African Americans are up to 50% more likely to develop diabetes, but most blacks don’t notice and pay the price for it. Fortunately, type 2 diabetes is preventable and manageable.
Brian (a pseudonym) was always athletic in middle school and high school, but started gaining weight in his 20s, which he didn’t care about and didn’t have time to care about. He was diagnosed with high blood pressure and high cholesterol five years ago, and his brother, a doctor, warned him that his weight and family history of diabetes meant he had a high probability of developing it, but he didn’t care.
He went to the doctor weighing 300 pounds, about 90 pounds over his normal weight despite being 1.95 meters tall. When the doctor measured his blood sugar, he found it was as high as 550 mg/dl, about five times the normal level. “You’ve probably never seen blood sugar this high,” says the founder of Black and Brown Sugar, a diabetes information website for minorities, and author of the forthcoming book Healing Our Community – A Self-Care Guide to Diabetes Management. A Self-Care Guide to Diabetes Control,” was a surprise to Lenore Coleman, CDE, founder of the minority-specific diabetes information website Black and Brown Sugar, and author of the forthcoming book Healing Our Village: A Self-Care Guide to Diabetes Control. Like millions of other black patients, Bryan has type 2 diabetes.
The dangers of diabetes
Diabetes is the 5th most deadly disease in the United States, and it disproportionately affects the black community. At current trends, diabetes will be endemic among blacks by 2050.
About 2.7 million or 11.4% of African Americans over the age of 20 have diabetes, but at least 1 in 3 are unaware of the problem.
Today, the average chance that a newborn African American will develop type 2 diabetes in his or her lifetime is 50%.
Tackling obesity
First, to address obesity, we don’t feel overweight when we’re 27 to 54 pounds above normal weight, said Lenore, who is black herself.
“My patient felt he was a little fatter than average, but never thought he was morbidly obese, but he was. Like many black people, he lives alone and eats alone, and that’s a big problem,” she said, “If you’re married, you plan your diet more and eat a little healthier. African-Americans prefer fried foods and foods that are high in carbohydrates, sugar and starches.”
Preventing type 2 diabetes
When blacks have diabetes, they are more likely to have one or more of the serious complications associated with diabetes, including amputation, kidney failure, blindness and cardiovascular disease.
Lenore said African Americans need to know how to prevent type 2 diabetes and, if they already have it, how to manage the condition. Many people have a fatalistic attitude that if their parents or grandparents had diabetes, then they will have it and do nothing about it, which is wrong.
Setting achievable goals
Jane Kelly, PhD, director of the National Diabetes Education Program, a joint effort of the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health, suggests, “Start by setting achievable goals. Set not only long-term goals like aiming to lose 45 pounds, but also short-term goals like how much weight you’ll lose by next Tuesday. For example, walking 10 minutes a day or eating one spoonful of dessert instead of two. Start with small goals and build up. Write them down and commit to them, and let your friends monitor them.”
Healthy activity
Add some simple actions to your lifestyle that are healthy and prevent diabetes.
Share a dessert
“Many African-Americans tell us it’s rude if someone offers food and you don’t eat it, so instead of giving up something you like and offending the host, share a little with a friend,” Jane says. If the host suggests something else, skip the potatoes and bread and eat more of the green stuff!
Exercise daily
Jane says, “It doesn’t take an hour of work to exercise. Get off the bus one stop early, or park farther from the parking lot when you go to the grocery store or shopping center.”
Drink more water
Jane says, “Pick a favorite souvenir mug, like one with the logo of your favorite sports team or church on it. Carry a water cup with you and encourage yourself to drink more water instead of sugary sodas and sodas that are higher in calories.”
A healthy lifestyle
The same advice to maintain a healthy diet and get more exercise can help black people with diabetes – and all people with diabetes – manage their condition.
One of the misconceptions in the medical community is that “diabetes care is more effective than taking medications. Medication is important, but diabetes treatment is tied to lifestyle,” said Jane. Jane said.
Lenore said, “Many people think that once they are diagnosed with diabetes, they have to cut out sugary foods and eat only expensive ‘diabetic-friendly foods,’ but that’s not true. Just eat a balanced diet with three meals a day and abstain from monosaccharide foods. No cakes, doughnuts or candy, but you can eat fruit and you can eat things like frozen yogurt.”
Know your blood sugar, blood pressure and cholesterol levels
Another key to managing diabetes, Jane said, is to know your ABCs.
- A is the glycated hemoglobin (HbA1c) level, which tells patients how well their blood sugar is being controlled. Keeping HbA1c levels at or below 7% can reduce the risk of damage to the eyes, kidneys, and nerves.
- B is blood pressure. The goal is to keep it 130/80 mmHg or lower, thus protecting the kidneys and eyes and preventing strokes.
- C is cholesterol. See your doctor to check your cholesterol level and keep it within a safe range. Low-density lipoprotein (LDL) or “harmful” cholesterol should be less than 100 mg/dl.
Jane said, “If you keep a close eye on these tests and work actively with your doctor to keep these indicators out of the danger zone, your diabetes symptoms can be controlled.”