Researchers believe that genetic, environmental, socioeconomic, physiological, and behavioral factors are all contributors to this health disparity, notes the National Institute of Health (NIH). According to a past article, in the United States, the risk of diabetes is 77 percent higher among non-Hispanic Black Americans than it is in non-Hispanic white Americans. The data suggests that Black people tend to experience more diabetes-related complications, like diabetic retinopathy and neuropathy, than non-Hispanic white Americans. Those who are Black are also 2.6 times more likely to have end-stage renal disease caused by diabetes, reports the American Diabetes Association (ADA). RELATED: How to Help Prevent Kidney Disease When You Have Diabetes While some of the risk factors for type 2 diabetes in Black people can be beyond an individual’s control, being educated about the things you can change may help reduce the risk of the disease. An article published in Diabetes Care confirmed that genetics play a role in a person’s chances of getting type 2 diabetes. The article notes that the risk of developing type 2 diabetes is 40 percent when one parent has the disease, and 70 percent when both parents have diabetes. But genetics aren’t the only thing that can affect diabetes risk. RELATED: How Diabetes Risk Changes When You Have a Parent With the Disease
Why Dietary Choices Matter When It Comes to Preventing Type 2 Diabetes
Regardless of race, ethnicity, or sex, achieving or maintaining a healthy body weight matters when it comes to preventing diabetes. According to the American Heart Association (AHA), among non-Hispanic Black people ages 20 and older, 63 percent of men and 77 percent of women are overweight or have obesity. “Excess weight on the body can lead to insulin resistance, which means blood glucose levels will increase,” says New York City–based Dacia Bryant, CDCES, founder of A ONE C LifeBox, a digital coaching and support platform that equips Black and Hispanic people with the tools and information to manage their diabetes more effectively. Insulin resistance can exist alone, but this condition increases the risk for type 2 diabetes, according to an article published in December 2019 in StatPearls. While genetics do play a role in weight, for Black Americans, certain unhealthy yet traditional dietary choices may increase the chances of obesity. “Our diets tend to be high in carbs like mac and cheese and [white] rice, but low in things that can help control blood sugar and weight, like fiber and green leafy vegetables,” Bryant says. Understanding what makes for a diabetes-friendly diet — and which traditions don’t fall under that umbrella — may help you achieve a healthy weight, as well as prevent or delay diabetes from progressing. RELATED: 7 Healthy Meal Tips for Type 2 Diabetes
How Access, Discrimination, and Stress Play a Role
Past research has suggested that Black and Hispanic adults with diabetes in the United States have worse glycemic and blood pressure control than other groups of Americans, and that there is growing reason to believe that race and ethnicity may influence individuals’ diabetes care, even for those people who are fully insured. The study found that poor (or lack of) physician support, as well as not perceiving the condition as serious, and not having knowledge of how to treat diabetes, contributed to higher rates. In addition to a lack of education, the elevated risk of diabetes for Black Americans may be influenced by a lack of neighborhood resources that support exercise and proper nutrition, suggested a study published in November 2014 in the American Journal of Public Health. “A lot of the answers point to social determinants of health as contributors to the disease,” says Tiffany Gary-Webb, PhD, associate professor of behavioral and community health sciences at the University of Pittsburgh (who was not involved in the November 2014 study). “For example, aspects of residential environment, particularly in neighborhoods with more poverty, contribute to these disparities through lack of access to healthy food. [These] ‘food deserts’ and ‘food swamps’ are places saturated with fast food, convenience stores, and unhealthy foods,” she says, adding that poor access to exercise facilities or safe outdoor areas to exercise may also be contributing factors. In the same vein, stress and emotional distress play a role in diabetes risk and management. In fact, past research suggests that stress can contribute to both the onset and progression of diabetes. “African Americans experience increased stress due to discrimination, institutional racism, and many other factors,” Dr. Gary-Webb explains. “Researchers are studying what this increased stress does to the body — for example, whether it leads to higher levels of the stress hormone cortisol or accelerated cellular aging.” RELATED: Can Stress Trigger Type 2 Diabetes?
6 Ways to Prevent or Improve Your Management of Diabetes
While factors such as racism and discrimination, as well as access to healthy food, education, and exercise are broader societal issues beyond most individuals’ direct control, many factors — even genetics — are not. “Diabetes doesn’t have to be your destiny,” says Ginn-Meadow. Here are six ways to help reduce your risk of diabetes:
1. Get Screened
During your annual doctor’s visit, ask to be screened for prediabetes and diabetes. Simple blood test options include A1C, and fasting and glucose tolerance, notes the Mayo Clinic. “Typically, if you have a parent or a sibling with diabetes, you are at risk,” says Ginn-Meadow, advising those in this group who are over age 40 to get screened. Also, keep in mind that the standard A1C test may not be enough to receive a diagnosis in Black Americans. According to a September 2017 review published in PLoS One, about 11 percent of Black Americans contain a gene variant that may make the A1C test ineffective. If all signs point to diabetes, ask your doctor for another test, such as a fasting or glucose tolerance test, to check for diabetes. RELATED: A1C Test May Miss Diabetes in Some Black Americans, Study Finds
2. Break With Unhealthy Traditions
In adults with diabetes, the most common causes of death are heart disease and stroke, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD). And unfortunately, Black Americans have an elevated risk for these diseases, warns the AHA. “We all love Sunday dinner, and we know what’s on the table,” Ginn-Meadow says, “but some of our traditions of how we prepare food can negatively impact our heart.” Instead of frying your food, Ginn-Meadow recommends baking, broiling, and grilling fish and lean meats, as well as using peanut oil instead of shortening, and cutting back on salt.
3. Watch Your Sugar Intake
“The first thing I tell my clients to get rid of is sweet tea and soda, and to drink more water,” advises Ginn-Meadow. “This small step will help you manage your blood sugar better.” According to a June 2020 report out of the Rudd Center for Food Policy & Obesity at the University of Connecticut, called Sugary Drinks Facts 2020, beverage companies continue to disproportionately target advertising for these beverages to Black and Hispanic youth, which likely contributes to the higher rates of obesity, type 2 diabetes, and heart disease in these groups. Metabolically, sugary drinks are insidious. As a past article noted, sugary beverages are high in added sugar and don’t offer nutrition, leading to weight gain and increasing cravings for sugary products. Independently, the high refined carbohydrate content increases the risk of insulin resistance, inflammation, and impaired B cell function, which is a combination of factors that sets the stage for type 2 diabetes. In addition to cutting back on sugary drinks, Ginn-Meadow recommends adding half a plate of veggies to each meal and eating more whole fruits instead of juice. For example, she says, “Eat an orange instead of drinking orange juice.” The reason: Whole fruits contain more fiber than juice, which has been stripped of this nutrient. Most Americans do not get enough fiber (between 21 and 38 grams, depending on sex, per the Mayo Clinic). Yet this nutrient may be protective against metabolic disease including diabetes, suggested a meta-analysis published in December 2017 in Nutrients.
4. Get Moving
According to the Diabetes Prevention Program, you can prevent or delay the onset of type 2 diabetes by losing 5 to 7 percent of your body weight. You can also increase your chances of weight loss by following a low-fat diet and exercising for 150 minutes a week, the program found. Exercise is particularly beneficial for people at risk for type 2 diabetes because it helps increase insulin sensitivity, thereby helping the body use glucose more efficiently, noted an article published in March 2017 in BMJ Open Sport — Exercise Medicine. In fact, a review published in June 2016 in the World Journal of Diabetes cited prior research that suggested walking for 30 minutes each day could reduce type 2 diabetes risk by 50 percent. If you’re new to exercise, Ginn-Meadow recommends taking baby steps. “You don’t have to go to the gym and pump iron,” she says. “Walk with a girlfriend during your lunch break.” Similarly, take the stairs instead of the elevator, or park farther away from the door in the grocery store parking lot.
5. Don’t Smoke, or Quit if You Do
According to the CDC, smokers are 30 to 40 percent more likely to develop type 2 diabetes than those who don’t have this habit. Smoking increases inflammation and disrupts the way your cells function, potentially interfering with how your body uses insulin, notes the U.S. Food and Drug Administration (FDA). If you do develop type 2 diabetes, continuing to smoke can further elevate your risk for diabetes complications such as stroke and heart disease, per the CDC and FDA.
6. Seek Preventive Care
Although access to quality medical care and finding a positive doctor-patient relationship is challenging for many Black Americans, Ginn-Meadow says that, if possible, having regular checkups with your primary care physician, eye doctor, dentist, and foot doctor can help you spot warning signs sooner, reduce your risk for diabetes, or increase your chances of getting the right treatment if you end up receiving a diagnosis. RELATED: 10 People Who Can Help You Manage Type 2 Diabetes
One Last Thing About Lowering Your Risk of Diabetes
Although diabetes is a real threat among Black Americans, you can take steps to stay healthy and avoid the onset of this disease. Work with your healthcare provider to reduce your risk factors. A healthy diet, staying physically active, losing weight, and giving up bad habits like smoking can help keep your blood sugar within a healthy range and keep diabetes at bay. Additional reporting by Valencia Higuera.
