Especially for Black People

Especially for Black People

ESPECIALLY FOR BLACK PEOPLE

by Enid B. Jones

Five years ago I was diagnosed as diabetic (type 2) by my gynecologist—a
strange way to learn this fact. Fifteen years ago I was told I had gestational
diabetes, and then that I was a "borderline diabetic." I developed
arrhythmia (irregular heartbeat), recurring yeast infections, irritable bowel
syndrome, dizziness, recurring lesions under my toes, bouts of severe thirst,
etc...
Now that I have read all that I can about diabetes I realize
that I have been diabetic for a long time. I should also point out that I was
very active in that I played tennis and was always enrolled in exercise classes
of one type or another until my son entered high school and I had to sublimate
my activities to support his. At that time I developed a fairly sedentary life
style, sitting through basketball games, track meets, and after-school events.
The issue is why was my diabetes was not detected earlier? Several
blood tests were done, but the results of these tests showed "close to
normal" blood sugar levels and so I did not receive treatment—not
until I went through the pre-op screening for elective surgery and was told
that my sugar level was too high for surgery to be done at that time. So finally,
I began to receive treatment for my type 2 diabetes.
Why did I title this article "Especially For Black People"?
For three and a half years I was treated as a borderline type 2 diabetic, though
my daily blood glucose tests ran from 165 to 185mg/dL, and my quarterly A1c
test readings averaged 7.0. I was doing the things I was supposed to do, and
taking my medications on time, but my diet control/exercise plan did not alleviate
my problems, and my daily doses of glucotrol were not bringing my numbers down.
I was experiencing problems common to a person with far higher sugar levels.
Why?
Then I moved to another state, and had to change doctors, twice
in fact. The second doctor, who tested my blood with the three-month gHb test
instead of HbA1c, asked me: "Did you know you have the gene for sickle
cell?"
I responded: " Yes! I've known for a long time that I have
sickle cell trait. It is not a problem, is it?"
Doctor: "Yes, in a way, because you need and should have
had a hemoglobin-S test; your sugar level is masked otherwise (with the A1c)."
My reading under the new test (new to me) was a few decimals
below nine. I was not close to "normal" at all! My doctor changed
my treatment to reflect this—and my daily readings dropped to within the
normal range, while the quarterly tests are down to eight. I now take glucophage,
which is helping tremendously. I have no more trouble with my feet and only
occasional discomfort in my stomach.
Since sickle cell is found predominantly in black people, and
presence of the sickle trait can make the A1c test read falsely low, the blood
glucose gHb test should be recommended for standard screening of black people,
or anyone who knows they are carrying the trait for sickle cell.