Diabetes is a chronic (long-lasting) illness that affects how the body turns food into energy. It causes the body to prepare food improperly for energy utilization.
When a person has diabetes, the body either can’t use insulin properly or doesn’t produce enough of it. The majority of the food a person with diabetes consume is converted to sugar, commonly known as glucose, and then absorbed into circulation (Forouhi, et al, 2019).
Hormone insulin has the responsibility to control blood glucose levels, which is produced by the pancreas. After eating, the blood glucose level increases, and the pancreas releases insulin to allow the glucose into body cells, thereby bringing the blood glucose level back to normal.
Diabetes symptoms include excessive urination, intense thirst, tiredness, weight loss, malnutrition, skin problems, wounds that heal slowly, yeast infections, and tingling or numbness in the feet or toes for a lifetime.
Type 1 and Type 2 diabetes are the two main types. While Type 2 diabetes is more frequent among Blacks and accounts for roughly 90% of all diabetes-related problems, Type 1 diabetes can arise at any age but is most common in children and young people (Khan, et al, 2019).
Causes
Type 1 Diabetes
When the immune system, the body’s defense against infection, disrupts the pancreas’ beta cells that produce insulin, type 1 diabetes develops.
According to scientists, type 1 diabetes may be caused due to environmental triggers, including infections or genetic predispositions.
However, research is still ongoing to understand the root causes of type 1 diabetes and potential treatments (Ferrari, et al, 2018).
Type 2 Diabetes
Insulin resistance is a condition where cells of the liver, fat, or muscles are no longer eligible to use insulin in a proper way that typically causes type 2 diabetes. Type 2 diabetes is more common in the Black community (Mitchell, et al, 2020).
How to Diagnose Diabetes?
There are several tests to diagnose diabetes, for instance
- A1C Test for Glycated Hemoglobin
This is a blood test with no requirement of prolonged fasting, revealing the average blood sugar level over the previous two to three months. It calculates the proportion of blood sugar that is associated with hemoglobin.
- Random Test for Blood Sugar
For this test, a blood sample is required. If the blood sugar level is 200 mg/dL (11.1 mmol/L) or above, diabetes is a possibility.
- Blood Sugar Test after Fasting
Before eating anything the night before, a blood sample is needed. It is normal to have a fasting blood sugar level of less than 100 mg/dL (5.6 mmol/L).
Prediabetes is defined as having a fasting blood sugar level between 100 and 125 mg/dL (5.6 and 6.9 mmol/L). A person might have diabetes if it is 126 mg/dL (7 mmol/L) or above on two different tests (LeRoith, et al, 2019).
Complications
Diabetes is not just a single disease but a bulk of associated health-related problems. When a person has diabetes, he becomes more prone to various diseases such as retinopathy, foot problems, kidney problems, nerve damage, etc., (Karam, et al, 2018).
Not just minor ones, but a person is likely to be affected by a heart attack, stroke, gum disease, and other mouth-related problems. Diabetes is associated with other severe diseases, including cancer (Chait, et al, 2020).
Those with diabetes are at high risk of cancer, but sometimes cancer makes diabetes worse and makes it complicated for a person to control their blood sugar level.
Research has shown that cardiac disease has been linked to diabetes for ages. 40 to 50 percent of diabetics without documented heart illness exhibit anomalies of left ventricular mechanical function, which are predominantly diastolic in nature (Lee, et al, 2019).
In the absence of hypertension, left ventricular hypertrophy may ultimately develop. Due in significant part to decreased breakdown, interstitial collagen accumulation appears to be connected to diastolic dysfunction (Chait, et al, 2020).
Moreover, in some cases, diabetes becomes a consequence of sexual problems as well. The ability to become aroused may be restricted due to a blood supply limitation to the sexual organs.
Impotence, sometimes known as erectile dysfunction, may result from diabetes. One may experience loss of feeling in their genital organs if blood flow to those areas is restricted due to nerve damage and blood vessel.
For instance, according to a research study, 53.3% of people with diabetes mellitus experience sexual dysfunction (Rahmanian, et al, 2019).
Research has shown that diabetic men have sexual dysfunction at a higher rate and at a younger age than non-diabetic males. Similarly, a study done in northern Ethiopia revealed that 69% of people with diabetes had erectile dysfunction (Asefa, et al, 2019).
Another investigation has shown that women with diabetes have low sexual desire, low vaginal lubrication, lack sexual satisfaction, and are likely to have orgasmic dysfunction (Asefa, et al, 2019).
Hence, it is essential to diagnose diabetes before it gets worse and becomes health associated complications.
Treatments for Type 1 Diabetes
- Insulin Pumps
Insulin pen but an effective substitute for injecting with an insulin pen is the use of an insulin pump suggested by physicians.
- Islet Cell Transplant
An islet cell transplant may be an option for those with Type 1 diabetes. However, without consultation, it is not recommended.
Treatments for Type 2 Diabetes
- Exercise and Diet
Many people with Type 2 diabetes control their condition without using medications, favoring healthy food and regular exercise. All they need is a healthy life.
- Medications and Tablets
Medications are sufficient for those with 2 diabetes to help control their blood sugar levels. There are many other kinds of tablets; however, metformin is the most popular one that we usually suggest (according to the condition of the patient).
Moreover, sulphonylureas are one type of medicine that stimulates the pancreas to make insulin (Ferrari, et al, 2018).
- Insulin
It’s possible that a person would not need to use insulin right after a type 2 diabetes diagnosis. However, some persons have extremely high blood sugar levels at the time of their initial diagnosis.
The blood sugar level can be controlled by short-term insulin therapy. For a specific reason, such as a severe illness, during pregnancy, or after surgery, some people may need to take insulin.
If other drugs haven’t worked to control the blood sugar levels, one should start taking insulin. Insulin therapy is frequently required for type 2 diabetics at any point (LeRoith, et al, 2019).
Why African Americans at High Risk for Diabetes?
Racial and ethnic minority groups are always at higher risk of diseases. Diabetes is one of those diseases which runs frequently among African American (Black) community.
In the U.S. around 60% of black adults are more likely to be diagnosed with diabetes than white adults. It has been estimated that non-Hispanic Black people in 2018 were twice as likely to die from diabetes as non-Hispanic white people (Choi, et al, 2019).
According to a study, there are biological risk factors among Black communities that make them more prone to diabetes, such as fasting glucose level, body mass index (BMI), and blood pressure, leading to health disparities (Mitchell, et al, 2020).
A good reason why Blacks are mostly affected as they are more inclined to live in under-resourced neighborhoods.
Contributing factors such as social determinants of health, including lacking access to healthy food, poverty, inadequate employment, safe physical activity restrictions, and limited opportunities for education lead to negative outcomes of health in such communities (Ard, et al, 2020).
It was observed that markets stocked with unhealthy processed foods and fast-food restaurants are abundant in Black communities. However, on the other hand, markets with an abundance of vegetables and fresh fruits and grocery stores are more likely to be part of white counterparts.
This health disparity enhances the risk of diabetes among Blacks as lifestyle and food has a greater impact on health and are directly associated with diabetes.
Facts Regarding Diabetes Among Blacks
Type 2 diabetes affects 90% of all diabetics in the USA, and the number rises even more for individuals over the age of 45 (Ard, et al, 2020).
The American Diabetes Association has identified African Americans as an ethnic group with a high risk of developing diabetes. Compared to white Americans, African Americans have a 1.6-fold greater frequency of diagnosed diabetes.
While type 1 diabetes is four times more common in white Americans than in African Americans, type 2 diabetes is 1.4 to 2.3 times more common in black people (Brown, et al, 2019).
Children, teenagers, and even members of the US military who are on active duty are affected by the growing frequency of type 2 diabetes among African Americans (Cunningham, et al, 2018).
Additionally, a disproportionate amount of diabetes-related morbidity and mortality affect African Americans. As a result, when compared to white Americans, diabetic African Americans have a higher rate of microalbuminuria, retinopathy, lower extremity amputation, end-stage renal disease, and mortality (Cunningham, et al, 2018).
Written by: Emmanuel J. Osemota
References
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- Khan, R. M. M., Chua, Z. J. Y., Tan, J. C., Yang, Y., Liao, Z., & Zhao, Y. (2019). From pre-diabetes to diabetes: diagnosis, treatments and translational research. Medicina, 55(9), 546.
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