Empower yourself to fight diabetes
Control it through better diet, exercise
Merdies Hayes | 11/21/2013, midnight
Diabetes is one of the most serious and life-changing diseases among Americans today. With November serving as National Diabetes Month, physicians nationwide urge the public to take action against the disease which, according to a 2012 report from the Centers For Disease Control and Prevention, affects 8.3 percent of the U.S. population (or 25.8 million people).
Diabetes, particularly the “type 2” form of the disease, hits African Americans especially hard with approximately 5 million (or 18.7 percent of the non-Hispanic Black population) people living with the disease. Among all races, half of the people showing symptoms of diabetes don’t even know they have it—a startling revelation from a 2011 report from the National Diabetes Education Program.
According to the African American Community Health Advisory Committee, the disease is diagnosed in several forms—“type 1,” which is an autoimmune disease in which the body does not produce any insulin. It occurs most often in children and young adults. People with type 1 diabetes require daily insulin injections to live. About five to 10 percent of people with diabetes have this form. The symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision and extreme fatigue.
“Type 2,” the most common form, is a metabolic disorder resulting from the body’s inability to make enough—or properly use—insulin, requiring the person to begin immediate treatment. These symptoms include: feeling tired or ill, unusual thirst, frequent need to urinate (especially at night), weight loss, blurred vision, frequent infections and slow-healing wounds. Once called “adult onset diabetes,” the name was changed to encompass the increasing numbers of children and youth diagnosed with the disease.
According to a 2011 report from the African American Community Health Advisory Committee, African Americans are 1.7 times as likely to develop type 2 diabetes as the general population.
Type 2 diabetes can also develop in people who are thin. This is more common in the elderly.
Gestational diabetes develops in 2 to 5 percent of all pregnancies, but disappears when the pregnancy is over. However, women who have gestational diabetes have a 30- to 60-percent chance of developing type 2 diabetes within 10 to 20 years following diagnosis.
If there is a family history of diabetes, there is a possibility that your pancreas cannot keep up with the increased insulin demand during pregnancy, consequently blood glucose levels may rise too high, resulting in gestational diabetes.
According to the Mayo Clinic, for most women, gestational diabetes doesn’t cause noticeable signs or symptoms. Rarely, it may cause excessive thirst or increased urination.
Other forms of diabetes can result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illness. African Americans experience higher rates of at least three of the complications of the disease, including diabetic retinopathy (blindness) which occurs when the small blood vessels in the eye are weakened by diabetes. Blacks are twice as likely to have diabetes-related blindness; this complication is what caused Dodgers great Jackie Robinson to lose his sight.
A second complication comes when an excess of glucose builds up in the blood thereby causing failure of the lower extremities. African Americans are 1.5 to 2.5 times more likely to have a lower limb amputated, and are 2.5 to 5.6 times more like to suffer from kidney disease with more than 4,000 new cases annually of renal disease requiring a kidney transplant or regular dialysis.
The American Diabetes Association (ADA) announced this summer that, when people develop type 2 diabetes, they almost always have “pre-diabetes,” or blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes.
There are no clear symptoms of pre-diabetes—a reason why so many persons are unaware they are living with the disease. The ADA recommends testing begin no later than age 20 and then a doctor visit every one to two years to keep abreast of your health, particularly if the disease is common within your family. You don’t develop type 2 diabetes auto automatically, if you have pre-diabetes; ADA research has demonstrated that early treatment can return blood glucose levels to the normal range.
The ADA this month announced that besides the nearly 26 million children and adults who have diabetes, another 79 million Americans have pre-diabetes. The organization found that recent estimates project that as many as one in three American adults will have diabetes by 2050 unless steps are taken to stem the tide of cases. Two out of three people with diabetes die from heart disease or stroke. Diabetes is also the leading cause of kidney failure, the leading cause of new cases of blindness among adults, and the rate of amputation for people with diabetes is 10 times higher than for people without the disease. Also, about 60 to 70 percent of persons with diabetes have mild to severe forms of nerve damage that could result in pain in the feet or hands, slowed digestion, sexual dysfunction and other nerve problems.
The majority of the time, diabetes is classified as a “pre-existing” condition with the cost of diagnosed cases in excess of $245 billion annually, including direct medical payments ($176 billion). The average medical expenditure among people with diabetes is 2.3 times higher than those who do not have it. Indirect costs (disability, work loss, and premature death) amount to $69 billion every year. With the national discussion focusing on reducing the rising cost of healthcare—primarily through the federal Affordable Care Act—the ADA found that one in 10 healthcare dollars is spent treating diabetes and its complications, while one in five healthcare dollars is spent caring for people with the disease.
The research also shows that a person can lower their risk for type 2 diabetes by 58 percent by losing just seven percent of body weight (or 15 pounds if you weigh 200 pounds), and by regular, moderate exercise (a brisk 30-minute walk daily). Even if you can’t reach your ideal body weight, losing 10 to 15 pounds can make a big difference in warding off the disease.
“Diabetes is prevalent because of our diet, lifestyle and the way we cook food,” said Hutson Morris-Irvin, director of marketing and communications for the Los Angeles office of the ADA. She said that although a definitive answer for the cause remains years away, there are actionable methods available to each person to lower their risk of diabetes. “There are hereditary components for sure,” Morris-Irvin said, “but a healthy lifestyle is the best way to prevent type 2 diabetes. If you have type 2 diabetes, work with your physician. Pre-diabetes responds to medical suggestions. It’s not always weight because even fit persons should be checked for diabetes. Look at your diet; cut down on fried, fatty food; cook vegetables without meat (ex: collard greens sans ham hocks) and walk or jog more. A balanced diet and regular exercise are the best ways to prevent type 2 diabetes.”
According to a 2011 report from the National Diabetes Education Program (NDEP), type 2 diabetes accounts for 90 to 95 percent of all diagnosed cases of diabetes in adults. You are more likely to develop type 2 diabetes if:
• you have a family history of the disease;
• are a member of an ethnic group;
• are overweight or obese;
• are 45 years or older;
• had diabetes while pregnant;
• have pre-diabetes
• have high blood pressure
• have abnormal cholesterol (lipid) levels;
• are not getting enough physical activity;
• have polycystuic ovary syndrome;
• have blood vessel problems affecting the heart, brain or legs;
• or have dark, thick and velvety patches of skin around the neck and armpits (called acanthusis nigricans).
Dr. James R. Gavin III, chair of the ADA’s African American Program, says diabetes can be controlled and even prevented with a proactive regimen of exercise, a balanced diet and education. “By keeping fit, eating right and getting regular exercise, we can decrease our risk for diabetes quite substantially,” Gavin explained. “This is a disease about which we can do a great deal, but only when those affected are informed and empowered to take control of this disease is this possible,” Gavin admitted that the medical profession still does now know why diabetes (and a range of other maladies including heart disease, breast cancer in women, high blood pressure) strike the Black community in such disproportionate numbers, but he does point to ADA statistics gathered from the past 50 years showing that number of African Americans with diabetes has tripled, leading to a near epidemic in a community already twice as likely than the general population to have the disease. “We have looked and looked and, unfortunately, what we don’t know is why our community is such a primary target.”
Although the medical profession cannot yet pinpoint why Blacks are so susceptible to diabetes, part of the answer may trace back to the traditional diet of African Americans. Centuries ago, many Black families dined on heavy, fat-laden fare such as chitterlings, hog maws, ham hocks, pig’s feet, fat back, neck bones, ox tales etc.
This non-nutritious food was a primary staple of the slave family which, after the livestock was butchered, received the non-desirable portions of the kill. They made due with it, often creating tasty dishes from portions of the animal that Whites would not eat. Fried food, especially chicken and fish, also became a regular item in Black households because it was inexpensive, readily available and easy to prepare.
Skip ahead to today, and this tradition continues by virtue of mothers and grandmothers who taught their daughters to prepare and delight in these tasty but cholesterol-laden libations. In the inner city, because of the spreading “food desert,” soaring grocery prices and on-going cutbacks in food assistance, nutritious fruit and vegetables have become cost prohibitive in many poor households of color. Fast food has become a more economically feasible way to feed children—a mere five or six dollars can go a long way at so-called “dollar” or “value” menus.
This is when obesity can begin to affect youngsters and, sometimes pre-diabetes is often diagnosed as early as the teen years. With a poor diet going unchecked, type 2 diabetes can set in as early as the mid-20s.
The NDEP is studying the link between cardiovascular disease and diabetes. Cardiovascular disease is the leading cause of death for people with diabetes—about two out of three people with diabetes die of heart disease or stroke. The group found that adults with diabetes have heart disease death rates about two to four times higher than adults with out the disease. The risk for stroke is two to four times higher among people with diabetes, while about 67 percent of adults with diabetes also have high blood pressure. Smoking doubles the risk for heart disease for people with diabetes.
“Look at your diet and cut down on fried, fatty food,” said Morris-Irvin. “Steam your veggies; try skinless, non-fried chicken. You can reduce the risk of contracting diabetes by curtailing your diet away from processed food and toward more home-cooked meals. It is also vital that you teach your children early about a healthy diet because children copy what their parents do—in this instance diet. Kids love fast food, but years ago this was a treat maybe once a week. Today, many kids eat burgers and fries nightly. Yes, it’s cheap when you’re trying to stretch a dollar, but in the long run that type of food is one of the main causes of obesity and the on set of type 2 diabetes.”
African Americans are not the only persons of color who may practice poor eating habits. A 2011 survey conducted by the United States Department of Agriculture (USDA) found that contemporary Hispanics partake in a far less nutritious diet than did their elders. Although today’s Hispanics still retain core elements of a traditional diet that has stretched back generations (a reliance on grains and beans and the incorporation of fresh fruit and vegetables), first-generation Hispanics, particularly Mexican Americans, consumed more nutritious food.
With the exception of tomatoes, the survey revealed that today’s Hispanic population is less likely to consume vegetables. It seems that American culture has altered the diet of Hispanics. Additionally, the lifestyle of Hispanic Americans is undergoing a transition away from the traditional dietary habits of their ancestors and, through the process of acculturation, the diet of second-generation Mexican American women more closely resembles that of non-Hispanic White women in that it relies more heavily on processed food which is loaded with trans fat.
Essentially, USDA researchers found, younger Hispanic mothers do not serve their children the same vitamin-rich diet as did the previous generation. The changing nature of their diet is showing serious implications for Hispanic health as the prevalence of type 2 diabetes is two to three times higher than previous generations. An estimated 10 percent of adults over age of 20, and 25 to 30 percent of those over 50 are afflicted with type 2 diabetes.
To address the growing problem of diabetes within L.A’s Black and Hispanic communities, an educational community awareness event will be hosted from 9 a.m. to 4 p.m., Nov. 23 at Charles R. Drew University of Medicine and Science, 1731 E. 120th St. in Los Angeles. Dr. Khadijah Lang, vice chair of Region 6 of the National Medical Association, will moderate the event. She will explain that diabetes is not a fatal disease, if you learn how to manage it.
“There’s still no answer as to why diabetes is so prevalent within the Black community, but we are making great strides on learning how to help prevent it and to live a healthy life, if you do contract it,” Lang said. “There is a strong correlation between diabetes and lifestyle habits. We’re more sedentary today. Kids don’t play enough. Exercise helps the body use sugar and insulin properly, and obesity—already high within the Black community—is firmly connected to diabetes.” Lang explained that the rates of obesity and diabetes have risen at the same rate over the past decade. She added that a balanced diet and exercise are the “best ways” to prevent diabetes. “You’re not helpless if you are diagnosed with diabetes,” she said. “We must become more proactive, stick to a low-fat diet, get off the couch more and instill in our kids good dieting and health habits.”
The ADA has set forth a number of positive and workable nutrition guidelines to help prevent and/or live with diabetes. First, read the food labels at the supermarket. For people living with diabetes, key areas are the serving size and carbohydrates. Second, find the true serving size. There is often more than one serving contained in a food package. When looking at the serving size, be sure to compare the serving size to the total servings. For instance, there may be more than just one serving in a whole bag of chips; the bag could actually contain four to five total servings, which would be four to five times the calories, fat, carbohydrates and other contents.
Third, look for healthier foods. Health and nutrition are not synonymous: Some nutritious foods like fruit and milk may be high in sugar. Both sugar and fiber are counted on food labels as carbohydrates. For sugar-free products, look for carbohydrate content because a sugar-free product may end up having the same amount of carbohydrate grams as its standard version.
Fourth, examine the fat content. “Good fats” such as monounsaturated (nuts, olive oil, avocados) or polyunsaturated (seeds, fish and whole grains) can protect your heart and lower cholesterol. “Bad fats” like saturated (butter, shortening, snack food) and trans fat (packaged food and fast food) always raise the cholesterol level and increase the risk of heart disease.
Fifth, check your portion control. Controlling the amount of food you eat at one time is important to diet control and your overall health. Deciding to eat healthy portions can go a long way toward maintaining and controlling your weight and your diabetes. Finally, keep track of meal and snack times. Depending on the type of diabetes medicine you use, you may need to follow a careful schedule for meals and snacking.
Dwayne “The Rock” Johnson is one celebrity who has sounded the alarm regarding diabetes awareness. Known from the football field to professional wrestling and now Hollywood, Johnson in 2010 told the magazine Diabetes Focus that he joined the Diabetes Awareness campaign because he has several family members and friends who have either type 1 or type 2 diabetes. When recovering from a football injury at the University of Miami, Johnson said regular exercise and a more balanced diet helped him during that down time, and he suggested his regimen to diabetic friends and family. “Sticking to a regular exercise routine is one of the hardest things for many people to do,” he said. “So, I always encourage people to find an exercise activity they’re going to have fun participating in. Do a bit of research, take a friend with you and try out many types of activities. Make healthy choices, and be diligent about gaining as much knowledge about the challenge. If you learn about it, you can formulate a ‘game plan’ to move forward.”