Having a “touch of sugar” is not an inevitable part of African American life – neither is losing a foot or some other appendage to diabetes. Learning the right things to do if you have it and learning what to do to prevent it may save your life.
Diabetes is a chronic disease caused by high levels of blood glucose (a type of sugar) from defective insulin production, problems with how the insulin works, or both. The American Diabetes Association says there are 3.2 million African Americans or 13.3 percent of the adult African American population age 20 and older who live with diabetes.
There are different types of diabetes.
Type 1, previously called insulin-dependent or juvenile diabetes, occurs when the body’s immune system destroys cells in the pancreas (pancreatic beta cells) ? the only cells in the body that make the hormone insulin. Insulin is needed to convert blood glucose into useable energy for the cells. This type of diabetes strikes children and adults at any age and type 1 diabetes require insulin shots or pump injections to survive.
There is no cure for diabetes, but the most common form, type 2 diabetes, can be controlled through behavioral changes ? healthy eating, exercise, losing weight and taking medication as prescribed. Type 2 diabetes usually begins with insulin residence, a disorder when the cells do not use insulin properly. As the need for insulin increases, the pancreas gradually loses its ability to produce the hormone. Type 2 diabetes is associated with obesity, older age, family history, impaired glucose metabolism, ethnicity and physical inactivity. Type 2 diabetes may be treated with oral medications but sometimes requires insulin or a combination of insulin and oral medications.
In gestational diabetes, pregnant women have higher levels of glucose but it goes back to normal after delivery. However, women who had gestational diabetes are at greater risk of developing diabetes in the next 5-10 years.
Normal fasting blood glucose levels are between 70 -100 mg/dL. The term pre-diabetes is given to persons with slightly higher than normal numbers with impaired fasting glucose (100-125 mg/dL) or impaired glucose tolerance tests (140-199 mg/dL), or both ? but not high enough to be called diabetes. Pre diabetes raises the risk of heart disease, stroke and full blown diabetes. Progression to diabetes is not inevitable. Studies show that losing weight and increasing physical activity can prevent or delay diabetes and even return blood glucose levels to normal.
The American Diabetes Association reaches out to the black community through churches to educate African Americans about diabetes and better management of the condition. The program, Project Power, is facilitated by onsite ambassadors who provide information, motivational support and training to participants.
“The program is geared at individuals changing one aspect of their life,” said Cathy Hartmann, associate director of programs of the American Diabetes Association of St. Louis. The ADA trains onsite ambassadors who are charged with taking an interest in the lives of the people and to following up and encouraging participants after the teaching modules. Hartman said 51 area churches have expressed interest in the program and 32 are in what she describes as a cultivation state.
“Our biggest challenge is getting them ? after training to follow up on the modules,” Hartmann said.
One of the most active churches with the faith-based Project POWER is Greater Pentecostal Church of God, located at 6080 West Florissant Rd. in North St. Louis. Connie Jackson is Project POWER ambassador at the church, where their final diabetes session ended two weeks ago.
“We need to change the way we think when it comes to diets and our lifestyles, and it includes getting more exercise, getting outside and it also includes eating more fruits and vegetables,” Jackson said. “I’ve watched a lot of young people with diabetes die and some older ones too –and even in my family. We’ve learned that … when they say you are ‘borderline diabetic,’ that’s not what it really is. You are pre-diabetic.”
Project POWER gives diabetics and family members easy to implement techniques to improve overall health. Jackson said members and participants are calling for more detailed sessions held more often. Current topics include diabetes basics, the importance of physical activity, incorporating healthy eating into everyday life, the relationship between diabetes and heart disease and stroke; and ways to avoid type 2 diabetes in youth.
Monitoring blood sugar levels is essential for diabetics. The ADA is now using the A1c as a better diagnostic tool. The A1C is an estimate of a person’s average blood glucose over the previous three months and can be converted into an eAG, estimated average blood glucose.
“Instead of a one shot … it is a snapshot of a three month picture,” Hartman said.
The American Diabetes Association recommends that a person with diabetes aim for an A1C below seven percent, which corresponds to an eAG below 154 mg/dL.
The A1c, along with healthier behaviors and medication if prescribed is the balancing act for diabetics to maintain blood sugar control.
Hartmann said, “Managing exercise, diet and insulin… you are trying to make all three of those factors come out to a level that is good.”
