Dr. Lorraine Cole

(WOMENSENEWS)–Cases of Type II diabetes, which occurs almost entirely in adults, are on the rise for all Americans. African American women, however, are being hit particularly hard. Of the 15.7 million men and women diagnosed with all forms of diabetes more than half are women–and more than half of them are African American.

“The increase in diabetes rates has a lot to do with the rise in obesity, our sedentary lifestyles and the fact that people are living longer,” says Joanne Gallivan, director of the National Diabetes Education Program at the National Institutes of Health.

According to the Joslin Diabetes Center in Boston, adult men and women of all races are about eight pounds heavier than they were in 1985. In fact, one of every two Americans is overweight.

Ninety percent of people with Type II diabetes are overweight, according to Dr. Terry Maratos-Flier, chief of the section on obesity at the Joslin Diabetes Center. “Certainly that is no coincidence.”

Obesity rates for black women are particularly high. The Black Women’s Health Project, for example, reports that out of every 100 black women, 67 are overweight and 38 of those overweight women are obese. (The Joslin Diabetes Center says a person is considered obese when he or she is 20 percent or more above her or his ideal body weight.)

“Many people eat to self-medicate,” says Dr. Maratos-Flier. “They are using food to treat their depression, loneliness and anger.”

Diabetes is a disease in which the body does not produce or make proper use of insulin, a hormone that converts sugar, starches and other food into energy.

Type II, Adult Onset Diabetes, Accounts for 90 Percent of All Cases

Type I, or juvenile, diabetes primarily affects children and young adults. People with Type I diabetes must take daily insulin injections to survive. Cases of Type I diabetes are often attributed to genetics. The number of Type I diabetes cases totals around 5 to 10 percent of all diagnosed diabetes cases.

On the other hand, Type II diabetes accounts for more than 90 percent of all diabetes cases worldwide. And the numbers continue to rise. A report released by the U.S. Centers for Disease Control and the American Diabetes Association says that diabetes increased by a record 6 percent between 1998 and 1999. And the prevalence of diagnosed diabetes, including gestational diabetes (a temporary condition during pregnancy), increased 33 percent from 1990 to 1998, with the largest increase occurring among people aged 30 to 39.

If left untreated, Type II diabetes can lead to blindness, amputation of limbs, kidney disease, stroke and heart attack–all potentially deadly.

The issue of food is critical.

Medicating the blues with food and the need to rely on inexpensive food, often higher in fat and lower in nutrition–has potentially deadly consequences for black women.

“High-fat diets, super-sized portions and lack of physical activity are resulting in extremely high rates of Type II diabetes in black women,” says Leslie Curtis of Sisters Together, a program of the National Institute of Diabetes and Digestive and Kidney Diseases last October.

Black Women Over 55 More Than Twice As Likely to Have Diabetes.

The National Women’s Health Information Center reports that black women over 55 are almost twice as likely as white women to have diabetes. Diabetes affects African Americans, both women and men, at a rate nearly double that of white Americans. And the death rates for African Americans with diabetes are 2.5 times higher than for their white counterparts.

“In order to address this epidemic among black women, we must address psycho-social factors as well as diet and physical activity,” said Dr. Lorraine Cole, president of the Black Women’s Health Project, a Washington-based nonprofit organization. “We have to address issues around stress and body image.”

Groups like Sisters Together are doing just that. “We understand how difficult it is to modify lifelong habits,” says Dr. Griffin Rodgers, the deputy director of the National Institute of Diabetes and Digestive and Kidney Diseases and the grand marshal for the Sisters Together launch.

“This is precisely why we are not suggesting that African American women make changes overnight. What’s important is to take incremental steps toward becoming healthier. Big changes often start with a few small steps.”

The centerpiece of Sisters Together is a series of free publications designed to encourage black women of all ages to improve their health.

Changing Lifestyles, When Stressors Remain, Is Difficult

“Black woman face lifestyle stressors where food means a lot more than nutrition,” says Cole. “Food represents comfort and love, which makes it extremely difficult for many women to change lifestyle patterns.”

But these patterns must be changed. Studies show that African Americans diagnosed with Type II diabetes experience higher rates of at least three serious complications including blindness, amputation and kidney failure.

Complications from diabetes can be particularly devastating to black women, many of whom are less likely to have access to quality health care. For example, Medicare and Medicaid, the federal government’s two largest health care programs, may limit access to many of the health care services needed to manage diabetes. Medicare–the health program covering those over 65–covers glucose monitoring, testing strips, lancing devices and education but does not cover medication or insulin.

“Our health is the poorest on every health indicator and the worst indicator on every disease,” says Cole. “Black women’s health hasn’t reached the level of recognition of crisis that it deserves.”

Cole hopes that a study launched by The Black Women’s Health Project to develop a weight management program to address the needs of the Black community will curtail the diabetes epidemic.

But health care providers like Dr. Judy Sharpless, director of the Women’s Health Clinic at the Joslin Diabetes Center in Massachusetts, know that the diabetes epidemic will not be stemmed until Americans, black and white, make their health a priority.

A September 2001 study published in The New England Journal of Medicine confirms the bad news.

The study, Diet, Lifestyle, And The Risk of Type 2 Diabetes Mellitus in Women, states that half the cases of diabetes in the study could have been prevented by the combination of a healthy diet, regular exercise, abstinence from smoking and moderate alcohol consumption. “The challenge is to get that message to all of our communities.”

Siobhan Benet is content manager and a staff writer for Women’s Enews.

For more information:

National Black Women’s Health Project, Inc.:

Sisters Together: Move More, Eat Better:

American Diabetes Association:

Joslin Diabetes Center:


National Diabetes Information Clearinghouse:

Diabetes Public Health Resource:

Women’s Health Matters: Diabetes Health Centre:

To read the study Diet, Lifestyle, and the Risk of Type 2
Diabetes Mellitus in Women:

The New England Journal of Medicine:

WEnews Brief

Federal Court Rules Michigan School Sports Biased

GRAND RAPIDS, Michigan (WOMENSENEWS)–A Federal District Court ruled here that the state’s high school athletic association’s practice of scheduling its female teams in nontraditional seasons discriminates against female athletes.

In Monday’s ruling in Michigan High School Athletic Association v. Communities for Equity, Chief U.S. District Judge Richard Alan Enslen declared that the association violated the Constitution and federal and state laws by scheduling the female team’s games out of sync with most other states.

The Michigan High School Athletic Association places six high school girls’ sports, but no boys’ sports, in nontraditional seasons. The Communities for Equity argued that this has resulted in limited opportunities for athletic scholarships and opportunities to play college sports; limited opportunities to play in club or Olympic development programs and missed opportunities for awards and recognition, such as All-American teams.

Communities for Equity, an organization of students and parents seeking gender equity in Michigan schools, filed the class action in 1998.

In his decision, Judge Enslen found that “the practice of scheduling only girls’ sports, but not boys’ sports,” in disadvantageous or non-traditional seasons “sends the clear message that female athletes are subordinate to their male counterparts…”

Diane Madsen, the President of Communities for Equity, praised the verdict.

“Michigan girls and their families can now be more confident that high school female athletes will be given equal opportunities to play sports and be treated fairly when they do play,” Madsen said.

The court ordered the Michigan High School Athletic Association to bring its scheduling of seasons into compliance with the law by the 2003-2004 school year.–Siobhan Benet