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Blacks And Diabetes

Lifelines Magazine

History
What exactly is Diabetes?
Additional Symptoms
Laboratory Tests
Treatment, Diet, Activity and Patient Education

History:
Early settlers arrived on eastern shores of the New World in search of a new way of life. As time passed, pioneers forged a path towards the west, establishing an era called Expansionism. This period in history opened the door for western urbanization to flourish. With this new social order came the emergence of many diseases, those who sought happiness and well being found themselves combating these diseases.

Diabetes was one of the emergent diseases that began to affect African Americans. Throughout the 19th century, blacks did not appear to be affected by diabetes. The disease was not recognized in the African American population until after urbanization. It is during this time that the disease began to proliferate. The most likely cause for this manifestation is the lifestyle changes that occurred during this period.

After slavery was abolished, African Americans adopted Western lifestyle patterns that contributed directly towards the incidence and prevalence of diabetes in blacks. Dietary behaviour, changes in physical activity and attitudes towards body size and weight played a direct role in the increase of diabetes in African Americans. These changes caused a condition called obesity--an excess amount of body fat.

As overall bodyweights increased, the frequency and commonness of the disease increased. The genesis of diabetes has increased steadily for both blacks and whites. Today, diabetes is one of the most common diseases that affect African Americans.

Diabetes is often colloquialized by blacks as having "sugar." In simple terms, diabetes is a disease of carbohydrate metabolism. It affects an estimated 16 million people in the United States but most people do not even know that they have it.

Those who have been diagnosed with diabetes do not have the care and education that they need to manage the disease. Blacks in particular do poorly in treatment because of many factors, however, poor compliance with recommendations for management of the disease seems to be at the top of the list.

Diabetes affects blacks at a disproportionately high rate. African Americans are 55% more likely than whites to have the disease. Blacks that have limited health care have more complications as a result of their disease. For blacks, the leading cause of blindness, amputation, and heart and kidney failure is diabetes.

Before blacks can begin to take charge of their diabetes, they must first become more knowledgeable about the disease itself. Education is the only way to understand the magnitude of the dreadful effects that diabetes has on the African American population. Unfortunately, many blacks do not realize the risk factors or mechanisms of the disease.
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What exactly is Diabetes?
As I stated earlier, diabetes is a defect in carbohydrate metabolism. Carbohydrates are a major nutrient in every person's diet. Protein and fats are the other two nutrients that make up the foods we eat. When we eat food with carbohydrates, that is, starch and sugars, the digestive process breaks down to much smaller parts called glucose. It is important to understand that the body needs glucose for energy to fuel the body and replenish cells.

Glucose travels through the digestive tract, is absorbed through the small intestines and into the blood stream to feed the cells. Insulin, a hormone that comes from the pancreas, is secreted and helps the glucose enter the cells. One of the results of glucose not being able to enter the cell is hyperglycaemia.
This is an increase of glucose in the blood and is what diabetics have. Not enough insulin is produced and the blood thickens with glucose. This is the most basic mechanism of the action. In addition to the insulin, other hormones are also produced to assist in controlling the levels of glucose (sugar) in the blood.
The diabetic's insulin and hormone production does not work properly.

When the pancreas does not produce enough insulin, it is referred to as Type I diabetes. Type I diabetics must take supplemental insulin to assist the process of glucose (carbohydrate) metabolism. Other times, people can manufacture enough insulin without having to supplement, but not enough to assist the glucose to enter the cells. This is Type II diabetes.

The thickened blood caused by excess glucose affects body organs. Kidneys try and help by removing excess glucose and are often overworked or damaged. Along with the body's removal of all the excess glucose, water is removed with it. As a result, diabetics are often thirsty and urinate a great deal.

The thickened blood causes damage to blood vessels and injure organs such as eyes and the heart. Blood vessels that are small are unable to filter the blood. As a result, limited quantities of blood are delivered to the distal (far away) regions of the body, like the feet and hands. This is the reason diabetics have poor circulation and often have problems with their feet, or even lose their legs to amputation.
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Additional Symptoms
Most Blacks have Type II diabetes. The most common effect of diabetes is sudden loss of weight. If a person is already obese and is attempting to lose weight, the sudden weight loss can go unnoticed. Some people will complain of a sensation of pins and needles in their fingers and toes. Non-specific causes of itching, nausea and vomiting, abdominal pain and changes in mental states (moods) can also signal diabetes.

Also, with the massive fluid loss from urination, some people will become light-headed, especially when standing from a sitting position. Does anyone in your family have diabetes, are you overweight, older than 35? Have you ever had blurred vision or any of the other symptoms of diabetes? If so, it is time to visit your doctor.
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Laboratory Tests
It is important for your doctor to check your urine. In ancient times, medicine men would taste urine and note its sweetness. In fact, diabetes mellitus means "sweet like honey."

Today, physicians do not taste the urine, they do what is called a urinalysis. Glucose and other substances called ketones show up on the tests as strongly positive with diabetics. Doctors also do "finger sticks" and serum glucose levels. A level greater than 140 mg/dl usually indicates diabetes. These readings can be influenced by whether you eat or not before the test.

It is important to follow your physician's instructions prior to taking the test. A more comprehensive test is called the Haemoglobin A1c and also involves testing your blood. This test allows the doctor to determine your glucose levels over a 45 to 60 day period. This test is often preferred by physicians and is an invaluable, objective measure of your glucose control.
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