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Racial and ethnic minority communities hit hard by type 2 diabetes: Here’s what we can do

December 19, 2017

About the Author

photo of A. Enrique Caballero, MD

A. Enrique Caballero, MD, Contributor

Dr. A. Enrique Caballero is an endocrinologist, clinical investigator, and educator. He works in the Office for External Education at Harvard Medical School, directing the development of programs in the field of diabetes and related disorders … See Full Bio
View all posts by A. Enrique Caballero, MD


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Kelsey Baffour
December 20, 2017

Accepting and continuously highlighting the fact that racism is embedded in many components of American society, including healthcare, is essential to mitigating these cyclic health outcomes. Multiple chronic diseases (hypertension,diabetes, heart disease, etc) are more common in ethnic minorities such as African Americans and Hispanics/Latinos. While genetic factors play a role, behaviors and environment factors, as well as quality of care, play a role as well. Environments that limit the ability to carry out healthy behaviors such as outdoor physical activity due to lack of green space, facilities, safety, and cleanliness already put an individual at a disadvantage. Additionally, these neighborhoods may also have an abundance of fast food restaurants and corner stores, but a lack of grocery stores with affordable fresh produce. These features are common in low-income communities which have been shown to be mainly populated by minorities. This, in combination with the issue mentioned in regards to quality of care for minorities only exacerbate the issue.

Efforts must be taken in improving the infrastructure of these communities and in improving the attitudes of healthcare providers and health policy makers. While infrastructure and the creation of health promoting establishments may be long term projects, individuals taking the time to address their own implicit bias or overt racism can yield instant improvements. There must be consistent coverage of the pervasiveness of racism in American society and how it impacts the quality of life of minorities. This in turn, threatens the public health outcomes of the U.S as a whole. By ignoring these truths or being willfully ignorant to them, we are encouraging the idea that it simply does not exist. Unfortunately, that mindset will not help the problem. It is time to become relentlessly aware.

Phyllis Mehlman
December 25, 2017

My husband has had many heart surgeries and a stroke in 2003, which left him visually impaired. He had 4 stents and a defibulator, and now need a new battery and it made into a Pacemaker within the early part of 2018. when the cardiologist at Scripps thinks he is ready. He also has Water on the Lung, which the urologist does not want to operate on since it is too dangerous, and an enlarged prostate. He was pre-diabetes for years until criteria changed and he was diagnosed with Diabetes 2. He exercises and watches his diet. He is 79 years old and now cannot walk nearly as much as he used to do in the walking club, and only can walk for 2 blocks without having to stop and find a bench. He recently was diagnosed with Brittle Diabetes, and his numbers were a high of 523 to the usual very low numbers of 56 to 75, most days by late afternoon, or even before lunch. After speaking with the Diabetes Educator at Scripps Anderson Pavilion, in S.D. she told me to give him more snacks, every 2 hours of a protein and sweets. He sweats profusely on the forehead and scalp when the numbers are so low. WE have gone out to diner two nights in a row, and he had unsalted peanuts and fruit before leaving the house. In just over an hour of getting to the restaurant, he started sweating profusely. He had candy on him, and I gave him some sweet coleslaw and red peppers from my platter, which slowed it down a little. Then I got my free Birthday treat, one night a chocolate mouse and the next night mud pie, with whipped cream, and chocolate base, drizzled in chocolate syrup. We shared some and brought the rest home and put in our freezer. This morning, after all that sugar, and a tangerine and sliced almonds before he went to sleep, his number was 120, a great number. Yesterday morning, after the chocolate moose, with whipped cream and strawberry slices, and later melon slices and hot tea, and then unsalted nuts and a tangerine before bedtime, his number was 140, also very good after all that sugar. Do you think he is appropriate for an insulin pump? I was told that he could go into Insulin Coma with his low blood sugar numbers within 3 hours and need to watch him closely. I have been his caregiver since 2003 and try my hardest to follow all the instructions and read about everything in medical magazines about Diabetes 2, but never saw anything about Brittle Diabetes or Insulin Coma. Can you offer me any advice on what needs to be done next, since it is very scary when he starts sweating.
Thanks very much. I look forward to your reply promptly. Happy Holiday.
Phyllis Mehlman

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