Type 2 Diabetes in African Americans Essay

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Type 2 Diabetes in African Americans Essay

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What is Type 2 Diabetes?

According to Camastra et al “Diabetes mellitus type 2 is a metabolic disorder that is primarily characterized by insulin resistance, relative insulin deficiency, and hyperglycemia. It is presently incurable. It is rapidly increasing in the developed world, and there is some evidence that this pattern will be followed in much of the rest of the world in coming years. The CDC has characterized the increase as an epidemic.” (Camastra et al, pp. 1307-1308)

Type 2 Diabetes in African Americans

Type 2 diabetes is 1.2–2.3 times more prevalent in African Americans than European Americans and is associated with higher rates of complications and greater levels of disability related to those complications (Harris, pp. 454–459) Approximately 1.5 million African Americans have been diagnosed with diabetes and another 730,000 have this illness but are unaware. Studies have shown that diabetes is 33 percent more common among African Americans than Whites, and that the highest rates are among African American women. (Pryor, p.1)

Higher rates of coronary heart disease, stroke, and end-stage renal disease contribute substantially to African Americans with diabetes living shorter and less healthy lives. There is an urgent need to develop culturally appropriate treatment approaches that will affect improvements in diabetes control in this population. (Brody et al, pp. 685–693)

Causes of Type 2 Diabetes in African Americans
Genetic Risk Factors:

Inherent traits: Researchers suggest that African Americans and recent African immigrants to America have inherited a thrifty gene from their African ancestors. Years ago, this gene enabled Africans, during feast and famine cycles, to use food energy more efficiently when food was scarce. Today, with fewer feast and famine cycles, the thrifty gene that developed for survival may instead make weight control more difficult. This genetic predisposition, along with impaired glucose tolerance (IGT), often occurs together with the genetic tendency toward high blood pressure.

African-American ancestry: is also an important predictor of the development of Type 2 diabetes. To understand how rates of diabetes vary among African Americans, it is important to look at the historical origins of black populations in America. Genetic predisposition to diabetes is based, in part, on a person’s lineage. The African-American population formed from a genetic ad-mixture across African ethnic groups and with other racial groups, primarily European and North American Caucasian.
Medical Risk Factors:

Impaired Glucose Tolerance (IGT): People with IGT have higher-than-normal blood glucose levels but not high enough to be diagnosed as diabetes. Some argue that IGT is actually an early stage of Type 2 diabetes. African-American men and women differ in their development of IGT. As black men grow older, they develop IGT at about the same rates as white American men and women. African-American women, who have higher rates of diabetes risk factors, convert more rapidly from IGT to overt diabetes than black men and white women and men.

Obesity: Obesity is a major medical risk factor for diabetes in African Americans. Some recent evidence shows that the degree to which obesity is a risk factor for diabetes may depend on the location of the excess weight. Truncal, or upper body obesity, is a greater risk factor for Type 2 diabetes, compared to excess weight carried below the waist. One study showed that African Americans have a greater tendency to develop upper-body obesity, which increases their risk of Type 2. (Resnick et al, pp. 1828-1835)

Although African Americans have higher rates of obesity, researchers do not believe that obesity alone accounts for their higher prevalence of diabetes. Even when compared to white Americans with the same levels of obesity, age, and socioeconomic status, African Americans still have higher rates of diabetes. Other factors, yet to be understood, appear to be at work. (Tull et al, pp. 613–629)

Intervention programs to prevent Type 2 Diabetes in African Americans

As I have already mentioned that obesity is one of the major reasons of high prevalence of type 2 diabetes in African Americans. Population-based data suggest that the epidemic of pediatric obesity is being followed by an increase in type 2 diabetes, particularly in adolescents of minority groups. (Pinhas-Hamiel et al, pp. 608-615) The American Diabetes Association estimates that between 8 and 45% of children newly diagnosed with diabetes have type 2 diabetes. In the greater Memphis, Tenn., area, the authors have reported a fivefold increase in childhood type 2 diabetes between 1990 and 2001, with type 2 diabetes accounting for 43% of the newly diagnosed cases in 2000 and overweight African-American adolescents accounting for roughly 86% of the new cases. (Burghen et al, p. 126A)

As a consequence of this epidemic, annual hospital costs for obesity and obesity-associated conditions in youth (6–17 years of age) increased from $35 million during the period from 1979 to 1981 to $127 million during the period from 1997 to 1999. (Goran et al, pp. 1417-1427) Hence a major step that African Americans should take is to reduce their weight. Just by losing 10% of the weight can help body work more efficiently and reduce risk of diabetes.

Exercise helps lower the risk of Type 2 diabetes in two different ways. First, it helps to lose weight, which cuts the risk. Secondly, exercise improves insulin sensitivity, allowing the cells of the body to use its own insulin better. That is the key against pre-diabetes and/or the metabolic syndrome. A research reports that viewing TV more than 14 hours a week increases the risk of type 2 diabetes in men and women. (David, pp. 603-2609) It was also reported that exercising a total of 2.5 hours a week or more was associated with a reduced risk of type 2 diabetes in both sexes. (Peters et al, pp. 1246-1252)

As we know that many African Americans in United States are living under poverty status and cannot afford to join expensive gym so for them it is recommended that taking a brisk half-hour walk every day can decrease a person’s risk of developing diabetes regardless of their weight. They can also try to walk 10,000 steps a day and use a pedometer. The main aim should be to exercise 4 to 6 times a week for 30 to 60 minutes each time.

Another important way to intervene and reduce the risk of developing Type 2 diabetes is through the intake of proper diet. Independently of the weight, a diet high in fat, calories and cholesterol increases your risk of diabetes. In addition, this diet can lead to obesity (another risk factor for diabetes) and other health problems. Studies suggest that people who eat from a wide variety of food groups tend to be healthier and have a reduced risk of disease, including diabetes.

Eating a variety of foods helps get a wider array of nutrients and increases your chances of getting all of the nutrients needed for good health. People who eat breakfast are significantly less likely to be obese and diabetic than those who usually don’t. A healthy diet is high in fiber and low in animal fat, but also low in refined starches and sugars. (Rob et al, pp. 417-424) Getting carbs from whole grains may help overweight adults to reduce their risk of type 2 diabetes. The consumption of low-fat dairy foods may reduce African American men’s risk of developing type 2 diabetes.

Women who consume nuts or peanut butter as part of their regular diet may reduce their risk of developing type 2 diabetes. Nuts are rich in fiber, magnesium, and many other essential nutrients. People who eat diets high in vitamin E were 30 percent less likely to develop type 2 diabetes. The best sources of vitamin E are avocados and vegetal fats like nuts, olive oil and canola oil. (Marion et al, pp. 148-198)


Brody GH, Jack L Jr, Murry VM, Landers-Potts M, Liburd L “Heuristic model linking contextual processes to self-management in African American adults with type 2 diabetes.” Diabetes Education 27:685–693 (2001)

Burghen GA, Christensen M, Krichevsky S, West B, Rose SR, Velasquez-Mieyer P, Danish

Broome DC, Lustig RH “Type 2 diabetes mellitus epidemic in African-American children” Pediatr Res 47:126A, (2000)

Camastra S, Bonora E, Del Prato S, Rett K, Weck M, Ferrannini E “Effect of obesity and insulin resistance on resting and glucose-induced thermogenesis in man. EGIR (European Group for the Study of Insulin Resistance)”. Int J Obes Relat Metab Disord 23 (12): 1307-1308, (1999)

David W. Dunstan “Physical Activity and Television Viewing in Relation to Risk of Undiagnosed Abnormal Glucose Metabolism in Adults” Diabetes Care 27: 2603-2609 (2004)

David Pryor, MD “Diabetes” p.1 (2006) http://www.blackwomenshealth.com/diabetes.htm

Engelgau MM, Narayan KM, Geiss LS, Thompson TJ, Beckles GL, Lopez L, Hartwell T, Visscher W, Liburd L “A project to reduce the burden of diabetes in the African-American community” Project DIRECT. J Natl Med Assoc 90:605–613, (1998)

Goran MI, Ball GD, Cruz ML “Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents.” J Clin Endocrinol Metab 88:1417–1427 (2003)

Harris MI “Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes” Diabetes Care 24:454–459 (2001)

Marion J. Franz, John P. Bantle “Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications” Diabetes Care 25: 148-198 (2002)

Peters AL, Davidson MB, Schriger DL, Hasselblad V “A clinical approach for the diagnosis of diabetes mellitus: an analysis using glycosylated hemoglobin levels” Meta-analysis Research Group on the Diagnosis of Diabetes Using Glycated Hemoglobin Levels. JAMA , 276(15): 1246-52, (16 Oct, 2004)

Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P “Increased incidence of non-insulin-dependent diabetes mellitus among adolescents.” J Pediatr 128:608–615, (1996)

Resnick HE, Valsania P, Halter JB, et al Differential effects of BMI on diabetes risk among black and white Americans. Diabetes Care;21: 1828–35 (1998)

Rob M. van Dam, Walter C. Willett. “Dietary Fat and Meat Intake in Relation to Risk of Type 2 Diabetes in Men” Diabetes Care 25: 417-424 (2002)

Tull ES, Roseman JM “Diabetes in African Americans” In: Harris MI, Couric CC, Reiber G, et al. eds. Diabetes in America. 2nd ed. Washington, DC: US Government Printing OYce, (NIH publication no. 95–1468):613–29, (1995)

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