Studies show diabetes, kidney disease affect African-American population in higher numbers

By: Nick Mordowanec | Fraser - Clinton Township Chronicle | Published March 1, 2017

METRO DETROIT — The National Kidney Foundation of Michigan is spreading awareness about the perils of diabetes and kidney disease in African-American communities by offering preventative tips and health management advice.

Diabetes is a major cause of heart disease and strokes, and is the seventh-leading cause of death in the United States. There are two major types of diabetes.

Type 1 diabetes refers to an individual who is dependent on insulin therapy to stay alive because the pancreas — the organ that makes insulin — is unable to do so.

Type 2 diabetes typically occurs later in life, but it has been spurred in people of all ages due to the obesity epidemic in this nation. It used to be called late onset diabetes, with root causes related to being overweight, engaging in no physical activity, and the body’s failure to effectively use insulin.

Diabetes is the leading cause of kidney failure among African-Americans, who are more prone to suffering from diabetes or kidney disease when compared to other races.

Dr. Art Franke, the senior vice president and chief science officer for the National Kidney Foundation of Michigan, said the issue is more complex than just looking at blacks’ genetics and treatment options.

He said the African-American population has been impacted biologically, though most reasons tend to lean toward the environmental side. Social determinants of health — where individuals live in low-income, economically distressed communities — pose certain challenges in regard to access to healthcare, literacy, education levels, employment and more.

All of those factors play a part in getting the diseases under control. However, the numbers continue to stagger.

A 2011 statistic list issued by the Centers for Disease Control and Prevention stated that diabetes affected 25.8 million people — or 8.3 percent of the general population — in 2010. Those figures related to both diagnosed and undiagnosed people.

From 2005 to 2008, people ages 65 or older represented nearly 27 percent of the population living with diagnosed or undiagnosed diabetes. In 2010, nearly 1.9 million people ages 20 or older were newly diagnosed, with 1.052 million of those people representing the 45-64 age range.

By 2010, about 215,000 individuals younger than 20 were diagnosed in some facet.

The NKFM referenced the estimated 4.9 million people, or 18.7 percent, of all non-Hispanic blacks age 20 and older who have been diagnosed. This affects youths, too, with Type 2 diabetes being more prevalent than Type 1 in non-Hispanic blacks ages 19 and younger.

African-Americans are twice as likely to be diagnosed with diabetes as non-Hispanic whites. They are also more prone to suffer diabetes-related complications, such as kidney failure, lower extremity amputations and blindness.

Franke said the CDC estimates are determined and analyzed in conjunction with other governmental organizations. These include the United States Renal Data System — which collects, analyzes and distributes information about chronic kidney disease and end-stage renal disease — and health and nutritional assessments of adults and children through the National Health and Nutrition Examination Survey.

“One third or so of people who have diabetes have never been told they have diabetes,” Franke said. “One of the insidious parts of diabetes is that people don’t necessarily feel bad. The symptoms are kind of subtle.”

Such symptoms include rather mundane, daily events, such as being thirsty or going to the bathroom. These are unnoticeable events that we all experience, Franke said, and it’s a particular issue with men because men tend to forego doctor visits more regularly.

Dr. Deloris Berrien-Jones practices internal medicine at the Fairlane Henry Ford Medical Center in Dearborn.

Her career has spanned more than 30 years, and the last decade has brought her face to face with individuals with diabetes. She said there’s clearly growing evidence that diabetes is a major disease, due to increased incidents of both diabetes and prediabetes.

She mentioned that multiple ethnic groups, including African-Americans, American Indians and Hispanics, as well as older or obese individuals, are more prone to being diagnosed.

Some statistics suggest that African-Americans who are diagnosed with diabetes are more likely to get kidney disease, which makes the problem overall even worse.

“The hard part is that for diabetes, you don’t know if you have it unless you get tested,” Berrien-Jones said. “It’s a silent disease, just like hypertension. Then, you get a heart attack, a stroke and have high blood sugar.

“We’re getting better … we’re screening now, we’re asking questions, there’s a risk assessment, there’s prediabetes now and a screening tool for that. We know there’s probably 89 million people out there who have (prediabetes), not counting the 22 (million) to 25 million who have diabetes.”

These things can be prevented, though, Franke said. Type 2 diabetes, for example, results in increased levels of blood glucose, but that doesn’t confirm full-blown diabetes.

Franke said adopting a healthier lifestyle, which includes losing 5 to 7 percent of body weight and engaging in 150 minutes of physical activity per week, can help lower levels.

Individuals can also find out for themselves by getting Hemoglobin A1C tests to determine levels over a two- or three-month period.

“It’s kind of like your batting average,” Franke said.

Berrien-Jones said prevention should be the first step toward avoiding diabetes. These are common daily goals, like avoiding burgers and fries at your favorite fast food joint or not smoking cigarettes. Going to the doctor and getting screened makes a difference.

She is also optimistic that the tide is turning. She mentioned how it’s difficult nowadays to avoid seeing or hearing a reference related to body figure or diet plans. The literature on the subject is rising.

“I think people are learning to be healthier,” she said. “When we get better at addressing obesity, looking at that more clearly and setting up more guidelines — hopefully that will impact diabetes and hypertension too.”

Science dictates that individuals who try to better their lives, physically, have a better opportunity to change their lives overall. People older than 60 who adopt lifestyle changes can reduce risks by 72 percent.

People don’t realize that 99 percent of what will be done to battle Type 2 diabetes is done by the patient, Franke added. The physician can offer medicine, but lifestyle changes that individuals adopt will make the real difference.

“It seems simple, but if you have decades of bad habits, it can be a major thing to adopt a healthy lifestyle change. … The content is not surprising, but it’s more the support and time it takes to change habits to new ones that make the difference,” he said.

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