Diabetes Control Falling Short Among African Americans

Behavioral changes and improved preventive measures are required to rein in poorly controlled blood sugar and cholesterol in African Americans with diabetes, according to a study published in the October issue of the American Journal of Preventive Medicine.

Participants in the study had access to similar levels of diabetes care as shown in previous national studies, but levels of diabetes control and self-management behaviors were low, says lead author Edward W. Gregg, Ph.D., an epidemiologist with CDCs diabetes prevention and control program. Poor control of blood sugar and cholesterol puts people with diabetes at increased risk for complications such as kidney, eye and heart disease as well as limb amputation.

These findings indicate a need to understand barriers to achieving and implementing good glycemic and lipid control among African-Americans with diabetes, he says.

The study included 625 people from Raleigh and Greensboro. They averaged about 59 years old, and 65 percent were women. All were interviewed at home about their health habits and self-management activities. Some also gave a blood sample. Residents in the community had received self-management and diabetes education materials as well as health promotion counseling.

Gregg and his colleagues found that 70 percent to 80 percent of study participants had received some of the recommended annual exams, but only 18 percent reported having them all. Fewer than half said they had the important blood test that checks for levels of glycosolated hemoglobin.

In addition, 31 percent reported having regular physical activity, while 41 percent engaged in daily self-monitoring of glucose levels, and 25 percent said they had never conducted such monitoring. Forty-percent of the men and 58 percent of the women were obese, and 25 percent of the total group were smokers.

Among the 383 study participants who gave a blood sample, glucose levels were acceptable in only 20 percent. Cholesterol levels were too high in at least half, and nearly 25 percent had total cholesterol readings over 240, the point at which medication is usually recommended.

Levels of diabetes preventive care services such as screening tests for eye and foot problems were similar to national estimates obtained from previous studies, but there were other preventive services that were lacking, such as tests for levels of glycosylated hemoglobin. Also few of those surveyed had received education on how to manage their diabetes.

In summary, the receipt of preventive care services during 1997 among African-Americans in these communities was comparable to national estimates, but the benefits of this care, as evidenced by glycemic and lipid control, was often inadequate for good health and to prevent future complications, says Gregg.

The American Diabetes Association recommends that all people with diabetes receive regular medical care, including cholesterol, eye and foot examinations. In addition, people are urged to frequently monitor their glucose levels frequently, engage in frequent exercise, keep their weight under control and refrain from smoking.

Source: Center for the Advancement of Health