Definition is a disease in which the body has problems producing or using insulin, a hormone needed to convert sugar, starches and other into energy. Compared to the general population, African Americans are disproportionately affected by diabetes: • 4.9 million (an increase from 3.7 million in 2007), or 18.7% of all African Americans, aged 20 years or older, also have diabetes. • African Americans are 1.8 times more likely to have diabetes as non Hispanic whites. • 25 percent of African Americans between the ages of 65 and 74 have diabetes. • 1 in 4 African American women over 55 years of age has diabetes. Diabetes is associated with an increased risk for a number of serious, sometimes life-threatening complications, and certain populations experience an even greater threat. Good diabetes management can help reduce your risk; however, many people are not even aware that they have diabetes until they develop one of its complications. • Blindness. African Americans are almost 50 percentas likely to develop diabetic retinopathy as non-Hispanic whites. • . African Americans are 2.6 to 5.6 times as likely to suffer from kidney disease with more than 4,000 new cases of End Stage Renal Disease (ESRD) each year. • Amputations. African Americans are 2.7 times as likely to suffer from lower-limb amputations. Amputation rates are 1.4 to 2.7 times higher in men than women with diabetes. • and Stroke. Heart disease and stroke account for about 65 percent of deaths in people with diabetes. Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk for stroke is 2 to 4 times higher and the risk of death from stroke is 2.8 times higher among people with diabetes. Alternative Names Noninsulin-dependent diabetes; Diabetes – type 2; Adult-onset diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Exactly why this happens is unknown, although excess weight andinactivity seem to be contributing factors. Insulin is a hormone that comes from the pancreas, a gland situated just behind and below the stomach. When you eat, the pancreas secretes insulin into the bloodstream. As insulin circulates, it acts like a key by unlocking microscopic doors that allow sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas. Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues. Glucose comes from two major sources: the food you eat and your liver. After intestinal digestion and absorption, sugar is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin. The liver acts as a glucose storage and manufacturing center. When your insulin levels are low — when you haven’t eaten in a while, for example — the liver metabolizes stored glycogen into glucose to keep your glucoselevel within a normal range. High blood sugar levels can cause several symptoms, including: • Blurry vision • Excess thirst • Fatigue • Frequent urination • Hunger • The fasting blood glucose test is the preferred test for diagnosing diabetes in children and nonpregnant adults. The test is most reliable when done in the morning. However, a diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day: • A blood glucose level of 126 milli grams per deciliter (mg/dL) or higher after an 8-hour fast. This test is called the fasting blood glucose test. • A blood glucose level of 200 mg/dL or higher 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT). • A random —taken at any time of day—blood glucose level of 200 mg/dL or higher, along with the presence of diabetes symptoms. • Gestational diabetes is diagnosedbased on blood glucose levels measured during the OGTT. Glucose levels are normally lower during pregnancy, so the cutoff levels for diagnosis of diabetes in pregnancy are lower. Blood glucose levels are measured before a woman drinks a beverage containing glucose. Then levels are checked 1, 2, and 3 hours afterward. If a woman has two blood glucose levels meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting blood glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL. Treatment for type 2 diabetes requires a lifelong commitment to: • Blood sugar monitoring • • Regular exercise • Possibly, diabetes medication or insulin therapy These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications. If managing your diabetes seems overwhelming, take it one day at a time. And remember that you’re not in it alone. You’ll work closely withyour diabetes treatment team — doctor, diabetes educator and registered dietitian — to keep your blood sugar level as close to normal as possible. Monitoring your blood sugar
Depending on your treatment plan, you may check and record your blood sugar level once a day or several times a week. Ask your doctor how often he or she wants you to check your blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Even if you eat on a rigid schedule, the amount of sugar in your blood can change unpredictably. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to: • Food. What and how much you eat will affect your blood sugar level. Blood sugar is typically highest one to two hours after a meal. • Physical activity. Physical activity moves sugar from your blood into your cells. The more active you are, the lower your blood sugar level. • Medication. Any medicationsyou take may affect your blood sugar level, sometimes requiring changes in your diabetes treatment plan. • Illness. During a cold or other illness, your body will produce hormones that raise your blood sugar level. • Alcohol. Alcohol and the substances you use to make mixed drinks can cause either high or low blood sugar, depending on how much you drink and whether you eat at the same time. • Stress. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly. • For women, fluctuations in hormone levels. As your hormone levels fluctuate during your menstrual cycle, so can your blood sugar level — particularly in the week before your period. Menopause may trigger fluctuations in your blood sugar level as well. Healthy eating
Contrary to popular perception, there’s no diabetes diet. You won’t be restricted to a lifetime of boring, bland foods. Instead, you’ll need plenty of: • Fruits • Vegetables • These foods arehigh in nutrition and low in fat and calories. You’ll also need to eat fewer animal products and sweets. Counting carbohydrates in your food is another thing you’ll need to incorporate into meal planning. A registered dietitian can help you learn to count carbohydrates and put together a meal plan that fits your health goals, food preferences and lifestyle. Once you’ve covered the basics, remember the importance of consistency. To keep your blood sugar on an even keel, try to eat the same amount of food with the same proportion of carbohydrates, proteins and fats at the same time every day. Low glycemic index foods also may be helpful. The glycemic index is a measure of how quickly a food causes a rise in your blood sugar. Foods with a high glycemic index raise your blood sugar quickly. Low glycemic foods may help you achieve a more stable blood sugar. Foods with a low glycemic index typically are foods that are higher in fiber. Physical activity
Everyone needs regular aerobicexercise, and people who have type 2 diabetes are no exception. Physical activity lowers blood sugar. Check your blood sugar level before any activity. You might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes medications that lower your blood sugar or insulin. Diabetes medications and insulin therapy
Some people who have type 2 diabetes can manage their blood sugar with diet and exercise alone, but many need diabetes medications or insulin therapy. Some studies indicate that early intervention with medication, even before the A1C is significantly elevated, may improve control of blood sugar levels over time. After many years, diabetes can lead to other serious problems: • You could have eye problems, including trouble seeing (especially at night) and light sensitivity. You could become blind. • Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be removed. Infection can also cause pain
