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Diabetes

Diabetes Prevention

Diabetes Prevention

Many people do not know this; type 2 diabetes is preventable. Even if you are already prediabetic, you can take some steps to keep your sugar level from progressing to diabetes.

Can diabetes be prevented?

The answer is Yes! By simply changing your eating habits and adjusting the frequency with which you do physical activity, you can keep type 2 diabetes at a safe distance. However, for type 1 diabetes, there is currently no known way to prevent its development.

One truth you must be aware of is that your commitment and dedication to the process are required. Intentionally making lifestyle changes is the first step to help prevent type 2 diabetes, the most common form of the disease. If you discover that you are at risk of developing the disease, you must take proactive steps toward preventing it. You are at high risk if you are obese, have a high cholesterol level, or are from a family with a history of diabetes. 

Don’t worry, because these changes you may need to make are easy. We will guide you through it—stay with us.

Diabetes Prevention Approaches In Categories

There are three suggested and working proactive approaches to diabetes prevention, namely: 

  • Primary Prevention

  • Secondary Prevention

  • Tertiary prevention

Primary Prevention

The primary preventive approach aims to stop diabetes from happening at all. It involves practicing healthy behavior daily. These healthy behavior include:

  • Getting more exercise and physical activities.

  • Maintaining a healthy diet routine, e.g., Controlling the intake of carbohydrates.

  • Losing excessive fat and body weight.

  • Eradicating processed sugar from your diet.

  • Consuming alcohol less frequently and in a moderate amount.

  • Quitting smoking

Secondary Prevention

After diagnosing diabetes, one can still reverse the blood sugar level to fall within a non-diabetic or prediabetic range; This is the aim of secondary prevention. After diagnosing diabetes, one should take measures known as secondary prevention. It involves

  • Monitoring or screening an individual's A1C levels

  • Drinking more water to reduce the sugar concentration

  • Getting regular exercise

  • Avoiding weight increase

  • Following the doctor's prescription

Modifying one’s way of life is essential, but secondary prevention often requires additional medical care to be effective. There will be a need to control some medically related risk factors.

Some examples of risk factors that require medical care;

  • Hypertension

  • Hyperlipidemia

  • Glycemic management

  • Microalbuminuria

Hypertension

Besides increasing the likelihood of developing cardiovascular disease, hypertension also exacerbates diabetic ocular and kidney complications. The incidence of hypertension is 2–3 times greater in people with non-insulin-dependent diabetes mellitus (NIDDM) compared to those who do not have it and much higher in specific racial and ethnic groupings. With increasing age, NIDDM patients are more likely to have hypertension. Thus, hypertension should be identified and treated early in the hopes of reducing the risk of diabetes developing as a secondary condition.

Non-insulin-dependent diabetes mellitus and hypertension are linked to insulin resistance and obesity. Modifying one’s lifestyle to lose weight might improve blood pressure and insulin sensitivity. If pharmaceutical treatment is necessary, it is recommended to begin with medications such as calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors, and alpha-blockers that do not negatively impact glucose tolerance, insulin sensitivity, and serum lipid concentrations.

Hyperlipidemia

Variations in blood lipid and lipoprotein concentrations, both quantitatively and qualitatively, are related to non-insulin-dependent diabetes. Coronary heart disease and peripheral vascular disease link to increased levels of bad cholesterol (LDL), very low-density lipoprotein (VLDL), total triglyceride, and decreased levels of good cholesterol (HDL).

Lipid abnormality screening is integral to secondary prevention for people with NIDDM. Although dietary and lifestyle changes should be attempted initially, specialized lipid-lowering medicine should be used if they fail to improve symptoms.

Low-density lipoprotein (LDL)-lowering medication may help minimize macrovascular problems in non-insulin-dependent diabetes mellitus; however, the evidence is weak.

Patients with diabetes who participated in the Helsinki Heart Study and were assigned to active medication (gemfibrozil) had a significantly reduced risk of coronary heart disease than those assigned to placebo. However, the results were not strong enough to be considered statistically significant.

Glycemic Management

People with insulin-dependent diabetes (IDDM) can reduce their risk of developing microvascular symptoms of diabetes by as much as 50-60% if they maintain tight control over their blood sugar levels.

The United Kingdom Prospective Diabetic Study 1994 suggests a strong association between glycemia and retinopathy.

Improvements in glycaemic management and their impact on macrovascular disease are less specific.

Microalbuminuria

Microalbuminuria occurs when the albumin excretion rate is 20–200 pg/min, below the cutoff for proteinuria on standard dip-stick testing of the urine.

A further indicator of early cardiovascular morbidity in NIDDM is microalbuminuria. IDDM has a higher prevalence of microalbuminuria as a predictor of ESRD than NIDDM; This is possible because people with NIDDM are more susceptible to dying from cardiovascular disease than end-stage renal failure.

Improving glycemic management and treating concomitant hypertension in microalbuminuric people with IDDM reduces albumin excretion rates and slows the onset of renal impairment.

The advantages, if any, exhibited in NIDDM participants with microalbuminuria remain to be seen. There is evidence that angiotensin inhibitors, particularly those targeting angiotensin II, may help people with and without hypertension control their blood pressure by decreasing their albumin excretion rates in individuals with insulin-dependent diabetes.

Tertiary Prevention

The objective of tertiary prevention is to protect the body against the different complications associated with diabetes. It involves adequately educating those at high risk and newly diagnosed patients on implementing healthy behaviors for effective diabetes management.

Examples of complications associated with diabetes:

1st Example: Nephropathy

Diagnosing and treating microalbuminuria is possibly the most significant prophylactic therapy for preventing the development of nephropathy. After nephropathy has developed, controlling high blood pressure is critical. Dietary factors may also influence the pace of deterioration in renal function.

In non-insulin-dependent diabetes mellitus (NIDDM), the pace of decrease in renal function is associated with systolic blood pressure. Treating hypertension may slow down the incidence of IDDM. When used by patients with either normotension or hypertension with microalbuminuria, ACE inhibitors delay the impairment of kidney function and the advancement to end-stage organ failure. There is currently no consensus on the role of these medications in NIDDM patients who have already developed nephropathy.

2nd Example: Retinopathy

Routine screening and timely consultation with an ophthalmologist are essential prophylactic approaches for preventing the development of baseline retinopathy to vision loss.

Adequately screening and timely referral to an ophthalmologist could prevent numerous cases of diabetes-related blindness.

This risk of developing retinopathy increases with the incidence of diabetes.

3rd Example: Distal limb amputations

Diabetic people have a 15-fold increased risk of lower limb amputations, and it is predicted that as much as 85 percent of these amputations might be avoided with proper foot care. An amputated lower leg is more likely to occur in patients with peripheral vascular disease or neuropathy. The early therapy of diabetic foot issues is still severely poor, despite the advantages of frequent chiropody, patient education, quitting smoking, and treating the infection as soon as possible.

NIDDM patients should anticipate at least an annual foot screening as a basic level of treatment. Lower limb amputations and their consequences inflict a heavy social and economic burden on communities. However, one can mitigate them by promptly and effectively diagnosing surgical cases early, detecting at-risk foot conditions, and managing associated risk factors.

Generally, diabetes prevention and management involve the following:

1.Losing excess weight

Extra weight will make it harder for the body to regulate sugar. Insulin resistance is more common in people with excess weight since the body’s cells cannot use insulin, eventually leading to diabetes. The American Diabetes Association (ADA) recommends that people with prediabetes lose at least 7% to 10% of their body weight to prevent or delay the onset of diabetes. You should talk to your doctor about setting realistic goals-such as losing 1-2 pounds per week.

2.Physical activity

Regular physical activity will give you the following benefits while maintaining your general health

  • Weight loss

  • Lower blood sugar

  • Boost your sensitivity to insulin- thereby helping to keep your blood sugar within the normal range

According to a study, the average percentage of hemoglobin A1C dropped from 9.6 to 8.6 after only four months of an exercise program.

What exercises can promote weight loss?

Exercises that can promote weight loss include:

1. Aerobic Exercise

Aerobic exercise refers to activity that increases the heart rate and the body’s use of oxygen. Examples of aerobic exercises for diabetes are yoga, walking, dance, and biking. Strive to engage in 30 minutes or more of moderate to vigorous aerobic activity. 

Researchers discovered that adults who engaged in a CDC-recognized lifestyle modification program, leading to a 5-7% reduction in their body weight and incorporating 150 minutes of aerobic exercise per week, experienced a 58% decrease in the likelihood of developing type 2 diabetes. For those aged over 60, this risk reduction was even more significant, at 71%.

2. Resistance exercises

These are exercises that involve the use of resistance and exercise contractions. For diabetes, they include light weight lifting, push-ups, and squats. People diagnosed with type 2 diabetes should try performing more resistance exercises at least twice weekly.

3. Limited Inactivity

If you spend extended periods in front of a computer, make sure to stand, walk around, or engage in light activity for a few minutes every 30 minutes.

4. Eat healthy plant foods

Plants are a healthy source of essential nutrients. Research suggests that a healthy plant-based diet effectively combats diabetes.

  • Nuts and avocados are good sources of healthy fat.

  • Fruits provide vitamins and minerals for a healthier diet.

  • Carbohydrates include sugars and starches, which are energy sources for the body.

  • Fiber-rich foods like legumes and vegetables aid in weight loss and reduce the risk of diabetes. Fiber slows the absorption of sugars and lowers blood sugar levels.

What foods can I eat to lower my risk of diabetes?

A diet based on foods with a low glycemic index may help control blood sugar levels in people with diabetes. The glycemic index is a value assigned to foods based on how slowly or quickly those foods cause increases in blood sugar levels. Foods with a high glycemic index raise blood sugar levels more rapidly than foods with a low glycemic index. There are many different types of foods that you can eat to help control your blood sugar levels.

  • Fruits like tomatoes, peppers, and tree fruits.

  • Non-starchy vegetables like leafy greens, broccoli, and cauliflower.

  • Legumes like beans, chickpeas, and lentils.

  • Whole grains like whole-wheat pasta and bread, whole-grain rice, whole oats, and quinoa.

Eat Healthy Fats

Fat is the number one culprit for many health risks. Irrespective of this, it is an essential nutrient that should be part of our diet. There are healthy fats and bad fats. Incorporate a range of foods containing unsaturated or “good fats” into your diet to aid in weight loss and management.

The unsaturated fats found in olive oil, nuts, and fish improve diabetes control by helping to increase insulin sensitivity. When insulin is more sensitive, the body does not have to produce as much of it to keep blood sugar levels under control; This can help to lower the risk for high blood sugar spikes and improve diabetes management overall. 

Sources of good fats include:

  • Oils like olive, sunflower, safflower, cottonseed, and canola

  • Nuts and seeds such as almonds, peanuts, flaxseed, and pumpkin seeds

  • Fatty fish varieties like salmon, mackerel, sardines, tuna, and cod

Saturated fats, or “bad fats,” are found in dairy products and meats. Limit these fats by eating low-fat dairy products and lean chicken and pork

Should I speak to my doctor about diabetes prevention?

The American Diabetes Association (ADA) recommends routine screening and diagnostic tests for type 2 diabetes for;

  • All adults aged 45 and older.

  • Individuals under the age of 45 who are overweight and/or possess one or more risk factors linked to diabetes.

  • People with a history of gestational diabetes, and

  • Those who have been diagnosed with prediabetes.

References

MARCIA BYGRAVE PHD
MARCIA BYGRAVE PHD

Marcia Bygrave is a licensed nurse. She received her PhD in public health from Walden University. She is currently a Sr. Enterprise Learning Development Advisor with a large managed care company. Marcia has 25+ years of experience in the healthcare field working in management, staff development and training and as a charge nurse. She has extensive experience training staff and caregivers and developing programs to address pertinent skills. Marcia is also an entrepreneur. Her most recent venture includes plans to open a diabetes education center in a local rural area in Alabama. Besides Marcia’s passion for learning, seeking knowledge, and training others, she is very passionate about helping diabetics learn skills to manage their diabetes. She has a unique background, bringing experience from both the corporate and educational environments. Marcia is an advocate of continued learning and advancement; very effective in influencing the grasp of knowledge and love of learning in others.

<h2 style="color: #3f3b36; font-family: Merriweather; font-size: 24px; font-weight: 400px;font-style:italic">MARCIA BYGRAVE PHD</h2>

MARCIA BYGRAVE PHD

Marcia Bygrave is a licensed nurse. She received her PhD in public health from Walden University. She is currently a Sr. Enterprise Learning Development Advisor with a large managed care company. Marcia has 25+ years of experience in the healthcare field working in management, staff development and training and as a charge nurse. She has extensive experience training staff and caregivers and developing programs to address pertinent skills. Marcia is also an entrepreneur. Her most recent venture includes plans to open a diabetes education center in a local rural area in Alabama. Besides Marcia’s passion for learning, seeking knowledge, and training others, she is very passionate about helping diabetics learn skills to manage their diabetes. She has a unique background, bringing experience from both the corporate and educational environments. Marcia is an advocate of continued learning and advancement; very effective in influencing the grasp of knowledge and love of learning in others.

Dr. Saman Aftab
Dr. Saman Aftab

Dr. Saman is a medical writer with over six years of experience in freelance writing, editing, and proofreading. She is a practicing healthcare professional holding a doctorate in physical therapy at DOW University of Health Sciences. She loves to write and read about Physical and Mental health. She started content writing to blend her passion for writing and medicine with extensive clinical experience.

<h2 style="color: #3f3b36; font-family: Merriweather; font-size: 24px; font-weight: 400px;font-style:italic">DR. SAMAN AFTAB</h2>

DR. SAMAN AFTAB

Dr. Saman is a medical writer with over six years of experience in freelance writing, editing, and proofreading. She is a practicing healthcare professional holding a doctorate in physical therapy at DOW University of Health Sciences. She loves to write and read about Physical and Mental health. She started content writing to blend her passion for writing and medicine with extensive clinical experience.

Diabetes

Diabetes Risk Factors

Diabetes Risk Factors

Diabetes can have a debilitating effect on anyone, regardless of ethnic or socioeconomic background. Several risks and complications are associated with the condition, some of which are life-threatening.

Generally, diabetes increases the risk of cardiovascular disease, stroke, amputation, and kidney problems. Common complications that may arise from diabetes are blindness, sexual problems, slow healing of wounds, neuropathy, and foot problems.  

Obesity and physical inactivity are major risk factors for diabetes development. Additional risk factors include older age, family history of diabetes, and prior gestational diabetes history.

The risk factors associated with diabetes can be grouped into two categories, namely:

Modifiable Risk Factors

Modifiable risk factors can be reduced by adjusting dietary and lifestyle choices. They include:

Non-Modifiable Risk Factors

These are the different risk factors that can not be changed. Non-modifiable risk factors of diabetes are:

  • Age
  • Family History
  • Genetics
  • Ethnicity
  • Low birth weight

The Types of Diabetes and Their Risk Factors

Type 1 Diabetes

Type 1 diabetes is an autoimmune condition that is still being studied for better understanding. Currently known Risk factors are listed below.

Risk Factors of Type 1 Diabetes

Family History

This includes the presence of a parent or other relative who has been diagnosed with type 1 diabetes in the family. The higher the frequency of Type 1 diabetes in the family history, the higher the chances of developing it.

Age

Although it is possible to develop type 1 diabetes at any age, children and adolescents are at higher risk.

Race

Caucasians are more likely to develop type 1 diabetes than African Americans and Hispanic/Latino Americans.

Prevention

Currently, there are no known preventive measures for type 1 diabetes.

Type 2 Diabetes

Type 2 diabetes is a condition marked by a malfunctioning in how the body regulates and uses sugar. The chances of developing type 2 diabetes are higher with the presence of the factors listed below.

Risk Factors of Type 2 Diabetes

Family History

If parents, grandparents, and other relatives have been diagnosed with Type 2 diabetes, then you are at risk. It has been shown that the risk of developing diabetes in adults is increased by a factor of four if there is a history of diabetes in one’s own family.

Age

The likelihood of developing Type 2 diabetes is greater if you are 45 and older.

Prediabetes

People with prediabetes are at a high risk of getting diabetes. Experts from the American Diabetes Association estimate that as many as 70% of people with prediabetes will go on to have type 2 diabetes.

Overweight

This includes the presence of a parent or other relative who has been diagnosed with type 1 diabetes in the family. The higher the frequency of Type 1 diabetes in the family history, the higher the chances of developing it.

Physical Activity

It is estimated that 10–20% of the disease prevalence in this area can be attributed to inactivity. Exercise and physical activity are great ways to balance blood sugar. Therefore, the chances of getting diagnosed with type 2 diabetes are higher in less physically active people.

Gestational Diabetes

If a pregnant woman’s body is unable to create enough insulin, she may develop gestational diabetes. Women who have experienced this or gave birth to a baby who weighed more than 9 pounds are at a high risk of type 2 diabetes.

Ethnicity

The chances are higher for African American, Hispanic/Latino American, American Indian, and Alaska Native. Native Americans have a 33% higher rate of diabetes than Alaska Natives, who have a 5.5% lower rate. 

The prevalence rates among NHWs and Asian Americans are quite close to one another (7.1% and 8.4%), whereas the prevalence rates among NHBs and Hispanic Americans are much higher (11.8% and 12.6%).

Prediabetes

Prediabetes is characterized by blood sugar (glucose) levels that are higher than usual but not as high to be classified as diabetes. Prediabetes is a precursor to type 2 diabetes and puts one at higher risk for cardiovascular disease and stroke.

Pathology of Prediabetes

Prediabetes has the same pathophysiology as type 2 diabetes mellitus, with insulin resistance and early beta cell loss being the two fundamental dysfunctions. 

Slow insulin oscillations and smaller amplitudes of big pulses are hallmarks of prediabetes. The reason for smaller amplitude big pulses is unclear but may be due to impaired insulin secretion and/or increased basal insulin levels. The former can lead to increased hepatic glucose production, while the latter can lead to increased peripheral glucose uptake.

Symptoms of Diabetes/Prediabetes

The following symptoms may be an indication of diabetes:

  • Frequent urination
  • Excessive thirst
  • Unexplained weight loss
  • Extreme hunger
  • Vision changes
  • Dehydrated skin
  • Sores slow to heal
  • Nausea(type 1 diabetes)

How does prediabetes turn into diabetes?

Individuals with prediabetes have cells that do not react appropriately to insulin. As a result, their pancreas produces more insulin in an effort to stimulate the cells. They eventually develop Type 2 diabetes because their pancreas becomes overworked and unable to maintain their blood sugar levels from rising.

What Measures Can We Take to Prevent Prediabetes Developing into Diabetes?

Some measures can be taken to prevent prediabetes from progressing to diabetes.

These include:

  • Losing weight if overweight or obese
  • Increasing physical activity levels
  • Eating a healthy diet
  • Quitting smoking

If diagnosed with prediabetes, one must see a doctor for regular check-ups and blood sugar testing. This will help to ensure that any changes in the condition are detected early and treatment can be started if necessary.

Type1 diabetes is an acute condition; therefore, its symptoms may have a sudden onset. However, type 2 diabetes is a chronic condition. As a result, its symptoms can progress slowly and undetected for some time. Hence, type 1 diabetes can result in acute worsening of health, leading to a medical emergency called Diabetic Ketoacidosis.

References

MARCIA BYGRAVE PHD
MARCIA BYGRAVE PHD

Marcia Bygrave is a licensed nurse. She received her PhD in public health from Walden University. She is currently a Sr. Enterprise Learning Development Advisor with a large managed care company. Marcia has 25+ years of experience in the healthcare field working in management, staff development and training and as a charge nurse. She has extensive experience training staff and caregivers and developing programs to address pertinent skills. Marcia is also an entrepreneur. Her most recent venture includes plans to open a diabetes education center in a local rural area in Alabama. Besides Marcia’s passion for learning, seeking knowledge, and training others, she is very passionate about helping diabetics learn skills to manage their diabetes. She has a unique background, bringing experience from both the corporate and educational environments. Marcia is an advocate of continued learning and advancement; very effective in influencing the grasp of knowledge and love of learning in others.

<h2 style="color: #3f3b36; font-family: Merriweather; font-size: 24px; font-weight: 400px;font-style:italic">MARCIA BYGRAVE PHD</h2>

MARCIA BYGRAVE PHD

Marcia Bygrave is a licensed nurse. She received her PhD in public health from Walden University. She is currently a Sr. Enterprise Learning Development Advisor with a large managed care company. Marcia has 25+ years of experience in the healthcare field working in management, staff development and training and as a charge nurse. She has extensive experience training staff and caregivers and developing programs to address pertinent skills. Marcia is also an entrepreneur. Her most recent venture includes plans to open a diabetes education center in a local rural area in Alabama. Besides Marcia’s passion for learning, seeking knowledge, and training others, she is very passionate about helping diabetics learn skills to manage their diabetes. She has a unique background, bringing experience from both the corporate and educational environments. Marcia is an advocate of continued learning and advancement; very effective in influencing the grasp of knowledge and love of learning in others.

Dr. Saman Aftab
Dr. Saman Aftab

Dr. Saman is a medical writer with over six years of experience in freelance writing, editing, and proofreading. She is a practicing healthcare professional holding a doctorate in physical therapy at DOW University of Health Sciences. She loves to write and read about Physical and Mental health. She started content writing to blend her passion for writing and medicine with extensive clinical experience.

<h2 style="color: #3f3b36; font-family: Merriweather; font-size: 24px; font-weight: 400px;font-style:italic">DR. SAMAN AFTAB</h2>

DR. SAMAN AFTAB

Dr. Saman is a medical writer with over six years of experience in freelance writing, editing, and proofreading. She is a practicing healthcare professional holding a doctorate in physical therapy at DOW University of Health Sciences. She loves to write and read about Physical and Mental health. She started content writing to blend her passion for writing and medicine with extensive clinical experience.

Diabetes

What is Diabetes?

What is Diabetes?

What is it and causes it?

Diabetes mellitus, often just called diabetes, is a condition that happens when glucose levels in the blood are too high. Glucose is found in foods and is stored in our liver, fat, and muscle cells. The pancreas produces a hormone called insulin which removes glucose from the blood and stores it in our cells. When the pancreas doesn’t produce enough insulin, or the insulin doesn’t work properly, then blood glucose levels begin to increase and may cause the condition known as diabetes. There are two types of diabetes: Type 1 and Type 2.

Types of Diabetes

Type of Diabetes

• Type 1 diabetes, also known as juvenile diabetes, is associated with early childhood or young adults.

• It is characterized by the body’s inability to make insulin or make enough insulin.

• Individuals with this type of diabetes are usually insulin dependent, meaning that they must regularly take insulin to stay healthy. This condition is referred to as insulin dependent diabetes mellitus, or IDDM.

• Type 1 diabetes is more prevalent in white people.

Type of Diabetes

• Type 2 diabetes, also known as adult-onset diabetes, can affect all age groups.

• This type of diabetes is more often seen in adults, people living with obesity, and people who are physically inactive.

• It is caused by insulin becoming less effective at removing glucose from the blood, or by the pancreas producing less insulin.

• Most individuals diagnosed with Type 2 diabetes use diabetes medications to help manage and control the condition.

• Black people are more likely to develop Type 2 diabetes than white people.

Diabetes Awareness

Who is affected?

Annually in the United States there are at least a half a million new cases of type 2 diabetes diagnosed among older adults and minority groups are at higher risk for being diagnosed with Type 2 diabetes mellitus as compared to Caucasians. 

At least 2.8% of the United States population is unaware that they have diabetes, and this number is higher in minority populations.  

Unfortunately, those who are not aware that they have diabetes are more likely to suffer from the acute and chronic diseases that result from poor diabetes management or uncontrolled diabetes.  

Diabetes is becoming an epidemic in the United States with the number of diagnosed and undiagnosed cases increasing among those aged 20 and older.

African Americans and Diabetes

• In 2018, non-Hispanic blacks were twice as likely as non-Hispanic whites to die from diabetes.

• African American adults are 60% more likely than non-Hispanic white adults to be diagnosed with diabetes.

• The increased prevalence of Type 2 diabetes among African Americans may extend to children and adolescents.

• African Americans are disproportionately affected by diabetes and bear the burden of the morbidity and mortality associated with diabetes.

Women and Diabetes

Although diabetes affects all genders, ethnic groups, and economic classes, specific groups within these demographics are at a higher risk for developing diabetes. Of the millions of adults affected by diabetes, 50% are women. Heart disease occurs more frequently in women than men and is one of the most life-threatening complications of diabetes. This means that women with diabetes are more likely to have a heart attack than men with diabetes, and a heart attack may occur at an earlier age than in women without diabetes.

African American Women and Diabetes

Diabetes is more prevalent in African American women and is deeply rooted in culture and perceptions of health and beauty. Historical and socio-cultural factors are just two reasons for the overwhelming number of black women diagnosed with diabetes.

One factor of the high diabetes risk in African American women is that more women in this ethnic group have a BMI score that puts them in the obese category.

<h2 style="color: #3f3b36; font-family: Merriweather, serif; font-size: 26px; font-weight: 400; font-style: italic;">MARCIA BYGRAVE PHD</h2>

MARCIA BYGRAVE PHD

Marcia Bygrave is a licensed nurse. She received her PhD in public health from Walden University. She is currently a Sr. Enterprise Learning Development Advisor with a large managed care company. Marcia has 25+ years of experience in the healthcare field working in management, staff development and training and as a charge nurse. She has extensive experience training staff and caregivers and developing programs to address pertinent skills. Marcia is also an entrepreneur. Her most recent venture includes plans to open a diabetes education center in a local rural area in Alabama. Besides Marcia’s passion for learning, seeking knowledge, and training others, she is very passionate about helping diabetics learn skills to manage their diabetes. She has a unique background, bringing experience from both the corporate and educational environments. Marcia is an advocate of continued learning and advancement; very effective in influencing the grasp of knowledge and love of learning in others.

<h2 style="color: #3f3b36; font-family: Merriweather, serif; font-size: 24px; font-weight: 400; font-style: italic;">MARCIA BYGRAVE PHD</h2>

MARCIA BYGRAVE PHD

Marcia Bygrave is a licensed nurse. She received her PhD in public health from Walden University. She is currently a Sr. Enterprise Learning Development Advisor with a large managed care company. Marcia has 25+ years of experience in the healthcare field working in management, staff development and training and as a charge nurse. She has extensive experience training staff and caregivers and developing programs to address pertinent skills. Marcia is also an entrepreneur. Her most recent venture includes plans to open a diabetes education center in a local rural area in Alabama. Besides Marcia’s passion for learning, seeking knowledge, and training others, she is very passionate about helping diabetics learn skills to manage their diabetes. She has a unique background, bringing experience from both the corporate and educational environments. Marcia is an advocate of continued learning and advancement; very effective in influencing the grasp of knowledge and love of learning in others.