By Sandra Millon Underwood, FAAN
Professor, UW-Milwaukee School of Nursing

Many of us grew up in households where we heard our elders talk about people who had ‘the sugar’. As adults, we have come to understand that what they were referring to was diabetes. The good news is that with some lifestyle changes, rather than being a death sentence, diabetes can be managed.
According to the Federal Drug Administration (FDA), 34.2 million people in the United States—just over one in ten people—have diabetes. In addition, the Centers for Disease Control and Prevention’s (CDC) National Diabetes Statistics Report (2020), found that about 88 million adults—approximately one in three people—have been diagnosed with prediabetes.
Lola Awoyinka, a full-time doctoral student in public and community health at the Medical College of Wisconsin, has researched volumes of data surrounding local diabetes disparities. She reports that, according to data from the Behavioral Risk Factor Surveillance System, nearly one in six African American adults in Milwaukee County— or 15 percent—have been diagnosed with diabetes.
Whether you’ve been newly diagnosed, have been fighting against type 1 or type 2 diabetes for a while or are helping a loved one, knowing the difference between the two and understanding the resources, health tips and managing proper food intake can help you live your best life.
According to the American Diabetes Association type 1 diabetes occurs at every age and in people of every race, shape, and size. In type 1 diabetes, the body does not produce insulin. The body breaks down the carbohydrates you eat into blood sugar that it uses for energy—and insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. With the help of insulin and other treatments, individuals can learn to manage their diabetes and live longer, healthier lives.
Type 2 diabetes is the most common form of diabetes. In this instance, the body doesn’t use insulin properly. And while some people can control their blood sugar levels with healthy eating and exercise, others may need medication or insulin to help manage it.
Prediabetes is when the blood sugar is higher than it should be but not high enough for your doctor to diagnose diabetes. More than a third of people in the United States have it, but most don’t know it. Prediabetes can make you more likely to get Type 2 diabetes and heart disease. Exercising more and losing extra pounds, even as little as five to seven percent of your body weight, can lower those risks.
In any of these instances, knowing and understanding your A1C is critical. According to the CDC, the A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures the average blood sugar levels over the past three months. It’s a commonly used test to diagnose prediabetes and diabetes and is also the main test to help manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is important.
Clayborn Benson, founding Executive Director of the Wisconsin Black Historical Society/ Museum, understands and appreciates the benefits of lifestyle changes. When he was first diagnosed with Type 2 diabetes, his A1C hovered around 12. He changed his eating habits and made a conscious effort to incorporate exercise into his daily regime. After about seven months, Benson is feeling better, has more energy, and during his last check up, his A1C was 6.9.
“Before I changed my diet and started exercising, I was experiencing dizziness and, at one point, was unable to keep food down. I was extremely sick for one week last year—that’s when I knew I had to take my diabetes diagnosis seriously because typically nothing stops me from living my best life, but this did. I incorporated more fruits and vegetables into my diet and cut down on carbs. I also started taking daily walks. Now that I understand how this disease can adversely affect me, I’m not going to stop. Diet and exercise have made a huge difference and drastically improved my quality of life,” Benson said.
Chef Marvin, who demonstrates healthy cooking options on HEAL’s Facebook page each Thursday at 12 noon, is a staunch advocate of healthy eating.
“When we talk about healthy cooking, I tend to cut corners in the caloric department, but not in nutrition. One easy way to do this is to cut salt from the diet and you can do this without compromising flavor. There are also many ways to eliminate carbohydrates and glucose to make recipes more diabetic- friendly. You can also use meat substitutes to fulfill nutrition goals. For example, mung bean products can be used as meat substitutes. A cup of these beans only has 60 calories while the same quantity of soybean products that are typically used as meat substitutes have 200 calories,” said Chef Marvin.
The Office of Minority Health and Health Equity (OMHHE) at the Food and Drug Administration (FDA) is building relationships with the American Diabetes Association (ADA) and other groups to help Americans prevent and treat diabetes, and to specifically address the disparities surrounding how severely it affects minority groups.
Typically, racial and ethnic minorities have higher rates of diabetes, worse diabetes control and are more likely to experience complications.
The reason for this disparity in minorities is a combination of risk factors, including lack of access to health care, socioeconomic status, cultural attitudes, and behaviors. These factors can become barriers to preventing diabetes and effectively managing diabetes once diagnosed. In addition, diabetes can progress faster in minority populations. This rapid progression can be compounded by a poor diet, obesity, and a sedentary life.
The American Diabetes Association offers a test to help determine if you or a loved one may be at risk of diabetes. Go to https://www.diabetes.org/risk-test to take the test and learn more about diabetes so you can live your best life!
The Healthy Eating and Active Living Milwaukee (HEAL) is a culturally-tailored program that aims to provide education, resources to secure healthy foods, and active living supports for adults at risk for developing lifestyle-related diseases; and, to empower adults to make changes in their physical and social environment to improve nutrition and physical activity. ‘Like’ their Facebook page that’s full of videos of healthy recipes and low-cost, no-cost exercise