How Does Diabetes Affect Special Populations? (Cont'd)

To address these challenges, Dr. Sandra Black, an associate professor at the University of Maryland School of Medicine's Division of Gerontology proposes the following actions:

1. Diabetes must be acknowledged as a public health problem. Community interventions, including early screening and lifestyle change, are paramount and must be culturally appropriate.
    
2. Effective treatment and prevention programs must become standard clinical practice. Intensive diabetes management and improved glycemic control will minimize the impact of diabetes and lead to fewer medical costs, lower rates of complications, and greatly reduced mortality as a result of the disease.¹⁰²
    
3. Screening and interventions in the prediabetic years must become the norm. We need to increase screening among high-risk groups and institute culturally appropriate interventions that will enhance change in the prediabetic years.
    
4. Those groups at highest risk must be empowered to take control of their own health. Control of diabetes is a highly demanding endeavor, requiring substantial vigilance, lifestyle change, medication adherence, and motivation. Those who suffer from the disease are often those least prepared to deal with it. All people at risk for diabetes must be helped to develop the skills necessary to prevent or manage the disease.¹⁰³

The sections below discuss how diabetes affects specific groups of elders. The recent results of the Diabetes Prevention Program study provide encouraging news for all people at risk for diabetes, including elders of color. People at high risk for type 2 diabetes can prevent or delay diabetes with regular physical activity, healthy eating changes, and modest weight loss. Much can be done to prevent and manage long-term diabetes-related problems as well.

For specific strategies on addressing cultural competence and health disparities among older adults, see "Creating Culturally Sensitive and Effective Health Promotion Materials" and "Strategies for Promoting Physical Activity in Culturally Diverse Communities." Additional resources on health disparities and cultural competence are listed in a resource list developed by the American Society on Aging's Healthcare and Aging Network in partnership with Network of Multicultural Aging.

African Americans
American Indians and Alaska Native
Asian/Pacific Islander Americans
Hispanic/Latino Americans

¹⁰² Heart Outcome Prevention Evaluation Study Investigators. (2000) "Effects of Angiotensin-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High Risk Patients." New England Journal of Medicine 342:145-153.

¹⁰³ Black, S.A. (2002) "Diabetes, Diversity, and Disparity: What Do We Do With the Evidence?" American Journal of Public Health 92(4):543-548.