MinorityNurse.com

Vital Signs

Two Studies Link Emotional Health to African Americans’ Diabetes Risk

According to the American Diabetes Association (ADA), approximately 11.4% of all African Americans aged 20 years or older have this serious chronic disease. For older African Americans, the numbers are even more dramatic: Diabetes currently affects 25% of black Americans aged 65 to 74 and one in four black women over age 55. Furthermore, African Americans are 1.6 times more likely to have the disease than their Caucasian counterparts and they also experience higher rates of diabetes complications, such as cardiovascular disease, blindness, amputation and kidney failure.

The ADA recommends that African Americans can reduce their risk for diabetes and its complications by improving their physical health--e.g., losing weight, exercising, eating a healthy diet, quitting smoking, controlling their blood pressure and cholesterol levels, and seeing their doctor regularly for checkups. However, two intriguing research studies published last December in the ADA’s journal Diabetes Care suggest that there may also be an important link between African Americans’ diabetes risk and their mental health.

One study, led by Dr. Susan Everson-Rose of Rush University Medical Center in Chicago, investigated the relationship between depression, insulin resistance and race in a sample of 2,662 women enrolled in a study of women’s health and aging. The group included Caucasian, African-American, Hispanic and Asian American women. The researchers found that depression was associated with higher levels of insulin resistance and the onset of diabetes, but this connection resulted primarily from abdominal obesity. When the data was adjusted to take the obesity risk factor into account, the link between depression and diabetes disappeared. But there was one notable exception: African-American women.

“African-American women with depression experience increased risk of diabetes independent of [abdominal fat deposits] and other risk factors,” the study concludes. In fact, over the three-year follow-up period, the occurrence of diabetes in black women with depression was more than twice that of Caucasian women. “[Health care professionals] should recognize that depressive symptoms can increase risk of diabetes and are related to higher levels of insulin resistance,” the researchers advise. “Patients should be encouraged to seek treatment for clinically significant depressive symptoms.”

The other study, led by Catherine Chesla, DNSc, RN, FAAN, a nursing professor at the University of California, San Francisco, suggests that African-American diabetes patients who have an emotionally healthy family life are better able to manage their disease. Specifically, this study of 159 African Americans living with type 2 diabetes found that patients whose family environments were characterized by structural togetherness, an optimistic world view, “emotional agility” and the ability to resolve diabetes-related family conflicts had better morale and disease management skills than patients whose family life was marked by negativity and unresolved conflicts.

In an interview with Reuters Health, Chesla recommended that “broadening the focus of care to include family relationships of patients with type 2 diabetes offers health care professionals a way to influence better diabetes management. Including significant family members in treatment, and assisting patients and their family members to negotiate differences regarding diabetes care in the home. . .holds promise for improving personal management of this complex disease.”