When did you last enjoy some chocolate? Given the stress of looming midterms as we reach this point of the semester, as well as the jumbo-sized bags of candy lining shelves for Halloween, my guess is, well, quite recently.
Yet well over 23 million Americans aren't able to indulge in this guilty pleasure on a daily basis. They suffer from diabetes, a condition in which one's pancreas does not produce enough insulin, or alternatively becomes resistant to insulin.
Once food is consumed, sugar in the form of glucose enters the bloodstream to serve as energy for the body. The pancreas is then supposed to relocate glucose from the bloodstream to fat, muscle and liver cells, so that food is capable of being converted to energy. However, this process does not occur in someone who is diabetic. The pancreas does not produce enough insulin to convert food into fuel, or the above-mentioned cells do not respond typically to insulin.
Diabetes is further broken down into three types. Type I diabetes is also known as "childhood diabetes." People with Type I diabetes need to take insulin on a daily basis, as their bodies will not produce any insulin. It is thought to be attributed to genetics, viruses and autoimmune conditions that destroy the pancreatic cells responsible for making insulin.
Type II diabetes is more prevalent among adults. Moreover, it is increasingly common in the general population of the United States, particularly as obesity and a sedentary lifestyle become commonplace. In Type II diabetes, the pancreas does not produce an adequate amount of insulin to maintain target levels of blood glucose, and the body does not respond well to insulin. The third category of diabetes is gestational diabetes. This occurs when high levels of blood glucose develop in pregnant woman who did not have diabetes prior to pregnancy. After delivery, blood sugar returns to levels that were normal for a woman prior to conception.
For years, researchers have pointed to risk factors for developing Type II diabetes, including heart disease, high cholesterol, obesity, lack of exercise, or an immediate family member who had the condition. In addition, African-Americans, Native Americans, Hispanic-Americans and Asian-Americans were thought to be at increased risk for diabetes.
Yet researchers at the Hopkins School of Public Health have recently begun to question this belief. In a study entitled "Environmental and Socio-Economic Factors as Contributors to Racial Disparities in Diabetes Prevalence," performed by researchers at the Hopkins Center for Healthcare Disparities Solutions along with Case Western Reserve University School of Medicine, found that genetics did not play as large a role as previously thought. African-Americans are more likely than Caucasians to have diabetes due to living conditions rather than genetics. When African-Americans and Caucasians live in comparable environments with similar incomes, their rates of diabetes do not greatly vary.
Although genes are one suspect for being a contributing factor to diabetes, it is more likely that environment is the probable cause. According to director of Hopkins Center for Health Disparities Solutions Thomas LaVeist, the lead author of the study, no one yet has discovered a single gene or mutation that exists in one ethnic group and not others that is also linked to diabetes.
As School of Public Health professor Michael Trush is known to say in Environment and Your Health, "genes load the gun, but environment pulls the trigger." Thus, researchers are hypothesizing that although genes do account for some role in diabetes, the high prevalence within particular ethnic groups is more likely attributable to the environment, particularly due to healthcare disparities.
These include the lack of access to quality medical care, neighborhoods that are not "walkable" (designed for one to be able to access school, work and errands via foot in areas that residents deem safe), and the limited availability of nutritious foods, including fresh fruits and vegetables.
