Nov 27, 2007

National Diabetes Month, Weeks 4 & 5: At-Risk Populations and Youth

Tara Dairman

As November draws to a close, so does National Diabetes Month, which has been devoted to increasing public awareness about the management and prevention of diabetes. Each week so far has focused on a different "face" of diabetes (see previous blog entries "National Diabetes Month, Week 1: Caregivers," "National Diabetes Month, Week 2: Employees," and "National Diabetes Month, Week 3: Around the World"). The final two weeks of the month are focused on at-risk populations (Week 4) and youth (Week 5).

Various studies have shown that several specific populations in the United States have an increased risk of developing diabetes. According to data from the U.S. Centers for Disease Control and Prevention (CDC), compared to white Americans of a similar age, Hispanic/Latino Americans are 1.5 times as likely to have diabetes; African-Americans are 1.6 times as likely to have diabetes; Native Hawaiians and Asian Americans are about twice as likely to have diabetes; and Native Americans and Alaska Natives are more than twice as likely to have diabetes. And these numbers are on the rise—the American Diabetes Association predicts that one in two people in these racial and/or ethnic groups born in 2000 will eventually develop diabetes if current trends continue.

Why the disparity in diabetes rates among different ethnic groups? Some studies have pointed to possible genetic differences among the groups; others have focused on socioeconomic factors; and still others have highlighted differences in lifestyle factors, such as diet and exercise, among the groups. In fact, DiabetesSelfManagement.com looked at multiple studies about ethnicity, chronic disease, and lifestyle factors earlier this year in the blog entry "How Much of a Risk Factor is Ethnicity?"

One recent study, published in October in the journal Diabetes Care, looked at differences in HbA1c levels among different ethnic groups. The study participants had impaired glucose tolerance (a precursor to Type 2 diabetes), not diabetes. After controlling for many factors likely to affect people's HbA1c levels—such as age, sex, education, blood pressure, body fat, red blood cell levels, insulin resistance, fasting blood glucose levels, and post-meal blood glucose levels—the researchers found that Hispanic/Latino Americans, Asian Americans, Native Americans, and African-Americans had higher HbA1c levels, as a group, than white Americans. The researchers concluded that these results "might reflect differences in biology and the way hemoglobin is glycated across those groups" rather than differences in medical care or blood glucose control.

Another recent study compared death rates among young white Americans and young African-Americans with diabetes. The study, published on November 16 by the CDC, analyzed deaths related to diabetes in children and teenagers between 1979 and 2004. It found that African-American children and teenagers were consistently more likely to die from diabetes than white youths, with death rates in African-American youths increasing significantly from 1994 to 2004, while rates remained steady in white youths. Because most of the diabetes-related deaths were due to hypoglycemia and ketoacidosis, both considered preventable complications, the researchers concluded that the disparity between the groups might be due to inequalities in diagnosis and management of diabetes.

Clearly, more research is needed to determine what steps will best help different groups of people control and prevent diabetes. In the meantime, however, learning as much as you can about diabetes management is key to staying on top of the condition. DiabetesSelfManagement.com offers many resources that can help children, teenagers, and their caregivers understand and manage diabetes—check out our "Kids & Diabetes" articles, which are full of information about treatment and advocacy for kids with Type 1 and Type 2 diabetes.

National Diabetes Month may be at an end, but the faces of diabetes it has highlighted deserve recognition and support year-round. Has your awareness of any particular diabetes issue been boosted this month? Share your thoughts with a comment below.

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