Issue 97 Item 12 Long-Term Tight Control of Diabetes is Critical and Difficult w

African-Americans and Hispanics are more likely to develop serious complications resulting from uncontrolled type 2 diabetes. The most effective way to measure how well a person’s diabetes is being controlled over time is the A1C test, which provides a picture of blood sugar levels during a three-month period. Although the A1C test is a key tool in the management of diabetes, nearly 40 percent of respondents with type 2 diabetes could not define the purpose of the test and 50 percent of the respondents with type 2 diabetes did not know what their target A1C level should be. Experts recommend a goal of 6.5 –7.0 percent for optimal diabetes management.

“Inadequately treated diabetes, as indicated by higher than recommended A1C levels, is dangerous because of the potential risk of long-term complications. Research shows that for every percent above the A1C target level, a patient’s risk of cardiovascular disease also increases,” stated Samuel Dagogo-Jack, M.D., FRCP, professor of medicine, Division of Endocrinology and Metabolism, University of Tennessee Health Science Center College of Medicine. “Tight control of diabetes is possible with diet, exercise and combination therapies, including drugs that target insulin resistance. These insulin sensitizers help patients use their own natural insulin more effectively.”

Ethnicity, Type 2 Diabetes and Heart Disease

The Centers for Disease Control and Prevention (CDC) has labeled diabetes “the epidemic of our time,” with the greatest increase in certain ethnic populations. According to the U.S. Office of Minority Health, the prevalence of diabetes among African-Americans is about 70 percent higher than in Caucasians and the prevalence in Hispanics is nearly double that of Caucasians. Currently, it is estimated that 2.3 million African-Americans and 1.2 million Hispanics have type 2 diabetes in the U.S. alone.

Despite ethnicity being a key risk factor in developing type 2 diabetes and its related complications such as heart disease, 50 percent of Hispanics and 48 percent of African-Americans are not very or not at all concerned with developing type 2 diabetes. Similarly, 44 percent of Hispanics and 51 percent of African-Americans are not very or not at all concerned with developing heart disease.

“Educating high-risk populations about the link between ethnicity, type 2 diabetes and heart disease is a critical step in managing this epidemic,” stated B. Waine Kong, Ph.D., J.D., chief executive officer, ABC. “The ABC urges everyone at high risk to talk to his or her doctor about ways to manage type 2 diabetes and help prevent complications.”

Diabetes is the sixth leading cause of death by disease in the U.S. with 75 percent of diabetes-related deaths attributable to cardiovascular disease. In fact, those with diabetes are two to four times more likely to have heart disease than people without diabetes. In addition, having type 2 diabetes increases heart attack risk as much as heart disease does for a person without diabetes. People with diabetes tend to experience several metabolic abnormalities that contribute to an increased risk of heart disease including obesity, high blood pressure, increased blood clotting, increased levels of proteins associated with atherosclerosis (hardening of the arteries) and insulin resistance