Type 2 diabetes is a preventable, chronic condition that, if not managed, can cause complications — some of which can be life-threatening.

Complications can include heart disease and stroke, blindness, kidney disease, amputations, and high-risk pregnancy among other conditions.

But diabetes can hit Black women particularly hard. Black women experience a higher rate of diabetes due to issues such as high blood pressure, obesity, and sedentary lifestyles.

According to the U.S. Department of Health and Human Services, Office of Minority Health, the risk for diagnosed diabetes is 80% higher among non-Hispanic Blacks than their White counterparts.

In addition, women with diabetes are more likely to experience pregnancy-related complications and are at greater risk than men with diabetes for heart-attack deaths and blindness.

The Black Women’s Health Imperative (BWHI) is committed to helping people learn how they can reduce these risks.

BWHI runs CYL2, a lifestyle program that offers coaches to teach women and men across the country how to change their lives by eating differently and moving more.

CYL2 leads the way in helping people to shed pounds and to take steps to prevent diabetes, heart disease, and many other chronic conditions. It’s part of the National Diabetes Prevention Program led by the Centers for Disease Control and Prevention (CDC).

Since November is National Diabetes Month, we went to Angela Marshall, MD, who is also board chair of the Black Women’s Health Imperative, with some key questions about diabetes prevention.

How do you find out if you have or are at risk for type 2 diabetes?

Doctors regularly screen for diabetes during physicals where blood work is done. The fasting blood sugar level is included in the most basic blood work panels. A level of 126 mg/dL or greater indicates the presence of diabetes, and a level of between 100 and 125 mg/dL usually suggests prediabetes.

There’s another blood test that’s often done, the Hemoglobin A1c, which can also be a helpful screening tool. It captures the 3-month cumulative blood sugar history for the individual.

So many Black women are living with type 2 diabetes but don’t know they have it. Why is that?

Many Black women are living with type 2 diabetes but do not know that they have it. There are several reasons for this.

We have to be better about taking care of our health more holistically. For example, we often are up to date on our pap smears and mammograms, but, sometimes, we’re not as vigilant about knowing our numbers for blood sugar, blood pressure, and cholesterol.

We should all prioritize making appointments with our primary care providers to take care of the rest of us.

The other part of this issue is denial. I have had many patients who absolutely rebuke the ‘D’ word when I tell them that they have it. This has to change.

I think there are situations where the communication from the healthcare providers needs to improve. I often see new patients who are absolutely surprised to hear that they have had diabetes and their previous physicians never told them. This also has to change.

Is diabetes or prediabetes reversible? How?

The complications of diabetes and prediabetes are completely avoidable, although once you’re diagnosed, we continue to say that you have it. The best way to ‘reverse’ it is with diet, exercise, and weight loss, if appropriate.

If a person is able to achieve completely normal blood sugars, we say that the person is ‘at goal,’ versus saying that they no longer have it. Surprisingly, for people with diabetes, sometimes all it takes is a weight loss of 5% to achieve normal blood sugars.

What are three things one can do to prevent diabetes?

The three things one can do to prevent diabetes are:

  1. Maintain a normal weight.
  2. Eat a healthy, well-balanced diet that’s low in refined sugars.
  3. Exercise regularly.

If you have family members who have diabetes, are you absolutely going to get it?

Having family members with diabetes does not mean that you will absolutely get it; however, it increases the likelihood of getting it.

Some experts believe that individuals with a strong family history should automatically consider themselves ‘at risk.’ It never hurts to follow the recommendations that we give to people with diabetes.

Advice like eating a healthy diet, exercising regularly, and getting regular checkups is recommended for everyone.


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The Black Women’s Health Imperative (BWHI) is the first nonprofit organization founded by Black women to protect and advance the health and well-being of Black women and girls. Learn more about BWHI by going to www.bwhi.org.