1. Diabetes in African Americans By: Kassandra Goncalves and Jamar Joesph 1

2. What is Diabetes: Diabetes is a disease in which levels of blood glucose are above normal levels. Type One Type Two 2 & 4 2 Is the diagnosis in children, teens, and adults in which the pancreas no longer creates insulin. This common form of diabetes usually develops at any age and even during childhood. It begins by insulin resistance in which the muscle liver and fat do not produce insulin properly.

3. Diagnosis Fasting Plasma Glucose : measures glucose level after a person fasts for 8 hours. a. 70-99 mg/dL (3.9-5.5 mmol/L) Postprandial: after two hours of eating a. 70-145 mg/dL (3.9-8.1 mmol/L) Random (casual): a. 70-125 mg/dL (3.9-6.9 mmol/L) 10 3

4. Blood Glucose Testing … Blood glucose testing: measures the amount of glucose in one’s bloodstream. Glucose levels in a blood sample can be taken from your vein. Ranges for Fasting Plasma Glucose testing: 126 mg/dL (7.0 mmol/L) or higher Ranges for oral glucose tolerance: 200 mg/dL (11.1 mmol/L) or higher 11 4

5. What is a health disparity? A Health Disparity is a health condition or disease that is higher for one group than the general population The idea of Health Disparities began since the Institute of Medicine issued its 2002 report titled, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” 1 5

6. Why is diabetes a Health disparity? 6 Diabetes is a health disparity due to the fact that when compared to the general population it has a high incidence rate in African Americans then in any other race or ethnicity in MA. Diabetes is a health disparity due to the fact that when compared to the general population it has a high incidence rate in African Americans then in any other race or ethnicity in MA.

7. African Americans & Diabetes Massachusetts adults reported being diagnosed with diabetes increased by an average of 4.1% per year between 2000 and 2009 Those who are older also have a higher prevalence of diabetes compared to those who are younger: 35-44 years of age: 4.3% 45-54 years of age: 6.9% 55-64 years of age: 14.2% 65-74 years of age: 19.5% 75 and older: 17.1% 3 7

8. Why African Americans?  African Americans are more likely to develop type two diabetes.  Main reasons: African-Americans are 1.7 times more likely to have type 2 diabetes than the general population. African-Americans, almost 11 percent, have diabetes.  African Americans and recent African immigrants have inherited a "thrifty gene" from their African ancestors. 9&1 8

9. Hospitalization a. In 2006, the diabetes hospitalization rate was approximately 140.0 per 100,000 hospitalization Death Rates a. 5.6 out of every 100 adults in Massachusetts has diabetes, ranking it 41st lowest in the nation for the ratio of people with diabetes to the general population. Key: The cause of diabetes is unknown, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. 1 9

10. Sounding the Alert Type One Risks for Type 1 : a. Family History: If anyone of your parents or siblings have Type 1 diabetes, you’re at a slight RISK! b. Genetics: Based on one’s genes, genetic testing can be done to see who in one’s family has Type 1 diabetes, thus increasing the risk. c. Low Vitamin D Levels: Vitamin D might be protective against Type 1 diabetes, but can result in increasing one’s chance. Type two Risks for Type 2: WEIGHT ( Obesity ): Being overweight is a main factor in being diagnosed with Type 2 diabetes. Inactivity: Physical activity helps you control your weight, thus glucose is used as energy and helps the cells become a sensitive to insulin. Age: People after the age of 45, are more prone to become diagnosed, due to insufficient exercise 3 10

11. Type 2 diabetes in African Americans Socioeconomic Factors Poor Health Care Education Environment Cultural Barriers African American Foods traditional foods during holidays African Americans describe their diet as “soul food” –receiving their nutritions some foods lack calcium and other nutrients Economically disadvantaged families have no choice but to eat priceless foods. 11

12. Complications Diabetes can also damage blood vessels in the eyes, causing vision problems or blindness. Cardiac diseases: heart attack. Infections of the female genital tract, the skin, or the urinary tract Lead to Kidney disease and kidney failure 5

13. Symptoms Type One diabetes Symptoms of diabetes: increased thirst and frequent urination (especially at night), unusual increase in appetite, unexplained weight loss, fatigue, erection problems, blurred vision, and tingling or numbness in the hands or feet. Type Two diabetes: Frequent infections, blurred vision, cuts/ bruises that are slow to heal, tingling/numbness in the hands & feet, recurring skin, gum, or bladder infections 11 13

14. Treatment & Care Type One Insulin injections, exercise, and a diabetic diet. Insulin is the only medication that can be used to control the increases in blood sugar that occur with the disease. Type Two Diabetes : People with type 2 diabetes (insulin can be used alone or in combination with diabetes pills or other. Taking Care of diabetes : 11 14

15. Continued. Proper care of diabetes: Tobacco: Nicotine and other products in tobacco make it more difficult for insulin properly. P.S : chewing tobacco is high in sugar Eyes: It is extremely important for diabetic patients to see their eye doctor at least once a year to have their pupils dilated and a thorough retinal exam performed. -- no proper care can lead to glaucoma & cataract Feet/ Skin: Changes in moisture of skin, Neuropathy: damage ability to feel any pain, or foot tension Poor circulation: can make your foot less able to fight infection. AMPUTATION – see health care provider 11 15

16. copy2005-2010 Massachusetts Department of Public Health 16 Area CountArea Age Adjusted Rate State Age Adjusted Rate White Non- Hispanic 3016.613.8 Black Non- Hispanic 126.930.7 Asian/Pacific Islander Non- Hispanic 00.010.4 Hispanic1094.221.4

17. Race /EthnicityWorcester PercentState Percent White Non-Hispanic 7.3 (6.2 - 8.3) 7.0 (6.7 - 7.3) Black Non Hispanic 10.3 (5.9 - 14.6) 11.0 (9.4 - 12.5) Asian Pacific Islander NA (NA - NA) 7.6 (5.1 - 10.1) Hispanic11.6 (8.1 - 15.2) 9.3 (8.2 - 10.3) MASSCHIP 8 17

18. Current News? “An increasing proportion of US children are so severely obese as to be at immediate risk for life-threatening complications including type 2 diabetes. Some will become candidates for treatment at newly established pediatric surgical weight loss programs throughout the country. “

19. Summary Diabetes is a very dominant disease in the African American Population. Causes of Diabetes : Lack of Insulin, or resistance to insulin. a. The role of the pancreas, risk factors, origin of diabetes, & current news Why African Americans: “thrifty gene” theory. Environmental factors, cultural differences Statistics : race/ ethnicity, Worcester mortality, and African Americans vs. Caucasians. 19

20. Works Cited 1. http://www.netwellness.org/healthtopics/aahealth/highblood.cf m/ http://www.netwellness.org/healthtopics/aahealth/highblood.cf m/ 2. http://www.cdc.gov/diabetes/consumer/learn.htm/ http://www.cdc.gov/diabetes/consumer/learn.htm/ 3. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ 4. http://www.umm.edu/patiented/articles/what_causes_type_1_d iabetes_000009_2.htm/ http://www.umm.edu/patiented/articles/what_causes_type_1_d iabetes_000009_2.htm/ 5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1743410/pdf/v081p0073 4.pdf/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1743410/pdf/v081p0073 4.pdf/ 6. http://jama.ama-assn.org/content/306/2/206.full/ http://jama.ama-assn.org/content/306/2/206.full/ 7. http://www.ipump.org/map/donors-massachusetts.html http://www.ipump.org/map/donors-massachusetts.html 20

21. 8)http://www.mass.gov/?pageID=eohhs2terminal&L=6&L0=Home&L1=Consu mer&L2=Prevention+and+Wellness&L3=Disease+Prevention&L4=Diabetes+ Prevention+and+Control+Program+(DPCP)&L5=Diabetes+Facts+and+Figures &sid=Eeohhs2&b=terminalcontent&f=dph_com_health_disease_prevention _c_diabetes_statistics&csid=Eeohhs2/ 9) http://www.deemwebsite.org/01_Mendoza_Affairs.pdf 10) http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/ 11) http://diabetes.webmd.com/blood-glucose 21