Diabetes: Lifestyle and Food among the Underserved

*This is an essay I did in a class I am taking and I thought it would be interesting to share... 😊

Diabetes is a condition where the pancreas loses some to all function in producing insulin. It can be characterized through different side effects such as extreme weight loss, hair loss, increased thirst/urination, unstable mood changes, higher or lower than normal blood sugar levels, etc. (WebMD).  This condition can be further specified by the severity of symptoms as well as the level of pancreatic function (WebMD). Type 1 diabetes, also called early-onset diabetes, is characterized by more severe symptoms and a full loss of pancreatic function. Type 1 diabetes tends to be more prevalent amongst children and young adults but can affect older individuals as well. Type 2 diabetes is characterized by milder symptoms and partial loss of pancreatic function. It is said that with good dietary changes, stress management, and regular exercise, Type 2 diabetics can regain the full function of their pancreas. Type 2 diabetes tends to affect older individuals but has affected younger people as well for multiple reasons. Although diabetes is researched and funded, there is still a lot of ignorance surrounding the disease and how it works. And while wealthier countries are able to receive funding for diabetes research, places that suffer through political turmoil, poverty, government abuse, discrimination, etc. have not been so lucky. Recently, there has been more research delving into how certain foods (as well as the lack of it) can affect the body. Type 1 and Type 2 diabetes is becoming more prevalent in impoverished areas faced with a lack of food security, government security, healthcare, etc. due to a dependence on preserved/canned foods, malnourishment, foods in high glycemic index, exposure to diseases, as well as exposure to trauma and stress. 

In Gary Paul Nabhan’s article, Diabetes, Diet, and Native American Foraging Traditions, in Food in the USA, he discusses how diabetes has afflicted the Native American community, especially among the O’odham, and how changes in their relationship to food have led to not only suffering from the disease but a loss of the indigenous traditions and culture that kept them contented and healthy (231). The essay begins by giving personal accounts of older indigenous peoples based on their reminiscence and practice of the traditional gathering and farming of desert foods (Nabhan 232). These indigenous people lived off of the land. The elders of the community hold tight onto the indigenous traditions, practices, and language surrounding food and have been concerned with the high prevalence of Type 2 diabetes in the community. They believe that so many young Natives are dying because of the “Anglo’s” food; they are not eating the foods of the desert which they are meant to eat (Nabhan 232). Nabhan brings on a great point that these traditional indigenous elders relate their “culinary traditions to their health and survival” (234). 

Before WWII and government work projects, many indigenous people were lean and healthy but subsequently were not able to persist in their traditions resorting to “cash economy and canned food” (Nabhan 234). Much of their land was overgrown or eroded and they were not able to gather nor farm the desert foods that had once been crucial to their traditional diet. Nabhan mentions that he believes that diabetes/obesity prevalence rose not because of the number of calories but in the kind of food that they were now eating (235). Due to the amount of poverty and the number of unemployed Natives, they can only afford food that is cheap or food supplied by the government (Nabhan 234). This food is processed, unhealthy, and at times high in the glycemic index which has caused such a high rate of diabetes. However, the increased prevalence of this disease among the indigenous communities serves as a motive to return to their traditional diet.   

In Lauren Carruth and Emily Mendelhall’s research article, “Wasting away”: Diabetes, food insecurity, and medical insecurity in the Somali Region of Ethiopia, they discuss the lack of research in impoverished areas with a high prevalence of diabetes. They also discuss the paradoxes in the etiology of diabetes (Carruth & Mendelhall). Even though diabetes is tagged along with obesity and unhealthy eating, the people of the Somali Region are malnourished and do not carry the appearance of obese individuals (Carruth & Mendelhall). Studies show connections between diabetes and stress, depression, trauma, violence, HIV, tuberculosis, low-quality diets, genetics or a combination of the above (Carruth & Mendelhall). In places like the Somali region, dietary changes and weight loss advice come short as these places have a lack of food and obesity is atypical. Eastern Ethiopia is affected by political turmoil as many individuals were evacuated from their homes due to political violence (Carruth & Mendelhall). Because of the high-stress environment, the body goes through stress as well. This gives certain infections the opportunity to invade the body. When that happens, the immune system becomes compromised and the body weakens and at times fails. That is where diabetes comes in. 

The Somali people call diabetes or its effects as “wasting away” as it leads people who were once full of vitality into complete body deterioration (Carruth & Mendelhall). Unfortunately, not everyone in East Ethiopia has the commodity of having a refrigerator to pack insulin, the money to buy insulin, the money to see an endocrinologist, the best health care in their communities, etc. This makes managing diabetes very difficult if it is even diagnosed in the first place. Because of the stereotype surrounding diabetes with overeating and poor exercise, many Somalis expressed surprise when they were diagnosed with diabetes instead of another acute infection like malaria (Carruth & Mendelhall). Once diagnosed, oftentimes with most individuals, it increases their fear and stress of further deterioration.   

Comparing these two impoverished communities is interesting because even though physically they looked very different, these two groups, similarly, suffered through extreme stress and changes applied to their bodies. The common factor in diabetes is not obesity or extreme weight loss but it is some sort of trauma that the body undergoes. When the body goes through stress and/or trauma, the immune system gets compromised and certain organs in the human body can altogether stop or slowly lose their functioning. Diabetes is the response to extreme changes in lifestyle that do not allow the body to recuperate or get used to the source of stress. This is seen in all communities, not just impoverished ones. The causes of diabetes were at some point a mystery but the new challenge of diabetes is the inability for many to manage diabetes properly while living a poor lifestyle and being exposed to high-stress environments. 

As a Type 1 Diabetic myself, I went through periods of high stress in my life and dietary changes while growing up. Right before I had started seeing common indicators of diabetes, I got afflicted by a malady with symptoms of extreme allergies, sore throat, and inability to hear from one ear. It is probable that I had gotten a virus. My body had gone through some sort of stress that compromised my immune system and rapidly deteriorated my pancreatic functioning. Managing diabetes, especially Type 1 diabetes (as it is more severe) was very frustrating and stressful. I was able to realize that eating low-carb foods as well as foods high in fiber could help me control my blood sugar levels, increase my insulin sensitivity, as well as minimize the deterioration going on in my body. Thankfully, I also do not have a poor quality of life. 

However, health insurance companies are huge factors in the United States as to why people are not getting the health care they need. Even though deductibles are paid to these companies in order to receive coverage for appointment visits, medications, and medical supplies, patients are put under even more stress and anxiety when met with pre-authorizations for doctors and further restrictions. Health insurance is expensive and people in the USA sometimes cannot afford it. It has led some people to opt-out of getting one. However, that comes with complications of its own. Diabetic supplies and medications are very expensive not because they are costly to make but because pharmaceutical companies overinflate the prices in order to make money. The system under which pharmaceutical and health insurance companies work under are abusive since there are not many therapeutic options available for diabetics. Diabetics of all types are either forced to pay for these over-inflated medical products or ultimately face death. Diabetics also face problems when low-carb foods and foods rich in fibers tend to be more expensive and less convenient than processed foods or foods high in the glycemic index like bread or sugared cereal. 

In conclusion, within our world community, there needs to be a stronger effort to bring about addressing these issues and how to face them directly. First, we need to learn how we can help underserved people get effective treatments cheaply. Second, we need to learn how we can provide healthy food and lifestyle choices without it being expensive. And finally, we need to learn how we can address and take down companies who are abusing their status to make money at the expense of the health and lives of people with this chronic condition.

Works Cited

Carruth, Lauren and Emily, Mendenhall. “‘Wasting away’: Diabetes, food insecurity, and

medical insecurity in the Somali Region of Ethiopia.” Social Science & Medicine, vol. 228, May, 2019, pp. 155-163, Elsevier.

“Early Signs and Symptoms of Diabetes: How To Tell If You Have It.” WebMD, WebMD, www.webmd.com/diabetes/guide/understanding-diabetes-symptoms#1.

Nabhan, Gary Paul. “Diabetes, Diet, and Native American Foraging Traditions.” Food in the USA

 A Reader, by Carole Counihan, Taylor and Francis, 2013, pp. 231–237.