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Diabetes is a disease that occurs when the level of blood glucose is high than normal. It is one of the most common diseases in different parts of the world. According to the American diabetes association, mode of living (including eating habits) and food choices reflect many symbolic, familial, ethnic and gender-specific associations. There are a number of diseases that African American women become a victim of, as per the research of many experts (Williams et al. 2019). One of the most common health conditions found in African American women is diabetes. There are two main types of diabetes and researches show that most African American women have a high percentage of type 2 diabetes (Williams et al. 2019). According to a researcher, M.C Marshall Jr, there are various elements like genetic traits, insulin resistance and prevalence of obesity that increase the risk of diabetes (especially of type 2 diabetes) in African American women. The estimated prevalence of diabetes in the United States of America is about 16 million people. About ninety percent of the people suffering from diabetes suffer from type 2 diabetes and it comprises the population more than 45 years. African American has 1-6-fold high diabetic rate as compared to other Americans and this proportion suffers from type 2 diabetes. In contrast, the risk of type 2 diabetes is 1-4 folds high in white Americans. African Americans bear the burden and threats of morbidity and mortality that is associated with diabetes (Williams et al. 2019).
Biological nature of Diabetes
There are a lot of dimensions and aspects narrated and quoted to assert and clarify the biological nature of diabetes type II. According to one of the reports by Shiyanbola, (2018) type 2 diabetes is caused by a chain reaction that results in the destruction of vital insulin-producing cells. In the same report, it is affirmed that a malfunctioning protein that is also called, "amyloid" is responsible for triggering the condition that may cause the body to lose its control on the blood sugar level (Shiyanbola et al. 2018). Some deposits from the cells of the pancreas are also considered responsible for damaging the cells that are responsible for producing insulin which is in return responsible for regulating blood sugar. Any interruption to these processes can help to control and stop the occurrence of insulin (Macaulay et al. 2018). In the medical journal, “Nature immunology” there is no prominent cause of type 2 diabetes except the increasing production of glucose in the blood. This condition is followed by less production of insulin or the inability of the body cells to react to the insulin. The role of IL-1Beta is also found in the occurrence of diabetes because this chemical is involved in the inflammatory reactions and this chemical is a major driver of both type 1 and type 2 diabetes (Robins et al. 2019). In one of the laboratory studies, it is asserted that there is a chemical that could activate the inflammation proteins in the people who suffer from type 2 diabetes. This reaction is followed by the loss of pancreatic insulin-producing cells also called islet or beta cells (Robins et al. 2019).
Environment Influence on type II Diabetes
There are a lot of environmental factors that are directly linked with the cause of Type II Diabetes. One of these factors is the lifestyle. According to Macaulay, (2018) African American women have a more sedentary lifestyle because either they are left to stay in houses doing nothing except for TV or they are employed somewhere, where they are doing some sedentary jobs (Macaulay et al. 2018).). It is asserted that African American women are the product of exposures that are inhaled from the familial role and social status which results in a comparative high blood pressure rate and, more chances of mental disease in African American Women. Also, about 80% of the women, as calculated by the records are obese and obesity is one of the most significant causes of Type II diabetes (Robins et al. 2019). Socioeconomic status is one of the most powerful and dominant environmental factors that can cause type II diabetes. It is highlighted that African American women are usually counted or positioned at or below the poverty line. The limited availability of resources paves the way for narrowed approach to life and inferiority complex that ultimately affects mental capabilities. So socioeconomic features are the drivers of Type II diabetes (Denis et al. 2018). Also, African American women are confined to the realms of sick societies where there is no exposure of women to the world where they could work to manage their lifestyle. Obesity is the product of such lifestyle which can direct to diabetes. Obesity runs into families and African American families have rare exercise and healthy eating habits (Macaulay et al. 2018). Other lifestyle features include exposure to the housing environment, sleep duration or the quality of sleep that those women are having. Consumption of tea, alcohol, and smoking is also included in the environmental factors that can influence Type II diabetes (Williams et al. 2019)
Incidence and Prevalence rate
Qualitative research method was used to collect the data on Type II diabetes in African American women. Out of 15 articles, 4 most relevant articles were chosen, the article was collected from MEDLINE by using keyword, "diabetes type II" and, "African American Women”. Google Scholar was also used to collect some peer-reviewed articles so that the required information can be collected (Macaulay et al. 2018). Generally, it is asserted that diabetes is 60% more common in black women as compared to white women. In the same report, it is highlighted that African American women are 2.5 times more likely to suffer from the amputation of a limb and in the same way, there are 5 to 6 times more chances of the women to suffer from diabetes. Reports have shown that 5.4 percent of white American females are diagnosed with diabetes and 9.9 percent of black women were found the victim of diabetes (Shiyanbola et al. 2018). By May 2, 2022, the middle-aged African would be developing diabetes as compared to White middle-aged Americans where women are more likely to be diagnosed with diabetes as compared to men (Macaulay et al. 2018). It is more important to note that diabetes further causes stroke, the problem of blood vessels, foot, nerves, heart, eye, and kidney. It is found that 1 in 4 Black women are affected with Type II Diabetes. It affects almost 12% of all Black women who are 20 years or older. In one of the researches, it was concluded that 1646 African American Women were suffering from Type II diabetes from the sample that was collected from four different parts of America. As per the database, it was found that African American women have high blood pressure even without diabetes so it ensures that in the future they will be suffering from diabetes (Shiyanbola et al. 2018).
There are factors such as cultural, behavioral and other human factors that can affect this disorder. The factors can cast both positive and negative effects on life. According to Shiyanbola (2018), both physical activity as well as eating behavior can cast an impact on type II diabetes, in the same way, positive modification of lifestyle can help to mitigate the impact of diabetes. Energetic lifestyle and physical activity can help to overcome the deterioration of health caused by diabetes (Denis et al. 2018). Culture is also one of the factors because many of the behaviors are actually promoted by culture. Moreover, exposure to different resources is also significant to note such as the availability of clean water, climatic changes such as rising global temperature affects the health condition of African American women, along with the supply of food. The prevalence and occurrence of diabetes in African American women is also influenced by the social factors such as familial relationships that are most disrupted and economic depression that eradicates and distort bodily functions (Williams et al. 2019).
Disparities associated with Diabetes
There are a lot of social, moral and ethical disparities associated with African American women having type II diabetes. It is asserted that Body Mass Index, the distribution of body mass, racial and ethnic groups are all differing widely along with the type of adipose tissue. It is highlighted that African American women are more towards dietary fibers, more sugar consumption and large consumption of carbohydrates that made them more vulnerable to type II diabetes. African American women are more obese, less physical active, and reluctant towards opportunities of awareness (Robins et al. 2019).
Ethical issues in diabetes
Ethical issues are one of the major factors that can influence Type II Diabetes. As African American women belong to minority groups, it is found that they face a lot of issues in terms of treatment, opportunities of awareness and then they are neglected in a number of opportunities that can impart and ensure a better lifestyle. It’s been several years, (since 2000) that the maximum people suffering from type II Diabetes in America majorly belonging to African American women. According to research by Robins (2019) gene mutation is a critical factor to consider and it is promoted by continuous exposure to the same environmental and lifestyle, along with the same societal treatment. Along with minority ignorance, African American women are not given quality health as compared to white people, driven by various factors such as race, and low socioeconomic status (Robins et al. 2019).
Denis, G. V., Sebastiani, P., Bertrand, K. A., Strissel, K. J., Tran, A. H., Slama, J., ... & Palmer, J. R. (2018). Inflammatory signatures distinguish metabolic health in African American women with obesity. PloS one, 13(5), e0196755.
Macaulay, S., Ngobeni, M., Dunger, D. B., & Norris, S. A. (2018). The prevalence of gestational diabetes mellitus amongst black South African women is a public health concern. Diabetes research and clinical practice, 139, 278-287.
Robins, J. L., & Kliewer, W. (2019). Stress and Coping Profiles and Cardiometabolic Risk in Low-Income African American Women. Journal of Women's Health, 28(5), 636-645.
Shiyanbola, O. O., Ward, E., & Brown, C. (2018). Sociocultural influences on African Americans’ representations of type 2 diabetes: a qualitative study. Ethnicity & disease, 28(1), 25.
Williams, A., Mc Dougal, D., Jenkins, W., Greene, N., Williams-DeVane, C., & Kimbro, K. S. (2019). Serum miR-17 levels are downregulated in obese, African American women with elevated HbA1c. Journal of Diabetes & Metabolic Disorders, 1-7.
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