Diabetes in African Americans may be in part a consequence of slavery

Medical folk have wondered for years why some racial groups have a greater tendency for diabetes than other groups. Recently a University of Carolina study found for African Americans diabetes is in the genes related to their history.

African Americans are considered to be among the most likely group of individuals to have diabetes.  The question of genetics vs diet is one of those issues that has been asked many times.  Often when people see someone who is overweight, then is told that person has diabetes, the assumption is that the individual has the disease because he or she has not been compliant with dieting methods or has been careless with eating.

Research, however, has examined diabetes in African Americans and found genetic factors related to slavery has played a key role in their having a higher proportion of diabetes in the group than those people in the general population.

Scientists considered a number of factors for racial disparities, including cultural patterns. But researchers at the University of North Carolina at Chapel Hill School of Medicine observe that inherited genetic variations exist between whites and blacks in the United States. This leads African Americans to have a less effcient metabolism of glucose. It presents them with the predisposition to diabetes.

Researchers looked at blood samples taken from both black and white patients undergoing treatment in the cardiac catherization lab. Those with problems in glucose metabolism were found to be more frequently of African-American descent than white.

“We found gene expression profiles that suggest that carbohydrate metabolism should be different in the African-Americans in our population compared to Caucasians,” said Cam Patterson, M.D., chief of cardiology and director of the McAllister Heart Institute at UNC.

Why does this happen? Scientists hypothesize by looking at the history of certain populations observing the movement of African populations to environments outside of their countries of origin. Their observations suggest the problems arose from response to an environment where food was scarce and diet significantly different than that consumed by whites.

Cam Patterson, M.D., chief of cardiology and director of the McAllister Heart Institute at UNC. said with respect to this hypothesis “In essence, although African populations moved geographically as they came to the United States, their genes retained a pattern more suited to their ancestor’s home, becoming maladaptive as African populations adopted a Western diet,” Patterson explained.

This controversial finding isn't a first since years ago researchers also found genetic variations in the same population with respect to red blood cells. They found G6PD deficiency, most common in African American males, evolved in some groups to protect them against malaria.

Patterson went on to say about the current findings,
“This study raises the question, are there other examples of groups of gene changes that might be protective under some environments or nutritional scenarios, and maladaptive under others? The practical value of this is providing a tool for looking for these sorts of things. If we really are going to be serious about personalized medicine, we can’t ignore the value of this type of knowledge."

These findings, coming as they do from reflections on the history of the population of African Americans, looks at geographic dislocations. An examination of historical resources finds considerable literature on the subject of the consequences socially, culturally and politically on the African American people, especially during the period of slavery. Now scientific findings point the way to the inclusion of genetic variables as a consequence of the transplantation of large numbers of African Americans to environments uniquely different from where they originated.

But as the dislocation of blacks is seen as an underpinning of diabetic factors, that same dislocation brought new diseases to European populations for which Africans had inherited immunity. Malaria was one of those diseases, but there were others according to experts. In looking at the spread of malaria by mosquitoes these experts observe how genetic factors played a part in impacting the health and culture of vast numbers of people, resulting in the death of many more Europeans than many of the wars of the same period.

Genetic factors related to disease and the study of history and how it is interwoven with science continues to fascinate scientists, as researchers declare, and raises issues of how migrations from one's country of origin might impact how one's ancestors are able to deal with the new environment as this study has done. It represents how dislocations of an entire people can affect generations of their ancestors.

Tired, sleepless, angry, depressed? You might be diabetic

[caption id="attachment_14077" align="alignleft" width="300"] insulin pump for diabetes[/caption]

Carol Forsloff - As a diabetic, diagnosed with the disease at age 66, I was surprised and saddened when I heard my doctor describe my condition, then learned over time about its negative impact from experience and research.  The progression of the disease is what makes diabetes insidious, difficult to manage and sometime leads to early disability or death; and the understanding of what that progression means could change medical costs and the human toll that diabetes takes on individuals and families.

Diabetes is described as a progressive disease by the medical profession.   New treatments hold promise for reducing effects of the disease and even its potential onset.  By the time an individual is diagnosed with diabetes, however, the individual often has already had years of suffering its consequences.  Family and friends can be included in that suffering as well, because diabetes negatively influences behavior and mental functioning as well as physical conditions.

Despite the fact there is evidence doctors have known for three hundred years that diabetes can influence emotions, most people think only about how it relates to sugar intake and what the physical issues might be in relationship to the disease.  We read about heart attacks, stroke, blindness, amputation, and other disabilities as well as dramatic weight gain and loss, but seldom do we learn about how diabetes affects feelings, behaviors and attitudes.

That angry man in line at the grocery store may be experiencing a “sugar episode.”  Research has shown that Type A individuals have higher glucose levels than the “B” personality types.  As the diabetes disease progresses slowly over time, it can begin to influence emotions before the diagnosis.  Behavior of the diabetic is often misunderstood by others, as we might respond negatively to that angry man at the grocery store as simply being impatient and self-centered.  But anger, depression and stress are exacerbated by problems with glucose control, even before a formal diagnosis of the diabetes.   After the diagnosis, sufferers of the disease often drift further into depression, especially as the body changes and medical concerns increase.  The manifestation of that depression is often the depression turned inside out to anger.

Many diabetics don’t know they have the disease because for some people the symptoms go unnoticed for many years or are diagnosed as evidence of some other condition that might be short-term and unrelated to the disease itself.  My doctors diagnosed me as having a rheumatoid-type condition because of complex muscle aches and fatigue.  Flakey skin was a dermatologist’s concern, with prescriptions for various ointments and lotions to calm infected areas on scalp and face.   Falling asleep after meals was disregarded entirely as a symptom of nothing more than doing too much.  Frequent infections, especially after surgeries, simply were treated episodically as opposed to viewing them as early symptoms of diabetic progression.  Some of these conditions started in my early twenties, causing infected nails, unexplained fatigue, and a raft of medical conditions, now seen as part of the progressive disease of diabetes but viewed at the time by friends, family and physicians simply as behavior related to some situation or event.  But these are the early signs of the disease, especially when they become progressively worse, even with care.

Unless someone has a family member with diabetes, the disease may not be acknowledged as a possibility when certain symptoms develop.  In my case,  the catalyst for diagnosis came during a period of severe headaches and fainting.  By that time it was clear from tests that I had diabetes.  There was no record of a family member having the disease, until an investigation found a close relative had died, exhibiting for years the symptoms I have had.   That relative was my Mother, an individual with a mental health condition that overrode almost every other medical evaluation made, so her symptoms were simply treated at the time, but not as symptomatic of the disease of diabetes.

Experts tell us those folks who observe changes in physical or mental condition, even small ones over time,  can find it helpful to begin prevention of diabetes early by beginning dietary changes and having a fasting blood sugar test at regular intervals.  It is that prevention, or early detection, that makes a difference in how an individual will fare with the disease.  It means that even those folks without a family member having the disease, or even with symptoms that may seem simple at the time, need to be examined by the patterns that present not just at the time of a doctor visit but over a period of time. as potentially predictive of the progression of disease.  Interrupting that progression early can make a difference both in health care costs and the welfare of the diabetic in the long term.

Type I diabetes: new research on prevention

[caption id="attachment_5908" align="alignleft" width="270" caption="Main symptoms of diabetes - wikimedia commons"][/caption]

Carol Forsloff - New research reported by Diabetes magazine reports that an oral or nasal administration of insulin can protect against the development of Type I diabetes.

52 adults were tested over a period of 12 months, some given a placebo and others nasal insulin.  The results showed that the nasal spray provided protection against the development of Type I by inducing an immune tolerance to insulin.

Gizmag quotes Professor Len Harrison of the Walter and Eliza Hall Institute in Melbourne, Australia as saying,  "The results showed that the vaccine allowed the immune system to restore immune tolerance to insulin.  When subsequently given insulin by injection, the participants who had received the nasal insulin vaccine were found to be desensitized to insulin."

According to the American Diabetes Association Type I diabetes is an early onset disease diagnosed in children and young adults and that is characterized by the body’s inability to produce insulin.  Insulin is a hormone required for sugar conversion and turning it into the kind of energy the body needs to live healthy life.

Those people who have early onset diabetes require lifelong insulin treatments, so this new research is considered a major breakthrough in prevention of the disease.