Type 1 vs. Type 2 Diabetes: Which Is Actually Worse For Blacks?

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A woman testing her blood sugar

According to the CDC, nearly 30 million Americans have diabetes. That figure represents over 9% of the population, or 1 in 10 people.

Sadly, the diabetes epidemic is hitting the African American community hardest. African Americans are twice as likely to be diagnosed with type 2 diabetes as non-Hispanic whites. In addition, they are more likely to:

• Be hospitalized for diabetes-associated illnesses.
• Face end-stage renal disease related to diabetes, as compared to non-Hispanic white men.
• Die from diabetes-associated illnesses.

But why?

According to the American Diabetes Association, in order to better understand your diabetes risk factors (if you don’t have diabetes), and to gain greater control over your diabetes management plan (if you do have diabetes), it’s essential to gain a better understanding of what diabetes is.

What is Diabetes?

According to Mayo Clinic, diabetes mellitus refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel.

If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems. While there is no cure for diabetes, it can be managed.

Chronic diabetes conditions include:

• Type 1 diabetes
• Type 2 diabetes
• Prediabetes
• Gestational diabetes

Type 1 Diabetes

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy.

According to Mayo Clinic, various factors may contribute to type 1 diabetes, including genetics and exposure to certain viruses. Although type 1 diabetes typically appears during childhood or adolescence, it also can develop in adults.

According to Mayo Clinic, some of the risk factors for type 1 diabetes include:

Your genes: Although the exact cause of type 1 diabetes is unknown, genetic factors likely play a role. Your risk of developing type 1 diabetes increases if you have a parent or sibling who has type 1 diabetes. Environmental factors, such as exposure to a viral illness, also likely play some role in type 1 diabetes.

Damaging immune system cells that make autoantibodies: Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes autoantibodies. If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But, not everyone who has these autoantibodies develops type 1.

Dietary factors: A number of dietary factors have been linked to an increased risk of type 1 diabetes, such as low vitamin D consumption; early exposure to cow’s milk or cow’s milk formula; or exposure to cereals before 4 months of age. However, none of these factors has been shown to cause type 1 diabetes.

Race: Type 1 diabetes is more common in whites than in other races.

Geography: Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes.

Type 2 Diabetes/Prediabetes

According to Mayo Clinic, the far more common type 2 diabetes occurs when the body becomes resistant to the effects of insulin or doesn’t make enough insulin. Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body’s main source of fuel.

With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn’t produce enough insulin to maintain a normal glucose level. Untreated, type 2 diabetes can be life-threatening.

Prior to the onset of type 2 diabetes, many people are affected by a potentially reversible diabetes condition called prediabetes, where blood sugar levels are higher than normal, but not high enough to be classified as diabetes.

Researchers don’t fully understand why some people develop prediabetes and type 2 diabetes and others don’t. However, they do agree that certain factors increase the risk, including:

Weight: The more fatty tissue you have, the more resistant your cells become to insulin.

Inactivity: The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. Exercising less than three times a week may increase your risk of type 2 diabetes.

Family history: Your risk increases if a parent or sibling has type 2 diabetes.

Race: Although it’s unclear why, people of certain races — including blacks, Hispanics, American Indians and Asians — are at higher risk.

Age: Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults.

Gestational diabetes: If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes later increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes.

Polycystic ovary syndrome (PCOS): For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.

High blood pressure: Having blood pressure over 140/90mm Hg is linked to an increased risk of type 2 diabetes.

Abnormal cholesterol levels: If you have low levels of high-density lipoprotein (HDL), or “good,” cholesterol, your risk of type 2 diabetes is higher. Low levels of HDL are defined as below 35 mg/dL.

High levels of triglycerides: Triglycerides are a fat carried in the blood. If your triglyceride levels are above 250 mg/dL, your risk of diabetes increases.

Can researchers really grow an artificial pancreas to end diabetes?

Mayo Clinic researchers and scientists have developed an “artificial pancreas” to monitor blood sugar and deliver the appropriate dose of insulin to people with type 1 diabetes. If the device tests well in clinical trials, it could be a boon to those people burdened by having to constantly assess diet, activity and insulin dosage.

Together, both types of diabetes affect about 24 million Americans. Diabetes is one of the biggest drivers of U.S. health care costs, with 1 out of 3 Medicare dollars spent on diabetes-related care. In partnership with the University of Minnesota, Mayo has launched a decade-long research effort to end diabetes.

Mayo Clinic’s Department of Endocrinology, which treats and researches diabetes, is yet again ranked as the #1 endocrinology center in the United States. For more information on diabetes, visit Mayo Clinic at www.mayoclinic.org.

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