Combating Diabetic Neuropathy in Black Communities: The Way Forward

Dr Bill Releford
February 8, 2022

The global epidemic that is diabetes has caused a corresponding increase in disorders and complications, and one such prevalent complication is diabetic neuropathy. Research shows that about 60-70% of diabetics will at some point develop a form of neuropathy. The statistics are even more worrying for Black and African American people since the risk of diabetes among these communities is 77% higher than the rest of the U.S population. It follows that Black and African American people are more likely to experience diabetes-related complications such as diabetic neuropathy.

What is Diabetic Neuropathy?

The term ‘neuropathy’ refers to the damage of nerve cells which are crucial for movement, sensation, and touch. Diabetic neuropathy is nerve damage caused by diabetes. If not properly managed, it can lead to various complications such as digestive issues, sexual dysfunction, infection in the legs and feet, and urinary problems.

The most prevalent form of diabetic neuropathy is distal symmetric polyneuropathy (DSP) that appears with a ‘stocking and glove’ distribution, whereby pain and numbness start developing symmetrically in the feet. It then moves up the legs as the condition progresses and eventually reaches the upper extremities. One may feel a tingle or burn in the hands or feet. As the disease progresses, there may be motor nerve dysfunction and weakness of the muscles.

Diabetic Neuropathy and Healthcare Access, Discrimination, and Stress

Previous studies show that minority groups have poor blood pressure control than other racial groups in the United States. There is growing reason to believe that race and ethnicity may influence individuals’ diabetes care, even for those with full health insurance. The research observed poor(or lack of) physician support, not perceiving the condition as serious, as well as little knowledge of how to treat diabetes contributed to poor outcomes among diabetic African Americans.

A study published in the November 2014 issue of the American Journal of Public Health found that many hospitals and health centers in Black communities are underfunded, ill-equipped, and understaffed. There’s also a lack of neighborhood resources that support exercise and proper nutrition.

African Americans exhibit increased stress due to discrimination, institutional racism, and many other factors. According to one study, stress can be a contributor to both the onset and progression of diabetes.

All these factors point to social determinants of health as contributors to diabetic neuropathy. Black and African American people have for a long time fought for equality in all aspects of their lives, healthcare included. If combating diabetic neuropathy is to be a success, then better access to quality healthcare and specialists cannot be ignored.

Managing Diabetic Neuropathy in Black Communities

Diabetes is among the leading causes of death in the United States, and it is concerning that this condition disproportionately affects Black and African American people. Approximately 2.7 million, or 11.4% of African Americans aged 20 years and above have diabetes. What’s worse, at least one-third of those don’t know they are diabetic. With these numbers expected to increase in the future, it is necessary to formulate strategies for combating diabetic neuropathy in the Black community.

Diabetic neuropathy cannot be reversed since it’s impossible for the body to naturally repair damaged nerve tissues. However, there are various measures such as increasing awareness, access to preventive care, and proper nutrition that aid in the prevention and management of diabetic neuropathy.

Know Your Family History

Diabetes has a tendency to run in families. An article published in Diabetes Care notes that if a father has type 1 diabetes, the risk of the child being diabetic is 1 in 17. The probability of inheriting the disease from the mother is 1 in 25 if the mother is below 25 years, and 1 in 100 if the mother is above 25 years.

The risk of developing type 2 diabetes is 40% when one parent has the disease and 70% when both parents are diabetic. Seeing as diabetes is prevalent in Black communities, it’s important to know where you are at the risk scale to prevent complications.

Get Regular Screening

Screening for prediabetes and diabetes among Blacks is an invaluable preventive and management strategy. It can be done through a simple blood test such as an A1C test, but this test is insufficient for diagnosis in African Americans. Research shows that about 11% of Black Americans contain a gene variant that can make an A1C test ineffective. The doctor may recommend another test, such as fasting or glucose tolerance for a clear diagnosis.

Proper Nutrition 

Proper nutrition is key to treating or preventing health issues stemming from diabetic neuropathy. Nerve damage is usually caused by high levels of blood glucose over long periods. Managing blood glucose helps prevent further nerve damage and can be achieved by maintaining a balanced diet that is heavy on vegetables, fruits, and fiber. B vitamin complex plays an important role in nerve health, and a deficiency of vitamin B12 can lead to neuropathy. Vitamin B6 also helps the brain produce chemicals that relay information in the body.

Physical Activity

A regular fitness routine can help address muscle weakness that some patients experience with neuropathy. Physical activity also aids in lowering high blood sugar. It is recommended that you consult with your healthcare provider before starting a new exercise regimen since neuropathy may affect the body’s response to injuries or activities that risk injury.

Treatment for Diabetic Neuropathy

To regulate the body’s blood glucose levels, you may need to take insulin or oral medications such as metformin (Glucophage). The American Academy of Neurology has set out guidelines for diabetic neuropathy treatments aimed at avoiding opioid use. Some of the effective medications listed include pregabalin, gabapentin, duloxetine, and amitriptyline.

Bottom Line

Diabetes and corresponding disorders such as neuropathy are a real threat in Black and African American communities. The aim should be to avoid the onset of diabetic neuropathy and keep risk factors at bay. A healthy diet, staying physically active, shedding weight, and giving up bad habits like smoking can help keep your blood sugar within a healthy range and fend off diabetic neuropathy.