Submitted by Shanda McManus, MD
Introduction
Type 2 diabetes is a condition in which your body is not responding to its own insulin as it should. Insulin is made in the pancreas and helps move glucose into your body’s cells to be used as energy. This impaired blood glucose regulation can lead to serious health problems, including heart disease, kidney disease, and vision loss. Nearly 4.9 million African-American adults, or 18.7% of all African Americans over 20 years, have diagnosed or undiagnosed diabetes. The risk of diabetes is 77% higher among African Americans than among non-Hispanic white Americans.
Diagnosis
The diabetes diagnosis can be made with a fasting glucose level of 126 mg per dL or greater, an A1C level of 6.5% or greater, or a random glucose level of 200 mg per dL or greater. Hemoglobin A1C levels are also used to assess diabetic glucose control. Levels below 7 percent in a diabetic undergoing treatment is good control. A1C is reported as a percentage because it represents the percent of your total hemoglobin with glucose bound to it. The higher the number, the higher the blood sugar has been the preceding three months. You should be screened for type 2 diabetes if your BMI is 25 or greater, and you have one of the following risk factors: *First-degree relative with diabetes, Cardiovascular disease A woman with Polycystic, Ovary Syndrome, HDL cholesterol less than 35 or triglyceride level greater that 250, a woman who had gestational diabetes or an infant weighing nine pounds or more, and physical inactivity. If you have no risk factors, you should be tested for diabetes every year at your annual physical, starting at age 45. If your tests are normal, you should have repeat screening every three years.
Lifestyle Intervention
You can help manage your diabetes or risk for developing diabetes with several lifestyle interventions.
• Maintain a healthy weight: aim to keep your BMI below 25.
• Make healthy food choices: Less than 25 percent of your daily calories should come from fat. Increase intake of green leafy vegetables.
• Exercise Regularly: You should get at least 150 minutes of moderate exercise a week. Add resistance training two to three times a week if you are physically able.
Conclusion
If you are diagnosed with diabetes, meeting with a diabetes educator is a great way to learn how to manage it and avoid life-threatening complications. Be informed about this important health threat. Help reduce the racial disparity in health outcomes and find your way to better personal health at the same time.
For further information: https://www.cdc.gov/diabetes/basics/type2.html
American Academy of Family Physicians: https://familydoctor.org
American Diabetes Association: http://www.diabetes.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www2.niddk.nih.gov
Sources consulted:
Am Fam Physician. 2016 Jan 15; 93(2): 103-109.
Am Fam Physician. 2009 Jan 1; 79(1): 42.