DIABETES

How do diabetes complications affect African Americans?
Compared with white Americans, African Americans experience higher rates of diabetes complications such as eye disease, kidney failure, and amputations. They also experience greater disability from these complications. Some factors that influence the frequency of these complications, such as high blood glucose levels, abnormal blood lipids, high blood pressure, and cigarette smoking, can be influenced by proper diabetes management.

Eye Disease
Diabetic retinopathy is a deterioration of the blood vessels in the eye that is caused by high blood glucose. It can lead to impaired vision and, ultimately, to blindness. The frequency of diabetic retinopathy is 40 percent to 50 percent higher in African Americans than in white Americans, according to NHANES III data.¹¹ Retinopathy may also occur more frequently in African Americans than in whites because of their higher rate of hypertension. Although blindness caused by diabetic retinopathy is believed to be more frequent in African Americans than in whites, there are no valid studies that compare rates of blindness between the two groups.

Kidney Failure
African Americans with diabetes experience kidney failure, also called end-stage renal disease (ESRD), about four times more often than diabetic white Americans.¹² In 1995, there were 27,258 new cases of ESRD attributed to diabetes in African Americans.¹³ Diabetes is the leading cause of kidney failure and accounted for 43 percent of the new cases of ESRD among African Americans during 1992-1996. Hypertension, the second leading cause of ESRD, accounted for 42 percent of cases. In spite of their high rates of ESRD, African Americans have better survival rates after they develop kidney failure than white Americans.¹²

Amputations
Based on the U.S. hospital discharge survey, there were about 13,000 amputations among African American diabetic individuals in 1994, which involved 155,000 days in the hospital.¹⁴ African Americans with diabetes are much more likely to undergo a lower-extremity amputation than white or Hispanic Americans with diabetes. The hospitalization rate of amputations for African Americans was 9.3 per 1,000 patients in 1994, compared with 5.8 per 1,000 white diabetic patients. However, the average length of hospital stay was lower for African Americans (12.1 days) than for white Americans (16.5 days).