was initially called Juvenile onset diabetes because it affects adolescents and young adults. It is caused by a sudden failure of the pancreas to produce Insulin. It is, therefore, an acute disease, presenting with thirst, polyuria (passing large amount of urine), diuresis and weight loss. Type I diabetes is not common, it accounts for less than 10% of all diabetes cases.NON-INSULIN DEPENDENT/ TYPE II DIABETES: This is the most prevalent type of diabetes, accounting for more than 80% of all diabetic cases. It is found in adults and the elderly. This type of diabetes develops gradually over a long period of time (unnoticed) and is characterized by insufficient insulin, deficient insulin in the blood or the inability of the body to utilize the insulin resent (Insulin resistance). Because of its slow and gradual occurrence, it is mostly undetected until one or more of its long-term complications appear.Unlike in Type I Diabetes, the Insulin in the blood of a Type II diabetic may be normal or even high, but lacks the desired effect, due to insulin resistance, and this is prevalent among obese people.GESTATIONAL DIABETES: This type of diabetes occurs during pregnancy and disappears after delivery, within 3weeks. An estimated 3% of all pregnancies are accompanied by gestational diabetes and almost half of these patients are prone to developing permanent diabetes later in life.
WHAT CAUSES DIABETES.As with hypertension and other non communicable diseases, no clear cut cause(s) can be attributed to the most prevalent type of diabetes (Type II Diabetes, Type I diabetes being secondary to failure of the pancreas). However, some factors are known to increase one’s chances of becoming diabetic and these are called risk factors. For example, indolent and well-fed populations are 2 – 20times more likely to develop type II diabetes than active and lean population of the same race. Some other factors known to increase one chances of getting diabetes include:OBESITY: It is estimated that three quarter (¾) of all Type II diabetes patient are obese. Indolent and affluent lifestyles tend to contribute to this. It is believed that a 10kg loss of weight can reduce fasting blood sugar level by almost 50md/dl. An active lifestyle with frequent exercise is also known to increase Insulin sensitivity.The International standard for measuring overweight and obesity is based on a value called BODY MASS INDEX (BMI). This value is derived by dividing the body weight (in Kilograms) by the square of height (in metres).i.e. BMI = Body weight (Kg) / Height2 (Metres).Note: 1ft = 0.305metres.For adults, a BMI less than 25kg/m2 is preferred.25 – 29kg/m2 is considered overweight and above 30kg/m2 is Obesity.FAMILY HISTORY: A family history of diabetes increases one’s chances of getting the disease. In such a situation, leading a healthy lifestyle and constant monitoring of one’s blood sugar level becomes very important.
AGE AND RACE: Most Type II diabetes patient are over 40yrs at presentation of the disease. However, the proportion of increase in the incidence of this disease with age is higher for those with a family history of diabetes, obese and probably those leading sedentary lifestyles. Moreover, diabetes tends to be more prevalent among Africans, African Americans, Latinos, Native Americans and Asian Americans. Belonging to any of the races is a risk factor in itself.HISTORY OF GESTATIONAL DIABETES: in a woman also increases her chances/possibility of developing permanent diabetes later in life.YOU CAN PREVENT/DELAY DIABETES!
Diabetes have no permanent cure once it develops, it is managed al through life. But you can prevent ever falling into this life long pain. Before diabetes present in people, it is almost always preceded by a situation called PRE DIABETES. A situation where the blood glucose is higher than normal, but not yet enough to be diagnosed as diabetes. Saddening, however, you cannot know when you fall into this category, if you have not being monitoring your blood glucose regularly.Pre Diabetes is itself a serious medical situation, though can still be reversed by making changes in diet pattern and increasing physical activity. To determine one’s blood sugar a test called Fasting Blood Glucose has to be conducted. This test measures the amount of glucose (sugar) in one’s blood before taking any meal for the day. It is measured in milligrams per deciliter (mg/dl).A value below 100mg/dl is generally accepted to be normal, while a value greater than 100mg/dl but less than 120mg/dl is not full diabetes yet, so it is regarded as Pre diabetes. An individual with a pre diabetes blood glucose level need to take urgent steps to reduce his blood glucose or risk life long diabetes.It should be emphasized, however, that the racial and genetic factors predisposing to diabetes are still beyond human comprehension and control. It makes common sense, therefore, to reduce all human controllable factors to the barest minimum. Most of these factors have to do with social occupational and diet habits.The following tips can help reduce your diabetes risk:* Reduce weight. Obesity seems to be the single most significant factor in diabetes. Reducing body weight and fat and maintaining an average body weight is very essential. To this end a body mass index (BMI) less than 25kg/m2 for males and less than 24kg/m2 for females is recommended.* Increase Physical Activity. It is an established fact that diabetes is more common among people that lead a sedentary affluent lifestyle. Simple dynamic exercises like brisk walking for 30-50mins daily or 3-5times weekly has been shown to be very helpful. Exercise reduces bodyweight and fat, increases functionality of the heart, reduces the chances of diabetes and also boosts emotions and healthy living.* Cut down or cut out alcohol. Alcoholic intake of more than 2units per day has been shown to adversely affect the body. Alcohol being an addictive drug makes it very difficult to maintain a definite amount of intake for a long time. It is better therefore to strive to cut out alcohol completely.* Avoid Smoking. Cigarette smoke has been shown to contain several poisonous substances. Cigarette smoking and alcohol have been related to several disease. Stopping smoking will definitely reduce the chances of several other ailments apart from diabetes.* Lean good eating habits, such as;* Cut down on fatty food and junks* Eat more of fish and poultry (without the skin is better).* Garlic reduces blood pressure cholesterol; add it to your meal plan once in a while.* Cut the number of eggs you take to 3- 4 weekly (better boiled than fried).* Reduce salt intake to less than 5.8grams daily.* Eat more of vegetables and fibre rich food, especially fruits.* Finally, constantly monitor your fasting blood glucose, as this is the only way to know when you are getting into trouble.CONCLUSIONDiabetes and Hypertension being so interlinked requires a comprehensive plan of care, and this revolves round one’s dietary habits, social and environmental factors. Several lifestyle changes like regular exercise, maintaining a moderate body weight, reduction of fat intake and high fibre diet all help to live a normal healthy life. These measures are known to increase insulin sensitivity and also reduce blood pressure.Conclusively, it is very important to create a more health conscious individuals in the populace. A people who practically believe that it is better and cheaper to prevent an illness than to treat it, when it has become stronger. Moreover, preventive health cannot be divorced from regular medical checks, as this two go hand in hand. There is no way to detect several non-communicable diseases without undergoing regular medical checks. The importance of these checks cannot be over emphasized.
Be alive to your health. Know your Blood glucose values and live a healthier life free from the pains of diabetes.