In 2018, non-Hispanic African Americans were twice as likely as non-Hispanic Caucasians to die from diabetes, with African Americans being 77% more likely to be diagnosed with type 2 diabetes by adulthood. In addition to this, African Americans were found to be 3.2 times more likely to be diagnosed with end stage renal disease and 2.3 times more likely to be hospitalized for lower limb amputations. So why are African Americans more at risk for developing type 2 diabetes? Research has shown it to be due to the African American population’s genetic variations and social health determinates, the variables caused by an individual’s environment. A study by the University of Alabama at Birmingham found that, while African Americans, especially those with a higher African proportion of ancestry, have a lower chance of developing cardiovascular or metabolic diseases, there are specific genetic variations that are more common in African Americans, predisposing them to diabetes. However, it was also found that the higher risk of type 2 diabetes among non-Hispanic African Americans was in part due to social determinates of health, such as where people are born, where they learn or work, where they live, and their age. Higher rates of obesity, poor blood sugar control, diet, and lack of exercise have been shown to contribute to the racial and ethnic disparities, or noticeable significant differences, in the prevalence of diabetes.
Diabetes is a chronic health condition that affects how the body processes food into energy. The food you eat gets broken down into sugar and released into your blood stream. When the amount of sugar in your blood increases, your pancreas releases insulin, which helps blood sugar enter the body’s cells so it can be used for energy. With type 1 diabetes, an autoimmune condition that develops in childhood, the body attacks the cells of the pancreas, making it harder to produce insulin. With type 2 diabetes, a chronic condition that often starts in adulthood, your body has a hard time recognizing insulin, a condition called insulin resistance. Without enough insulin, too much sugar stays in the bloodstream and can cause hyperglycemia, which can damage the vessels that supply blood to vital organs, increase the risk of heart disease and stroke, and can cause kidney disease, vision problems, and nerve problems.
In the U.S., black adults are nearly twice as likely than white adults to develop type 2 diabetes, a racial disparity that has been rising over the last 30 years. Studies done by the Northwestern University Feinberg School of Medicine found that the chance of type 2 diabetes was significantly higher in black adults than for white adults, (“about 66 more cases of diabetes per 1,000 people”), with the greatest difference being that between black women and white women. Researchers from a team led by Dr. Mercedes R. Carnethon analyzed information gathered from the participants of the study, including personal and family medical history, weight, health, hazardous health habits like drinking and smoking, and their diet. They also took social determinates like their neighborhood, level of education, income, and employment status into consideration. They found that the greatest accounted for risk in the health disparity between African Americans and other races was due to biological factors – things like BMI, waist measurement, fasting glucose (blood sugar) levels, blood pressure, lipids, and lung function. While some of the risk factors for type 2 diabetes can be out of your control, knowing what you can change can help reduce the risk of developing diabetes.
While genetics in black americans can play a role in weight, dietary choices can exacerbate and increase the chance of obesity. Another study found that there are disparities in care between Black Americans and other races, even for those that are fully insured. Lack of physician support, stress, and emotional distress due to discrimination also play a large role in the lack of seeking treatment and the risk for developed diabetes. Regardless of race, maintaining a healthy bodyweight and lifestyle is important for preventing diabetes; obesity and an unhealthy weight can cause insulin resistance. Prediabetes, or having a higher-than-normal blood sugar, is extremely common in the U.S. – about 96 million adults have it, and more than 80% are unaware that they do. Knowing how to manage your care is the first step to preventing diabetes.
Annual doctor’s visits are the best time to ask your doctor for a prediabetes and a diabetes screening. Your doctor may do this using an A1C test, a fasting blood sugar test, a glucose tolerance test, or a random blood sugar test. They may also use a combination of these tests to determine your risk for diabetes.
- A1C Test: Measures your average blood sugar over 2 or 3 months.
- Fasting Blood Sugar Test: Measures your blood sugar after an overnight fast.
- Glucose Tolerance Test: Measures your blood sugar before and 1 and 2 hours after drinking a liquid containing glucose (sugar), with an overnight fast before the test is conducted.
It’s important to note that a study done by the Journal of the American Medical Association (JAMA) in 2017 found that the A1C test may be inaccurate for about 11% of Black Americans due to a gene variant that may make the test ineffective.
An unhealthy diet can increase the risk of developed diabetes by 30%. Heavily processed carbs, fried foods, red meats, and processed meats have all been shown to increase the risk of type 2 diabetes. Sugary drinks with no added nutrition also increase weight gain and cravings for sugary products. They also increase insulin resistance, inflammation, and impaired B cell function, a type of white blood cell that makes antibodies. Eating more fiber and green leafy vegetables can help control blood sugar and weight. Fiber has also been suggested to protect against metabolic conditions, like diabetes.
A study by the Diabetes Prevention Program found that participants who ate less fat and fewer calories and exercised 150 minutes per week lost 7% of their body fat and were able to maintain their weight and sugar intake. Some easy exercises to maintain a healthy routine that can also be done at home are:
- High-Intensity Interval Training (HIIT)
- Resistance Training
Managing your care for prediabetes or type 2 diabetes can be difficult. Don’t let a lack of physician support be a barrier to your care. At FirstMed, we take your health seriously and can help you maintain and manage your prediabetic, type 1, and type 2 diabetic care. Make your health a priority today and call us at (702) 731-0909 to make an appointment, or find us at fmhwc.org to learn more about how we can help you manage your care.
Frederick L. Brancati, MD, MHS; W. H. Linda Kao, PhD; Aaron R. Folsom, MD, MPH; et al. (2000, May 3). Incident Type 2 Diabetes Mellitus in African American and White Adults. JAMA Network. Retrieved January 25, 2023, from https://jamanetwork.com/journals/jama/fullarticle/192658
Mary Ann Banerji, MD. (2004, May). Diabetes in African American: Unique Pathophysiologic Features. Springer Link. Retrieved January 25, 2023, from https://link.springer.com/article/10.1007/s11892-004-0027-3
Eleesha Lockett, MS. (2021, October 29). Is Diabetes More Prevalent Among African Americans? HealthLine. Retrieved January 25, 2023, from https://www.healthline.com/health/diabetes/diabetes-in-african-americans
Office of Minority Health Resource Center. (2021, March 1). Diabetes and African Americans. U.S. Department of Health & Human Services. Retrieved January 25, 2023, from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=18
Centers for Disease Control and Prevention. (2022, July 7). Diabetes. CDC. Retrieved January 25, 2023, from https://www.cdc.gov/diabetes/basics/diabetes.html
National Institutes of Health. (2018, January 9). Factors contributing to higher incidence of diabetes for black Americans. U.S. Department of Health & Human Services. Retrieved January 25, 2023, from https://www.nih.gov/news-events/nih-research-matters/factors-contributing-higher-incidence-diabetes-black-americans
Hopkins, T. (2020, July 24). Diabetes in Black Americans: How to Lower Your Risk. Everyday Health. Retrieved January 25, 2023, from https://www.everydayhealth.com/type-2-diabetes/diet/diabetes-african-americans-how-lower-your-risk/#:~:text=According%20to%20the%20Diabetes%20Prevention,a%20week%2C%20the%20program%20found.
PLOS. (2022, April 26). Poor diet associated with increased diabetes risk across all gradients of genetic risk: A poor diet, irrespective of genetic risk factors, is associated with a 30 percent increased risk of diabetes. ScienceDaily.Retrieved from January 28, 2023, from Science Daily.