2.7 million African-Americans have diabetes

Paul H. Johnson:

Over the past 25 years, the number of African-Americans with the disease has grown by more than 160 percent since 1980, according to the Centers for Disease Control and Prevention.

There are three main types of diabetes: type 1, which used to be called juvenile-onset diabetes; type 2, formerly called adult-onset diabetes; and gestational diabetes, which affects pregnant women. Type 2 is by far the most common form of the disease, and unlike type 1 can be regulated by diet and exercise.

Doctors say that African-Americans are nearly twice as likely as whites to develop type 2 diabetes. And when they do develop the disease, they are much more likely to suffer its most dangerous complications -- strokes, heart attacks and amputations. Native Americans are the only ethnic group with a higher incidence of type 2 diabetes, according to the American Diabetes Association.

The numbers are staggering. But doctors are equally concerned that even when people are diagnosed with the more common form of the disease, they don't take their treatment seriously until it is too late.

"That's really the tragedy, the amputations that could have been prevented with early aggressive treatment," said Dr. Leroy Strom, an endocrinologist at Englewood Hospital and Medical Center.

The reasons why diabetes is so common in blacks are:

Physicians say there are two main reasons for the high rates of diabetes among blacks -- diet and genes. Some also say lack of access to proper medical care contributes to the high rate of complications.

"The oversupply of food to the body is what causes [type 2] diabetes," said Dr. Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in the Bronx. He said that the nation's cities are particularly vulnerable because of the presence of many cheap fast food restaurants in poor neighborhoods.

"It's not only the quality of food, it's the quantity," Zonszein said. He said if the nation attacked fast food the same way it attacked smoking, it could help curb the diabetes epidemic, which has surged in the last 10 years.

One of the reasons why African-Americans and Native Americans have such high rates of diabetes is the rapid change in their diets over the last few decades, he said.

"The theory behind it is, there was a genetic adaptation for populations who didn't have readily available food," Zonszein said, so their bodies adapted to make it easier for them to store fat. But recently, with food so plentiful, he said, these same populations store too much fat when they eat highly processed foods and it has led to a rapid increase in the number of diabetes cases.

Northern Europeans, on the other hand, never had their bodies adapt to deal with starvation so they handled the rapid increase in food availability much better, Zonszein said.

The American Diabetes Association recommends that blood sugar levels should be between 80 and 120 milligrams per deciliter (mg/dl) of blood before meals and between 100 and 140 mg/dl or less two hours after a meal.

Nearly 7 percent of all Americans over the age of 20 have diabetes and nearly 12 percent of African-Americans have the disease in the same age group, according to the CDC.

Diabetes was the sixth-leading cause of death among Americans in 2002, and heart disease and stroke account for about 65 percent of deaths in people with diabetes.

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