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.