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Eliminate Disparities in Diabetes

What is the Burden of Diabetes in the United States?
Diabetes was the sixth leading cause of death in the year 2000.1 More than 17 million Americans have diabetes, and over 200,000 people die each year of related complications.2 Diabetes is a group of diseases described by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both.  This disease can cause serious complications and premature death, but persons with diabetes can take measures to reduce the likelihood of such occurrences.

  Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in the development of this type of diabetes.
  Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90 to 95 percent of all diagnosed cases of diabetes.2 Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity.

Examples of Important Disparities
The following groups are several times more likely to have type 2 diabetes as whites of similar age:3

red arrow pointer Overall, Hispanic/Latinos are 1.9 times. Mexican Americans are 2.0 times.
red arrow pointer African Americans are 2.0 times
red arrow pointer American Indians and Alaska Natives are 2.6 times

In addition, Native Hawaiians are 2.5 times more likely to have diagnosed diabetes than white residents on Hawaii of similar age.3  African Americans and American Indians have higher rates of diabetes-related complications such as kidney disease and amputations.4

What is the Goal?
The target date for eliminating health disparities is 2010. CDC and other public heath agencies intend to reduce deaths from diabetes by decreasing the overall rate of complications from diabetes and eventually by eliminating disparities among different groups.

Promising Strategies
To reduce the rate of diabetes and its complications among high-risk minority populations:

red triangle Increase early screening and early treatment
red triangle Improve care for control of diabetes and treatment of major complications, including eye and foot examinations
red triangle Conduct clinical trials to prevent the onset of type 2 diabetes in individuals at most risk for developing the disease. Minorities are most likely to be affected by type 2 diabetes

What can Healthcare Providers do to Reduce the Disparity of Diabetes?
Physicians should take advantage of their patients’ routine office visits to conduct foot and kidney exams, and recommend eye screenings once a year. Physicians should teach patients to make proper diabetes management a part of their daily lives. Because many complications from kidney disease, blindness, and amputations can be prevented, health care providers should regularly screen their patients with diabetes.  Reducing high blood pressure among people with diabetes could prevent one-third of diabetes-related eye, kidney, and nerve diseases. Approximately 60 percent of diabetes-related blindness could be avoided with good blood glucose control or by early detection and laser treatments. About half of all lower-extremity amputations can be prevented by properly caring for feet and by reducing risk factors such as abnormally high blood sugar, cigarette smoking, and high blood pressure.5

What can Individuals do to Decrease Their Risk of Developing Diabetes or Its Complications?
The increasing rate of diabetes is alarming, but much of this major public health problem can be prevented with early detection, improved care, and education on diabetes self-management. For example, because type 2 diabetes appears to be associated with obesity, people can change their lifestyles to increase regular physical activity and eat a low-fat diet. During routine doctor visits, patients with diabetes should ask for foot exams even if the visit is related to another health matter.

For more information about Diabetes:
  CDC Health Topic: Diabetes
  National Center for Chronic Disease Prevention & Health Promotion (NCCDPHP) Diabetes Public Health Resource
    Diabetes Projects: Racial & Ethnic Health Disparities Initiatives
  Indian Health Service (IHS) National Diabetes Program
  National Diabetes Information Clearinghouse (NDIC)
    National Diabetes Statistics
  National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
    Diabetes Page
    National Diabetes Education Program (NDEP)
 

American Diabetes Association (ADA)

    African Americans & Diabetes
    Asian Americans, Pacific Islanders, & Diabetes
    Diabetes Statistics for Latinos
    Diabetes Statistics for Native Americans
 

diabetesatwork.org

 

Testimony: Diabetes in American Indians
Diabetes Program Director
August 13, 2001

 

Sources:

  1 National Center for Health Statistics (NCHS), 2000.
  2 National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 2002.
  3 NCCDPHP, 2000.
  4 U.S. Department of Health and Human Services (HHS), 1999.
  5 American Diabetes Association (ADA), 2002.


 

 

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Last Updated on November 03, 2004
Office of Minority Health

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