Eliminate Disparities In Diabetes

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Eliminate Disparities In Diabetes

Diabetes was the sixth leading cause of death in the year 2000.1 More than
20.8 million Americans have diabetes.  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. 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.

Gestational
diabetes
is a form of glucose intolerance that is diagnosed in
some women during pregnancy. Gestational diabetes occurs more frequently among
African Americans, Hispanic/Latino Americans, and American Indians. It is also
more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal
blood glucose levels to avoid complications in the infant.

Examples of Important Health
Disparities

African Americans

– African Americans born in the year 2000 face a 2 in 5 risk for diabetes.

– Compared to whites, African Americans are more than twice as likely
to have diabetes.

– From 1980 through 2005, the age-adjusted
prevalence of diagnosed diabetes doubled among black males and increased 69%
among black females. However, of all groups observed, black females had the
highest overall prevalence.4

Hispanics/Latinos (H/L)

– Hispanics born in the year 2000 face a 2 in 5 risk for diabetes.

– Compared to whites, Hispanics are more than twice as likely to have
diabetes.

– From 1997 through 2005, the age-adjusted prevalence among
Hispanics increased 16% among males and 21% among females.

American Indians / Alaska Natives
(AI/AN)

– Among people younger than 20, American Indians aged 10-19 have the highest
prevalence of type 2 diabet

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 Intervention Strategies

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

– Increase early screening and early treatment


Improve care for control of diabetes and treatment of major complications,
including eye and foot examinations

– 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

Programs, Projects and Initiatives Addressing Diabetes in
Minority Communities

– Project
DIRECT

Project DIRECT is a multi-year community
diabetes demonstration project, funded primarily by the CDC focused on reducing
the burden of diabetes and its complications in an African American community
(southeast Raleigh, North Carolina) through a community diabetes demonstration
project.

To date, Project DIRECT has provided insight into preventive
care services and self-care behaviors among adult African Americans with
diabetes.  Findings include:

– Close to half have never received any
form of diabetes education.

– Less than half do not have annual A1C
examinations.

– More people are considered “sedentary” than either
“irregularly active” or “regularly active”.

– More than half monitor
their blood glucose once a day or less.

More Information on Project
DIRECT

– The National Diabetes Education
Program (NDEP)

NDEP is a co-sponsored CDC and NIH
initiative that involves public and private partners in efforts to promote early
diagnosis of diabetes, prevent or delay the onset of diabetes, and improve
treatment and outcomes for African Americans, Hispanics/Latinos, American
Indians/Alaska Natives and other groups at increased risk for diabetes

More Information on NDEP

– SEARCH for
Diabetes in Youth Study

To address the increasing
incidence of type 1 and type 2 diabetes in youth, CDC has collaborated with
other agencies to fund and initiate the SEARCH for Diabetes in Youth Study. Conducted in six geographically dispersed populations that encompass the
racial/ethnic diversity of the United States, one of SEARCH’s prime objectives
is to determine the magnitude and trends of type 1 and type 2 diabetes in youth,
including African Americans and Hispanics/Latinos.

Thus far, SEARCH has assembled the first data on the burden of type 1 and
type 2 diabetes in children, including findings on the burden of diabetes in
African American and Hispanic/Latino Youths:

– Among minority groups
included in the study, African American youth had the highest diabetes incidence
rates.
– For
type 2 diabetes, no group had greater incidence rates than African Americans.

– In youth aged 10 years or older, type 2 diabetes represented 58 percent of
new cases among African Americans.
– Among minority groups, Hispanics had
the highest number of diagnosed diabetes cases in each age group.
– About 1
in 500 Hispanic youths have diabetes.
More Information on SEARCH

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

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