June 13, 2018
On a Sugar High? Diabetes Rates Are on the Rise for African Americans
James LaVelle Dickens, DNP, FNP-BC, FAANP
Captain, U.S. Pubic Health Service Commissioned Corps
So often I hear from patients that they are tired of getting the same prescriptions to ward off any number of chronic conditions affecting Americans today. While it may sound like a broken record, don’t tune it out. Yes, a good diet, ample exercise and shedding those extra pounds will reduce your risk for developing heart disease and high blood pressure, but did you know these healthy living strategies can all but prevent diabetes?
Most people don’t, and that helps to explain why the prevalence of diabetes is on the rise. Nearly 30 million people are living with diabetes today, and African Americans are nearly twice as likely to be diagnosed than whites. Alarmingly, the problem is even bigger than that statistic would have you think. Once diagnosed, African Americans are far more likely to suffer the most severe complications from diabetes, making the disease that much more devastating.
Untreated, diabetes patients are twice as likely to have heart disease or a stroke, and they have a higher risk for developing kidney disease, high blood pressure, eye trouble and nerve damage. Still, African Americans with diabetes fare much worse than the rest of the population. We are far more likely to suffer blindness and amputations, for example, and more than two and a half times more likely to be diagnosed with end-stage renal disease.
Why the discrepancy? As it turns out, there are many factors. Here’s a look at what’s happening behind the scenes, and what you can do to avert this largely preventable disease.
- Awareness gaps. This is true for all racial groups, but African Americans are paying a higher price. More than 100 million Americans have diabetes or prediabetes – the precursor to diabetes marked by higher than normal blood sugar levels. Eight million people with diabetes have no idea they have it, and 90 percent of the 80-plus million who have prediabetes also have no clue. This is important because people who know they have prediabetes can make lifestyle changes to reverse the condition before it gets worse. Even full-blown diabetes can be effectively managed to minimize complications. Not knowing the risk, or worse, not knowing you have diabetes, is the biggest danger of all, so make an appointment with your provider to talk about your diabetes risk, and if you haven’t been tested, check that off the list.
- Rising obesity rates. Fat interferes with the body’s ability to use insulin effectively, which explains why almost 90 percent of people with type 2 diabetes are overweight. When we consider that more than 75 percent of African American adults are also overweight, it’s no wonder the incidence of diabetes is high. The good news here is little changes can have a big impact. Dropping as little as five percent of your body weight could cut your diabetes risk in half, especially if you exercise regularly and eat well in the process. Start slow and set weight-loss goals that will not only significantly reduce your diabetes risk, but address a whole host of other health problems as well.
- Lack of exercise. When you’re active, your cells become more sensitive to insulin, which helps them work more efficiently. Remarkably, physical activity can lower your blood glucose for 24 hours or longer after you exercise, so the more you do it, the lower your glucose levels become. If you struggle to find motivation, know that like weight loss, even small changes can make a difference. Set a goal to move for a combined 30 minutes a day, five day a week, and lower your diabetes risk by almost 60 percent. Obviously, weight loss and exercise go hand-in-hand, so kill two birds with one stone and address them together to significantly reduce the likelihood that you will develop diabetes as you age.
- A distorted big picture. Genetics play a role in diabetes, especially if you have a parent or sibling who has the condition, but lifestyle factors are a far more accurate predictor. Too often I hear patients say that diabetes runs in their family and there’s nothing they can do to prevent it, and this is simply not true. Finding a provider who can help manage personal risk factors, prediabetes and, if the time comes, diabetes, will help limit long-term complications and dramatically improve your health. Diabetes can be deadly when it is not managed, but controlled diabetes, especially when detected early, is a very treatable condition.
One third of Americans are on their way to developing diabetes. Ironically, lifestyle choices are by far the biggest risk factor or prevention tactic, depending on how you look at it. A lack of awareness about diabetes is a major contributor to the rising prevalence, along with misunderstandings about what causes it and how best to manage it. If you don’t know your risk or you’ve never been tested, make an appointment with your provider. Diabetes is preventable and treatable, but only if you know where you stand and take steps to address it.