Insulin and non-insulin dependent forms of diabetes have higher morbidity and mortality rates in African-Americans when compared to non-Hispanic whites. The African-American population also has high rates of end-stage renal disease, blindness, lower-extremity amputation, perinatal mortality, and major congenital malformations due in large part to diabetes.¹⁴

• Runs in families
• Is conceptualized as the result of excessive consumption of starchy, greasy foods, excessive worry about family and work-related stresses.
• For symptoms of weight loss, thirst and frequent urination, dietary changes, use of appropriate herbs, and reestablishment of harmony with family, friends and coworkers are initially recommended in the popular health beliefs.
• If the person is unable to make sufficient changes in these areas or the herbs do not appear to remedy the symptoms, then a visit to the physician is warranted.
• A diagnosis of diabetes is generally well-accepted when the patient is told that the blood sugar is elevated. With this explanation, insulin and oral hypoglycemic medications are more easily accepted because they are thought of as “bittering” agents used to lower the sugar content.
• Home remedies such as herbal teas, garlic and lemon juice may also be used to bitter the blood.
• Insulin may be viewed by some patients (generally older patients) as too powerful a substance, promoting addiction or dependence. This fear may be exacerbated when the patient is told that they will need therapy forever.