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Diabetes is a life-long disease marked by elevated levels of sugar (glucose) in the blood. It can be caused by too little insulin (a chemical produced by the pancreas to regulate blood sugar), resistance to insulin, or both. Approximately 2.7 million or 11.4% of all African Americans aged 20 years or older have diabetes. However, one-third of them do not know it.
The most life-threatening consequences of diabetes are heart disease and stroke, which strike people with diabetes more than twice as often as they do others. Adults with diabetes have heart disease death rates 2 to 4 times higher than those without diabetes. African Americans with diabetes are at increased risk for heart disease, stroke and other macro vascular complications. Other complications of diabetes include blindness, kidney disease, and amputations.
Most African Americans (about 90 to 95 percent) with diabetes have type 2 diabetes. This type of diabetes usually develops in adults and is caused by the body's resistance to insulin and to impaired insulin secretion. Although it is a very serious disease, diabetes can be treated with diet, exercise, diabetes pills, and injected insulin. A small number of African Americans (about 5 percent to 10 percent) have type 1 diabetes, which usually develops before age 20 and is always treated with insulin.
Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetic and environmental factors such as obesity and lack of exercise appear to play roles.
Major Types of Diabetes
Type 1 diabetes results from the body’s failure to produce insulin, the hormone that “unlocks” the cells of the body, allowing glucose to enter and fuel them. This type of diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes.
Type 2 diabetes is the most common form of diabetes. In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can cause two problems:
• Right away, your cells may be starved for energy.
• Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.
Before people develop type 2 diabetes, they almost always have "pre-diabetes" -- blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 41 million people in the United States, ages 40 to 74, who have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. People with pre-diabetes don't often have symptoms. In fact, millions have diabetes and don't know it because symptoms develop so gradually. Some have no symptoms at all. Symptoms of diabetes include unusual thirst, a frequent desire to urinate, blurred vision, or a feeling of being tired most of the time for no apparent reason.
There are more than 17 million Americans with diabetes with more than 1,000,000 new cases diagnosed every year. Diabetes a chronic disease and is known as a silent killer "because it annually contributes to approximately 18% of all deaths in the United States among patients who are age 25 and older.
• Patient education is critical. People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose, blood pressure and cholesterol levels, and receive regular checkups from their health care team. Smokers should stop smoking, and overweight African Americans should develop moderate exercise regimens under the guidance of a health care provider to help them achieve a healthy weight.
• Individuals with diabetes, with the help of their health care providers, should set goals for better control of blood glucose levels, as well as blood pressure and cholesterol levels.
Points to Remember
• 2.8 million African Americans have diabetes.
• On average, African Americans are twice as likely to have diabetes as white Americans of similar age.
• The highest Complications of diabetes in African Americans occur between 65 and 74 years of age.
• Obesity is a major medical risk factor for diabetes in African Americans, especially for women. Some diabetes may be prevented with weight control through healthy eating and regular exercise.
• African Americans have higher incidence of and greater disability from diabetes complications such as kidney failure, visual impairment, and amputations.
In ideal circumstances, African Americans with diabetes will have their disease under good control and continue to be monitored frequently by a health care team knowledgeable in the care of this deadly but controllable disease.