Diabetes is the 7th leading cause of death for the nation, but it represents the 5th leading cause of death for African Americans. Placing greater emphasis on diabetes self-management (DSM) for those diagnosed with type 2 diabetes, and emphasizing prevention in at risk individuals, are key factors for reducing diabetes prevalence. Prevention strategies include controlling risk factors such as diet, physical activity, and weight.
A study by Utz et al. (2008) identified many of the challenges and barriers that must be overcome to provide much needed diabetes self-management education (DSME) and prevention services in the African American population, particularly in rural settings. Primary barriers include poor health care service availability, a minimal number of trained specialists in rural areas, cost of care, lack of knowledge about accessing services, complex diabetes self-care instructions, and shame or stigma associated with diabetes. The next phase of the study addressed the researchers' main goal of assessing if an individual educational approach or culturally relevant group intervention worked best in rural African American populations. The study revealed that group DSME led to greater compliance with preventive behaviors such as diet and exercise, as compared to individual intervention. Additionally, group participants exhibited a greater level of confidence in their ability to manage their diabetic condition (Utz et al., 2008). For health educators, the results of this study revealed potential obstacles to diabetes education, while further illustrating the importance of determining the best setting and method of delivery for reaching a priority population with an intervention.
References
Centers for Disease Control and Prevention (2012). Black or African American populations: 10 leading causes of death for African Americans in 2009. Retrieved from http://www.cdc.gov/minorityhealth/populations/REMP/black.html
Utz, S. W., Williams, I. C., Jones, R., Hinton, I., Alexander, G., Yan, G., ... Oliver, M. N. (2008). Culturally tailored intervention for rural African Americans with type 2 diabetes. The Diabetes Educator, 34, 854-865. doi:10.1177/0145721708323642
The Healthy People 2020 initiative posts emerging issues in Diabetes that are considered as co-morbidity conditions of Type 2 Diabetes. These are: “cognitive impairment, incontinence, fracture risk, and cancer risk and prognosis” (Healthy People 2020, 2012, para. 10). Although, these are listed for all persons with Type 2 Diabetes, they do point out that the risks for certain ethnic groups may be higher than for other races. Healthy People 2020 continues with a discussion of some of the process indicators (foot exams, eye exams and blood tests) that may not be sensitive enough to determine the needs of the individual to be able to reduce these co-morbidities (para. 15). New indicators are being researched and new research studies are being proposed to determine the best way to identify high-risk individuals.
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Healthy People 2020. (2012). Diabetes. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=8
The National Diabetes Prevention program (2012)is sponsored by the Centers for Disease Control and Prevention(CDC) and has the United Health Group and the YMCA as partners in the program. The program utilizes a lifestyle coach to provide an education and exercise program over 16 weeks. The program has shown that increasing exercise to at least 150 minutes per week enabled the participants in the program to lose 5 to 7% of their starting body weight. That translates into reducing the risk of developing type II diabetes by 58%. That is a significant figure when you consider that over 40 million Americans are considered to have pre-diabetes symptoms (PubMed Health, 2012). As an inidividual with diabetes in my family, I try to keep up with things that I can do to prevent diabetes. Providing education to people as to the severe consequences that can result from diabetes, and the behaviors that can be initiated to prevent the onset of diabetes is extremely worthwhile and needed. Thanks for providing great nformation to remind people about this potential killer disease.
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Centers for Disease Control and Prevention. (2012). National Diabetes Prevention Program. Retrieved from www.cdc.gov/diabetes/prevention/about.htm
PubMed Health. (2012). Diabetes. Retrieved from www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194