November is American Diabetes Month, and Our Weekly will feature a series of articles exploring the who, what and what-can-you-do of the disease.
When health disparities are mentioned, African Americans typically find themselves at the bottom. When it comes to one disease, unfortunately, Black folk are over the top. In fact, some researchers are now saying that it has reached epidemic rates within the African American community.

That disease is diabetes.

Research has found that compared to the general public African Americans are 1.8 percent more likely to have the disease than non-Hispanic Whites.

Additionally, 18.7 percent or 4.9 million Blacks age 20 and older have diagnosed or undiagnosed diabetes; 25 percent of African Americans between the ages of 65 and 74 have diabetes; and 1 in 4 African American women over 55 years of age has diabetes.

And despite increased awareness, the rate of African Americans with this disease is increasing. In 1992, for example, according to the website netwellness.org, 10.8 percent of Blacks 20 and older had diabetes. That figure has jumped 8 percent.

However, researchers are not sure why Blacks are more susceptible to the disease than other populations.

According to articles on Diabetesdigest.com, there is a strong genetic factor in who gets diabetes.

Some researchers believe that Blacks inherited a gene from their African ancestors that enabled them to adopt more effectively to “feast and famine” food cycles. But with few such cycles in contemporary living, this survival gene may instead make the person more susceptible to developing type 2 diabetes.

Obesity is another factor that plays into the rate of diabetes development. Additionally, the location of the excess weight also matters. Researchers have found that carrying excess weight above the waist is a stronger risk factor for type 2 diabetes, and studies show that African Americans are more likely to carry their extra weight above the waist.

Lack of exercises has also been identified as one significant factor contributing to the high rates of diabetes in African Americans. People who participate in little or no physical activity are at great risk for diabetes. A national study found that 50 percent of African American men and 67 percent of Black women report they do not include exercise in their daily routines.

A new study by the United States Department of Housing and Urban Development (HUD) and published in the New England Journal of Medicine in October also pinpointed a link between poverty and higher levels of obesity and diabetes.

In “Neighborhoods, Obesity and Diabetes–A Randomized Social Experiment” about 4,500 very low income families living in housing projects in high-poverty neighborhoods in Baltimore, Boston, Chicago, Los Angeles and New York, were given the opportunity through housing vouchers to move to low-poverty communities.

Among the results was the surprising fact that women who moved to low-poverty areas were nearly one-fifth less likely to be extremely obese.

Additionally, for the women able to move to wealthier communities, the prevalence rate for diabetes was 5.2 percent lower; again making these women one-fifth less likely to have diabetes.

HUD researchers need to do further studies to find out why this is.

The neighborhoods study is part of a larger HUD program that began in 1994 called “The Moving to Opportunity for Fair Housing Demonstration Program.” It followed the families for 10 years.

So what exactly is diabetes?

According to information on the National Diabetes Education Program (NDEP) website, it is a group of diseases marked by high levels of glucose (sugar) resulting from defects in insulin production, insulin action or both. The disease is one of the leading causes of death and disability in the United States.

There are two types of diabetes–type 1, formerly called juvenile diabetes, occurs when the body’s immune system attacks and destroys its own insulin-producing beta cells in the pancreas.

Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision and extreme fatigue, and they usually develop in a short period of time. If not diagnosed and treated, a person can lapse into a life-threatening coma.

Type 2 diabetes, formerly called adult onset (the increase in the number of youth developing the disease prompted the name change), occurs when the body does not make enough insulin or cannot use the insulin it makes effectively. Symptoms include feeling tired or ill, unusual thirst, frequent urination (especially at night), weight loss, blurred vision, frequent infections and slow-healing wounds. These symptoms may develop gradually, but some people have none at all.

According to NDEP, 90 to 95 percent of all diagnosed diabetes cases in adults are type 2.

You are more likely to develop type 2 diabetes if:
* there is a family history of diabetes
* are a member of an ethnic group, like African American
* are overweight or obese
* are 45 or older
* had diabetes while pregnant (there is a 35-60 percent chance of developing diabetes in the next 10-20 years)
* have pre-diabetes (glucose levels are elevated but not high enough to be full-blown diabetes)
* have high blood pressure
* have abnormal cholesterol (lipid) levels
* are not getting enough exercise
* have polycystic ovary syndrome
* have blood vessel problems affecting the heart, brain and legs
* have dark, thick and velvety patches of skin around the neck and armpits