Introduction
In principle, scientists define diabetes as a condition that leads to an individual’s glucose (blood sugar) level going up above normal. Significantly, it is a condition one has to live with for the rest of their natural lives. Moreover, research has proved that two types of the disease exist. Therefore, depending on one’s symptoms and age, the type of diabetes can be known. In essence, Diabetes Type 1 is known to develop mainly in teenagers and children due to the pancreas’s failure to produce insulin. However, Type 2 diabetes is mostly diagnosed in old individuals above 40 years old and it is usually as a result of the pancreas’s failure to produce the needed amount of insulin or at times due to the body cells rejecting to react to the insulin (NHS, 2015). On a similar note, type 2 diabetes is the most common in adults with research claiming that 90% of adults diagnosed with diabetes have type 2.
According to a report published by Dr. Eugine Tull and Professor Jeffrey Roseman, incidences of insulin-dependent diabetes mellitus (IDDM) in black children population rose from 3.3 to a staggering 11.8 per 100000 in a single year. ^8(p613) In essence, this IDDM’s fourfold variation is believed to be as a result of distinct autoimmune and genetic phenomena such as Asp-57 frequency, islet cell antibodies, and HLA. Principally, the social, demographic traits of the black Americans and European colonization have significantly influenced diabetes rates amidst the blacks’ population.
In essence, when the black Americans were snatched from their motherland in ships they loosed the diverse genetic and cultural characteristics found in Africa. Moreover, because of the slavery system the black Americans were unable to keep their ethnic identity and by intermarrying resulted to genetic admixture. Furthermore, with comparison to the native relatives in Africa, black Americans have cultural beliefs such as physical activities, dietary behavior, and preference of body size that put them at a higher risk of getting diabetes.
Significantly, there are many views on the said risk factors of diabetes among African Americans. However, the most significant hypothesis proposed is based on environmental factors and genetic factors. For instance, one genetic theory suggests that diabetes in blacks is as a result of G6PD deficiency and their adoption of Western diet.^8(p615) Moreover, another dominant theory suggests that due to the African American population being subjected to famine in their native land they developed a thrift gene to help them cope with food deficiency. Therefore, when moved to a land of plenty food, they end up being obese hence the given condition.
Principally, other reports confirm this finding citing that 39.9% of African American women have abdominal obesity.^6 Moreover, individual physical inactivity can result in diabetes, and research has it that, less adolescent girls and women in African American population participate in physical activities thus, leaving more at risk of becoming diabetic. Furthermore, there is a higher rate among African American children to be resistant to insulin compared to their whites’ counterpart. In recent reports, African Americans have been found to have a dichotomous population that comprises of insulin resistant individuals and insulin sensitive people who if they reproduce give rise to a population that is more prone to diabetes.
In essence, the reason as to why there are more increased cases of diabetes amongst African American is due to lack of control. According to diabetes control and complications trial (DCCT), African Americans with diabetes are less controlled thus, are less likely to have intensified treatment that improves the control of glucose in the blood. ^6 Significantly, this is because of the poor socioeconomic status of African Americans resulting in their inability to access proper healthcare at the right time leading to the most diagnosis being on a disease that is at an advanced level.
Principally, the racial disparity is another factor that has led to increasing in morbidity among African Americans. The Institute of Medicine report shows that ethnic and racial minorities in the United States of America get poor quality health care compared to their whites counterparts regardless of individual insurance coverage, comorbid conditions, or age.^2 Furthermore, Medicare beneficiaries’ study showed that diabetic African-American patients were most times ignored during measurements of glycosylated hemoglobin.
Principally, approximately 6.6% (950000) of New York’s adult population has been diagnosed with diabetes as it has been noted by the Behavioral Risk Factor Surveillance System (BRFSS) study.^7 Moreover, it is estimated that 450000 more adults live with diabetes unknowingly. Concurrently, the prevalence of diabetes in today’s society represents an increase of 50% since 1993. However, surveys carried out by the New York State Department of Health showed that African Americans had a twice diabetic prevalence rate compared to their white counterparts.
In essence, it is crucial to improving conditions faced by people with diabetes and at the same time tries and reduces long-term health care costs due to diabetes. Principally, the healthcare sector has been seen by many to discriminate against African Americans. However, information on how to be able to prevent diabetes is readily available on the internet while some prevention methods are publicly known by many. For instance, Kleinman LC, Lutz D, Plumb EJ, Barkley P, Nazario HR, et al. explain that physical exercise is necessary and also healthy eating.^5(p232)
Significantly, the New York State Department of Health usually conducts talks and sessions to enlighten the public on the factors that cause diabetes and how one can be able to take preventive methods if not treatment. Moreover, a lot of information has been shared on the need to stay healthy and ensure one does not get overweight since people with obesity are at a more risk of getting diabetes. Significantly, hospitals and schools are one of the greatest sources of information on diabetes with both holding community enlightening programs to see more people learn of the disease.
According to the Diabetes Prevention Program (DPP), the best way to combat diabetes is to change the known lifestyle and not try to prevent impaired glucose tolerance progression as a way of averting diabetes. In essence, there have been many published reviews citing the best type of treatment for type 2 diabetes. Moreover, they give a detailed description of the dose range, adverse effects, mode of action, and recommended pharmacological agents.
Significantly, there have been improved strategies put in place to ensure African Americans access health care. For instance, setting up community clinics to help indigent patients, primary care clinic based in universities, and diabetes clinics in hospitals where all African Americans can be able to get treatment and the needed information on diabetes. Concurrently, this is made possible by the ever presence of nurses and other professions in the healthcare sector who are always ready to serve.
Principally, African Americans’ adherence to diabetes is reduced and even more alarming when self-care is put into play. For instance, report by Izquierdo R, Eimickle JP, Teresi JA, et al showed that due to lack of information on diabetes and proper education then many did not know when underserved or how to go about with their healthcare.^4 Significantly, this mass spread ignorance on diabetes has resulted in many people living with the disease unknowingly. Furthermore, it frustrates any treatment activities taken since when the person is diagnosed the disease is usually far gone and at a critical stage hard to control. Therefore, there is a need to put more effort and place emphasis on the importance of people knowing their status with regards to diabetes and try adopting a healthy living in terms of diet and physical activities.
In essence, when it comes to private managed organizations, the National Committee for Quality Assurance (NCQA) and Health Care Employer Data health plan and Information Set (HEDIS)’s diabetes care comprehensive measures act as diabetes care performance indicators. ^7 on a similar note, the New York state has set up a Diabetes Minority Initiative, which serves the minority population by giving the information on diabetes and any treatment needed. Concurrently, the State has adopted the CDC’s set national objectives to have an upper hand in the war against diabetes. ^1
In principle, most pharmacists have turned from the Madam Curie role to a more profit-minded state. However, as professional if they would take a second and go back to their work ethic bi-laws then most people would be able to benefit from their services. In essence, pharmacists reach the greatest portion of the population and frequently interact with African Americans thus amidst these interactions, pharmacists can take it upon themselves to educate the public about the dangers of unhealthy living and how reading it is to ignore diabetes. On a similar note, as they provide diabetes drugs to the patients they should be more inquisitive and hence be able to offer the right prescription. Moreover, most people who live with diabetes unknowingly can show up at the pharmacy exhibiting certain symptoms and it should, therefore, be the pharmacist’s role to determine whether such an individual has diabetes or not and even if not try to convince the person to seek medical help.
Conclusion
In essence, many people perish due to lack of the right information that would have saved them. Therefore, it is the role of all in the healthcare sector and the government to ensure that information about diabetes is put within public reach and that no one is discriminated against when seeking help. Furthermore, continuous negligence of one race or ethnic group will still haunt all in the future only because intermarriages cannot be controlled. Principally, in the battle against diabetes all must unite for a lot still needs to be done to ensure the safety of tomorrow’s generation. Moreover, everyone is responsible for his/ her health care and should be conscious of what happens to their health.
Bibliography
Centers for Disease Control and Prevention. Black or African American Populations. http://www.cdc.gov/diabetes/programs/programs.html.Published October 24, 2014. Accessed April 27, 2015.
Chow, A, Foster, H, Gonzalez, V, & Mclver, L. The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations. Published July 30, 2012. Accessed at April 27, 2015.
Horowitz CR, Williams L, & Bickell NA. A Community-Centered Approach to Diabetes in East Harlem. PMID, J Gen Intern Med; 2003.
Izquierdo R, Eimickle JP, Teresi JA, et al. Adherence to diabetes self care for white, African-American and Hispanic American telemedicine participants: 5 year results from the IDEATel project. http://www.ncbi.nlm.nih.gov/pubmed/22762449. Published July 5, 2012. Accessed April 27, 2015.
Kleinman LC, Lutz D, Plumb EJ, Barkley P, Nazario HR, et al. A partnered approach for structured observation to assess the environment of a neighborhood with high diabetes rates. Prog Community Health Partnersh. 2011 Fall;5(3):249-59. PubMed PMID: 22080773; NIHMSID: NIHMS349564; PubMed Central PMCID: PMC3487413.
Marshall, M. Jr. Diabetes in African Americans. http://pmj.bmj.com/content/81/962/734.full. Published March 10, 2005. Accessed April 27, 2015.
New York State Department of Health. New York State Strategic Plan for the Prevention and Control of Diabetes. https://www.health.ny.gov/diseases/conditions/diabetes/strategicplan.htm. Accessed April 27, 2015.
Tull, Eugene & Roseman, Jeffrey. Diabetes in African Americans. http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CB4QFjAA&url=http%3A%2F%2Fdiabetes.niddk.nih.gov%2Fdm%2Fpubs%2Famerica%2Fpdf%2Fchapter31.pdf&ei=LGk-Vcy-IZLvaO_dgLAH&usg=AFQjCNEQigS7GYk6SHZHvU0sNG2G2sHX3g&sig2=V1R3EgsBnPxV8EqzCy5dxA. Accessed April 27, 2015.
