DIABETES-MELLITUS AND ITS COMPLICATIONS IN AN AFRICAN-AMERICAN COMMUNITY - PROJECT DIRECT

Project DIRECT (Diabetes intervention Reaching and Educating Communiti es Together) is a multilevel community-based intervention project desi gned to address diabetes and Its complications in an African-American community This article presents results of the Project DIRECT pilot st udy and describes risk factors for diabetes, diabetes prevalence, comp lications, and care practices. During 1993, a pilot study was conducte d among persons 20 to 74 years of age in Wake County, North Carolina. The study involved household interviews and examinations, and more ext ensive health center interviews-and examinations based on the race of the head of the household, previous diagnosis of diabetes, and results of capillary glucose tests done in the household. Of the black popula tion aged 20 to 74 years, 52 +/- 3% reported being inactive and 51 +/- 3% were overweight; the prevalence of diagnosed diabetes was 5.2 +/- 0.9%; the prevalence of undiagnosed diabetes was 5.7 +/- 2.7%; and the prevalence of impaired glucose tolerance was 11.4 +/- 7.5%. Blacks wi th diabetes were significantly more likely than nonblacks with diabete s to have uncontrolled hypertension and to smoke cigarettes. Blacks wi th diabetes were significantly less likely to report having health ins urance or to have a private health-care provider. Diabetes mellitus is a major public health problem in the African-American community of Wa ke County Modifiable risk factors For diabetes and undiagnosed diabete s are common. Project DIRECT is attempting to improve the health-relat ed quality of life of this population by reducing the burden of diabet es and its complications through a multilevel, community-based interve ntion.