To fully understand any disease, it is necessary to first describe it and define some or most of its symptoms, causes and effects, and to determine to what degree they may be decreased and/or regulated.

There are many types of serious diseases and conditions that fall in many different categories. A short list  includes acute and chronic diseases, infectious diseases, immunological diseases, congenital and hereditary diseases, hormonal diseases, degenerative diseases, neo-plastic diseases, nutritional diseases, occupational and environmental diseases, and mental and emotional diseases.  Now many of those named may cross categories — and the list is by no means complete.

For the purposes of this article, the targeted disease is diabetes.

Diabetes is a disease of the body chemistry that slows the body down from using food to make energy. It is associated with inadequate production of insulin in the pancreas and is ordinarily characterized by excessive urinary secretion containing an above average quantity of sugar. The pancreas is a large organ near the stomach, and it contains specialized areas of tissue (clusters) where insulin is manufactured. When the pancreas and other organs do not function in harmony and/or go awry, the causes and effects that result produce diabetes, often worsening incrementally.

The body needs insulin to control the use of sugar, fats and proteins.  Insulin is a hormone produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in the blood into the cells and lowers the blood sugar level; a high level of sugar is counterproductive.  The body affected with diabetes usually does not produce enough insulin or does not utilize that which it has properly.

Hence, those afflicted with diabetes may often be seen taking insulin intravenously.

There are three main types of diabetes: TYPE 1 DIABETES; TYPE 2 DIABETES; and GESTATIONAL DIABETES.  According to medical data and research:

Type 1: Results from the body’s failure to produce insulin. It is estimated that 5-10% of Americans who are diagnosed with diabetes have Type 1 diabetes. Presently almost all persons with type 1 diabetes must take insulin injections.

Type 2: Results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have Type 2 diabetes. Many people destined to develop Type 2 diabetes spend many years in a state of pre-diabetes. Termed “America’s largest healthcare epidemic,” pre-diabetes indicates a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of Type 2 diabetes. As of 2009 there were 57 million Americans who have pre-diabetes.

Gestational diabetes: Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women. It may precede the development of Type 2 (or, rarely, Type 1).

Other forms of diabetes are categorized separately, including congenital diabetes due to genetic defects of insulin secretion; cystic fibrosis-related diabetes; steroid diabetes induced by high doses of glucocorticoids; and several forms of monogenic diabetes.

LIVING WITH DIABETES

“Diabetes is something you have to handle with care. You have to eat the right foods. It is a hard situation to deal with and it has been life-changing for me,” said Jane Doe, who is afflicted with diabetes.  “Children and young adults must be persuaded that their own future can be hampered by ill health and that diabetes brings with it other serious health complications.”

Jennifer Bihm is a stay-at-home mother, a reporter and contributing writer, a former staff writer for a Los Angeles weekly newspaper and a 2008 California Endowment Health Journalism Fellow.  She explains: “My life with diabetes … I like to tell people that my children saved my life. Without them, I would have been a statistic, part of the one-third African American population walking around with diabetes without knowing it. Like many others, I never bothered with doctors unless it was some kind of emergency, and I was hardly ever sick.

“In 1999, I had no idea how drastically my life was about to change. I had just finished an internship in marketing that spring, and my best friend and I shared an apartment in Inglewood. I had a boyfriend and was passing out my resume like crazy. All my dreams were ahead of me and life was pretty good.

“Did I get my period this month?  I tried to remember as I ironed my clothes for a job interview one morning in May of 2000.  The pink parallel lines on the pregnancy stick gave me my answer. Everything was matter of fact … finding a job, telling my boyfriend, looking for a new place. By October, I was working two jobs, seven days a week feeling extremely tired … and thirsty.
“Your urine is full of sugar,” the doctor told me. Gestational diabetes is what he called it. It would go away as soon as I had the baby, and I would be at risk for it later on in life like when I was close to 50. Until then, I had to follow a special diet and take insulin.  I hadn’t been an absolute stranger to diabetes. In fact, my father was in and out of the hospital that same year, suffering from complications of it. Like my father (who died at the year’s end), I wanted to be in denial about my condition.”

Compared to the general population, African Americans are disproportionately affected by diabetes, according to statistics printed by the American Diabetes Association (ADA). Thirty-two million, or 13.3 percent of all African Americans aged 20 or older, have diabetes, the ADA reported. African Americans are 1.8 times more likely to have diabetes as non-Hispanic Whites.  Diabetes is associated with an increased risk for a number of serious, sometimes life-threatening complications like blindness, kidney disease, heart disease, stroke and limb amputation, say health officials.

As Bihm continued, “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. For my part, I was ambitious. I wanted to hurry up and have my baby so I could get back to ‘real life.’  I didn’t want to bother with any special diets or medications. My son was born four days after a rather unhappy Christmas that year, and subsequently I went through about five or six months of depression.

“I didn’t think about diabetes at all. In fact, I hardly ate or slept, just mostly changed diapers, nursed my baby and came to the realization that my life had taken a totally different turn.

“You probably have a bladder infection,” my aunt told me, as I came from the bathroom for about the fifth or sixth time one night in June 2001.

“Then the doctor who was supposed to be telling me whether or not I had a bladder infection later that same week told me that I was pregnant. Diabetes showed up again during routine tests at the prenatal clinic. I felt fine but was admitted into the high risk maternity ward in the hospital anyway, where I stayed for a week.

“This time one of the doctors told me, ‘It’s not gestational; you have Type 2 diabetes — and will have it for the rest of your life.’ ”

TREATING DIABETES

Dr. Bill Releford is an authority on treating diabetes.  According to the Releford Foot and Ankle Institute, he is a leader in the industry of limb preservation and wound management.  Dr. Releford has over 20 years’ experience in successfully providing specialized care to people with chronic wounds, especially those originating from diabetes, chronic venous insufficiency, peripheral arterial disease and pressure.

The Releford Institute utilizes a multidisciplinary approach to limb preservation by collaborating with vascular surgeons, radiologist, endocrinologist, nutritionist as well as other chronic disease specialists. Collectively, their team is dedicated to decreasing the amputation rate in Los Angeles and surrounding communities.

I spoke with Dr. Releford for this article: “Type 2 diabetes,” he said, “is the type that primarily affects African Americans, and I’ve always said that the way our community is contiguous with lack of open space to exercise and the number of fast-food venues upon our community, we are face with a diabetes tsunami that will hit in the next 15 to 20 years.”

Furthermore, when asked about the connection to diabetes in the community and African Americans’ quality of life generally, Dr. Releford stated emphatically, “Absolutely; and it’s a plethora of things that contribute to people who may be subjected to this big tidal wave of fabrication. Of course, when we were coming up, we had to have this education in our schools.  Now, the kids don’t have to exercise; there are fast foods in the schools now, when that was not the case.  Now you have McDonalds, Taco Bells, Burger King and things like that.  Then we have what I call an ‘obesigenic’ society, where obesity is becoming the norm.

“In my lectures, I show a clip of ‘Soul Train’ – the Soul Train line. Number one, they’re skinny, compared with the people in the audience.  And when you look at people, you know, we’ve gradually become comfortable with obesity; so now, this is normal.

“When you go into the store, just get in the corner and look around, and you’d see a few things.  What’s in the basket and whose pushing the basket tells a story in direct correlation. Usually the people who are obese … overweight … their baskets are usually full and overflowing. They usually have cases of soda, potato chips and things like that.  And these people are usually impoverished so they are using their food stamps and whatever government subsidy they have to buy those things.

“Then you have another group that’s lean; their baskets are half full or full of perishables like spinach, collard greens, something from the deli department – that’s it.

“So we have embraced this kind of society where we are endorsing obesity. Look at some of the celebrities like Monique … and a big woman’s guide to a small-minded world … things like that.  So what she is doing is like, ‘you can be big in ‘stats’ and large and in charge.’

“But there are certain laws that you cannot break.  You may be able to run a red light and not get caught; steal a piece of candy and not get caught.  BUT YOU WILL NOT BE ABLE TO ABUSE YOUR BODY AND THINK THAT YOU WILL LIVE A HEALTHY LONG PRODUCTIVE LIFE.”

“One of the words that I’ve coined is ‘DENIABETES’; most of the people who have diabetes know thatthey have it but are in denial.  They are ‘DENIABETICS.’ ”

CONCLUSION

Diabetes and obesity are closely related.

Today, about one in three American adults is considered to be obese, but obesity is also becoming an increasing health problem globally. The good news is that even modest weight loss can improve or prevent the health problems associated with obesity.

There are many myths about diabetes that make it difficult for people to believe some of the hard facts – such as diabetes is not a serious and potentially deadly disease.  These myths can create a picture of diabetes that is not accurate and full of stereotypes and stigma.

The key to keeping diabetes in control is first having a good team. A good team usually consists of support from family and friends, a doctor, a nurse, an ophthalmologist, a podiatrist, a nutritionist and an endocrinologist.  Your team will help with creating meal plans, planning workouts or physical activities, scheduling when to check sugar and take medications, planning blood sugar goals and providing emotional support.

Anyone who has diabetes it or thinks they may have it is encouraged to get to a doctor for a physical, nutrition advice and a regiment that works for you.  In women, the signs to look for are excessive urination and thirst, fatigue or yeast infection. A study completed in the U.S. found that more American women are entering pregnancy with preexisting diabetes.