VCU news

By Leha Byrd

As part of Black History Month, VCU Health hosted a social series that highlighted four health issues that disproportionately affect African-Americans, including diabetes. More than 100 million U.S. adults are now living with diabetes or prediabetes, according to the Centers for Disease Control and Prevention. However, African-American adults are almost twice as likely to be diagnosed with diabetes as non-Hispanic whites, according to the U.S. Department of Health and Human Services Office of Minority Health.

VCU Health diabetes educator Amber Spain hosted a Twitter chat Feb. 28 to address the issue of diabetes in the African-American community. She offered tips for health practices that prevent the onset of diabetes, and presented information on how to react responsibly to a diagnosis. Below are her responses to questions posed during the chat.

What is Type 2 diabetes and how does it manifest in the body?

There are two issues going on in the body of a person who has diabetes. First, the body is experiencing insulin resistance and can't use the insulin the body produces effectively. Insulin helps keeps your blood sugar level from getting too high or low. Secondly, the pancreas, which makes insulin, tries hard to keep up with demand but cannot. That produces an insulin shortage. A lack of insulin causes diabetes.

What are the early signs that a person has Type 2 diabetes?

A person who is very thirsty, urinating more than normal and is experiencing tingling, pain or numbness in their hands and feet might be experiencing diabetes. Blurry vision, unintentional weight loss and slow healing wounds are also signs of the disease. Contact your physician if these symptoms persist.

What lifestyle factors influence Type 2 diabetes?

The main lifestyle factors are not eating or drinking healthily and a lack of physical activity. These practices can help to not only delay the onset of Type 2 diabetes, but also help with the management of glucose or sugar after diagnosis.

What role does heredity and genetics play in Type 2 diabetes, if any?

There is a genetic component, but it is not completely understood. If you have a sibling or parent with Type 2 diabetes, it increases your risk for developing it, too.

What medical reasons have presented themselves as triggers for African-Americans being disproportionately affected by Type 2 diabetes?

There are several components thought to play a part in this, including a higher percentage of minorities who are under- or uninsured and don’t have access to routine screenings. There’s also the lack of access to healthful food and an unfortunate socio-economic status that doesn’t always afford people the chance to get the information or life skills that will help them stay guarded against this type of disease.

Are there any statistics you've come across that highlight the starkness of how much African-Americans are affected by Type 2 diabetes?

According to the U.S. Department of Health and Human Services Office of Minority Health, the fact that African-American adults are 80 percent more likely than non-Hispanic white adults to get a diabetes diagnosis is jarring.

What options are available to help this demographic break societal barriers and be proactive about preventing and managing Type 2 diabetes?

A key suggestion is to know your numbers, which include blood pressure, cholesterol and A1C, which measures blood sugar. Type 2 diabetes is diagnosed when the A1C is over 6.5 percent. Also, improving dietary habits to well-rounded options in reasonable portions and increasing physical activity are two important components for preventing and managing diabetes. By doing this, you have control over even some societal barriers by being proactive and responsibly reactive if you find that your numbers aren’t indicative of good health.

We encourage patients and health care providers to focus on positive behavior changes that can, and do, make positive outcomes.

Is there anything health care professionals can do to groom this demographic on the dangers of Type 2 diabetes and encourage prevention?

In addition to helping patients know their numbers, it’s helpful to recognize that a 7 to 10 percent weight loss can delay and prevent the development of Type 2 diabetes. Threats or fear-based interventions are widely ineffective. Instead, we encourage patients and health care providers to focus on positive behavior changes that can, and do, make positive outcomes. We should be coaching our patients that small changes to dietary patterns can have a big impact. Being physically active is another wonderful tool that should be supported or encouraged. 

What services are available at VCU Health to help those with Type 2 diabetes?

VCU Health offers education in several settings. We have one-on-one education that’s provided to patients who come to see one of our endocrinologists. Our primary care physicians offer comprehensive diabetes visits, too. And, Women's Health/OBGYN offers diabetes classes to their patients a few times annually. Support groups are planned for the near future. People who’reinterested can email us at diabetes@vcuhealth.org to receive notification once the schedule is determined.

Are there other diseases that develop as a result of Type 2 diabetes?

Yes. They include neuropathy, which causes nerve pain or damage in the feet and hands; kidney damage; retinopathy, which causes damage to nerves in the eyes; and skin conditions like bacterial or fungal infections and dryness. Other results of diabetes are stroke, gastroparesis or poor emptying of the stomach and depression. People living with diabetes, or any chronic illness, are twice as likely to experience depression. 

What are key rules for managing Type 2 diabetes?

There are seven suggested self-care behaviors:

• Being active with 150 minutes of physical activity per week.
• Healthy eating, often demonstrated by Choose My Plate.
• Monitoring blood glucose as per your health care team.
• Taking medications as prescribed.
• Problem solving how to respond to glucose readings that are above or below your target range.
• Reducing risks with routine health maintenance, such as foot exams/care, eye exams, dental care, routine labs and quitting smoking.
• Healthy coping by having stress management built into your routine and knowing who to ask for help.