The Diabetes Epidemic Among African Americans
WHAT IS DIABETES?
Diabetes is a group of diseases marked by high levels of blood glucose resulting from
defects in insulin production, insulin action, or both. Diabetes can lead to serious
complications and premature death, but people with diabetes can take steps to control the
disease and lower the risk of complications.
Diabetes is one of the leading causes of death and disability in the United States. Total health
care and related costs for the treatment of diabetes run about $174 billion annually.
WHAT ARE THE DIFFERENT TYPES OF DIABETES?
Type 1 diabetes (formerly called juvenile diabetes) results when the body’s immune system
attacks and destroys its own insulin-producing beta cells in the pancreas. People with type 1
diabetes must have insulin delivered by injection or a pump. Symptoms of type 1 diabetes –
increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue –
usually develop over a short period of time. If type 1 diabetes is not diagnosed and treated, a
person can lapse into a life-threatening coma.
Type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes.
Type 2 diabetes (formerly called adult-onset diabetes) occurs when the body does not make
enough insulin or cannot use the insulin it makes effectively. This form of diabetes usually
develops in adults over the age of 40 but is becoming more prevalent in younger age groups –
including children and adolescents. The symptoms of type 2 diabetes – feeling tired or ill, unusual
thirst, frequent urination (especially at night), weight loss, blurred vision, frequent infections, and
slow-healing wounds – may develop gradually and may not be as noticeable as in type 1
diabetes. Some people have no symptoms.
Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes.
A person is more likely to develop type 2 diabetes if they:
o have a family history of diabetes
o are a member of an ethnic group like African Americans
o are overweight or obese
o are 45 year old or older
o had diabetes while pregnant (gestational diabetes)
o have high blood pressure
o have abnormal cholesterol (lipid) levels
o are not getting enough physical activity
o have polycystic ovary syndrome (PCOS)
o have blood vessel problems affecting the heart, brain or legs
o have dark, thick and velvety patches of skin around the neck and armpits (This is
called acanthosis nigricans.)
Gestational diabetes develops during pregnancy. Women who have had gestational diabetes
have a 40 to 60 percent chance of developing diabetes, mostly type 2, in the next five to 10 years.
HOW MANY AFRICAN AMERICANS HAVE DIABETES?
3.7 million; 14.7 percent of all non-Hispanic blacks ages twenty and older have diagnosed
and undiagnosed diabetes
11.8 percent had diagnosed diabetes according to age adjusted 2004-2006 national survey
WHAT IS 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.
Adults with diabetes have heart disease death rates about two to four times higher than
adults without diabetes.
The risk for stroke is two to four times higher among people with diabetes.
About 75 percent of adults with diabetes also have high blood pressure.
Smoking doubles the risk for heart disease in people with diabetes.
WHAT CAN AFRICAN AMERICANS DO TO PREVENT HEART DISEASE OR STROKE AND
OTHER DIABETES COMPLICATIONS?
Diabetes is a self-managed disease. People with diabetes must take responsibility for their
day-to-day care. The chances of having diabetes complications can be reduced or delayed
significantly by keeping blood glucose (blood sugar), blood pressure, and cholesterol levels
(called the ABCs of Diabetes) in the target range.
The National Diabetes Education Program recommends the following targets for reducing
the risk of heart disease and stroke for most people with diabetes:
A1C (Blood Glucose)
Less than 7 percent **
Less than 130/80 mmHg
Less than 100 mg/dl
(check at least twice a year)
(check every doctor’s visit)
(check once a year)
**Targets should be individualized – less stringent targets may be advised with severe
hypoglycemia, limited life expectancy, other medical conditions, or longstanding
People with diabetes can manage their disease by eating healthy foods, being physically
active, taking diabetes medicine as prescribed and testing blood glucose levels.
Community education and support programs can help people with diabetes and their
families to manage their diabetes.
CAN TYPE 2 DIABETES BE PREVENTED?
YES! The Diabetes Prevention Program (DPP), an important trial sponsored by the National
Institutes of Health, and the DPPOS, the 10 year follow up study to the DPP, showed that
type 2 diabetes can be delayed or prevented in overweight adults with pre-diabetes,
including African Americans. Pre-diabetes is a condition where blood glucose levels are
higher than normal, but not yet high enough for a diagnosis of diabetes.
Risk factors for pre-diabetes are the same as those listed for type 2 diabetes.
To prevent diabetes, the people who participated in the DPP study:
Lost 5 to 7 percent of their body weight (that is 10 to 14 pounds for a person who weighs 200
Were physically active for 30 minutes a day, 5 days a week. Most participants chose brisk
Made healthier food choices and limited the amount of calories and fat in their diet.
WHERE CAN I GO FOR MORE INFORMATION?
For more information about preventing and controlling diabetes, call 1-888-693-NDEP (6337) or
visit the National Diabetes Education Program website at www.YourDiabetesInfo.org.
Adapted from the National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics,
2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.
Updated December 2009