Diabetes is a fact of life for more than 2.3 million blacks, yet fully a third of those afflicted don’t know they have the disease. The dilemma becomes even more unfortunate in light of a study published this week in the New England Journal of Medicine, which indicates that diet and exercise can prevent most diabetes cases.
"What this shows is that individuals, especially those of races highly susceptible to diabetes, can take a powerfully active role in prevention," said Jerry Franz, American Diabetes Association vice president for communications.
The study’s findings indicate one can prevent diabetes, regardless of race, through an average reduction of 7 percent in total body weight, combined with at least 30 minutes of moderate physical activity, such as walking, five times a week.
Individuals of all races benefit more or less equally from adopting such a plan, but the findings offer special hope for such high-risk groups as blacks, 1.7 times more likely to have diabetes than non-Hispanic whites.
Blacks experience extremely high rates of at least three serious complications caused by diabetes — blindness, amputation and kidney failure. They are twice as likely as non-Hispanic whites to become blinded by diabetes complications that cause blood-vessel walls in the retina to break down or weaken.
They are 1.5 to 2.5 times more likely to suffer lower-limb amputations, since high blood sugar from diabetes can cause nerve damage and poor blood flow. The latter can keep sores and infections from healing.
Finally, blacks with diabetes are 2.6 to 5.6 times more likely to suffer from kidney disease than whites are.
Like Hispanics, people of African descent have greater difficulties tolerating a diet high in fat, a characteristic of today’s average American diet.
Both groups have ancestors who generally lived a feast-or-famine existence and, thus, became adept at more efficiently storing fat to aid in survival during thin times.
However, blacks, Hispanics, American Indians and others with similar ancient cultural backgrounds are, simply put, unequipped to cope with the high-fat diet fostered by Caucasians in the New World.
"Obesity is fairly common among African-Americans, and this is largely a combination of both their genetics and their environment," said Dr. Gary Holland in Abilene. "Both circumstances provide an enormous pool of favorable conditions for any number of diseases."
Diabetes affects the body’s ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy.
The study simply reinforces what many diabetics and diabetes educators already know: Diet and exercise can save lives.
"The problem is that most people don’t seriously entertain thoughts of prevention until it’s too late, and that’s true no matter what race is being examined," said Donna Goble, a diabetes educator with Hendrick Health System in Abilene.
"Once you have it, it doesn’t go away, so it’s always best to prevent it entirely if you can."
The black community needs to become more aware of both signs and symptoms of the disease as well as prevention and treatment strategies, said Edith Smith, a Hendrick clinical educator. She regularly takes a diabetes-awareness message to her church family as well as almost anyone else who will listen.
"It’s a drastic adjustment to your lifestyle once you’re diagnosed," said Smith, who has diabetes. "It’s something everyone needs to be aware of, no matter whether they’re black, white, Hispanic or Native American." NEJM 2002-02-07