1. I S A B E L L E G I G A N T E
V U S M
8 / 2 4 / 1 6
Improving Cardiovascular Health
in African-Americans with
Diabetes
2. Case Presentation
Patient is a 58 y/o African American female
Hx of HTN, DM2, GERD, insomnia, knee pain
Diabetes treated with metformin, most recent A1C of 7.7
HTN well-controlled without medication
Hyperlipidemia treated with pravastatin
No family hx of CVD or diabetes
Non-smoker
4. ASCVD Risk Calculation
2012: age 54
HDL: 44
Total cholesterol: 155
No smoking, HTN, or diabetes
ASCVD 10 year risk 2.3%: ; Lifetime risk: 27%
2016: age 58
HDL: 42
Total cholesterol: 173 (on statin)
Diabetes, HTN well-controlled without medication, no
smoking
ASCVD: 10 year risk: 10.1%; Lifetime risk: 39%
5. Cardiovascular Disease
Leading cause of death with 17.3 million deaths per
year worldwide
Every 40 seconds, someone in America dies from
CVD
Claims more lives than all forms of cancer combined
Almost half of African-American adults have CVD
Source: American Heart Association
8. The Veggie Project
Goal: “To make Nashville a healthier community by
improving access to fresh fruits and vegetables in
food desert neighborhoods while supporting local
farmers and empowering and educating youth.”
Target audience included racial/ethnic minorities
Results: In 2010, 55 produce markets were held at
six locations. During this time, were 1,003 adult
transactions, 298 youth transactions, eight Youth
Leader board meetings were held and 8,894 pounds
of fresh produce were sold
13. Why: Ethnic minorities are disproportionately
affected by both diabetes and CVD
Risk of diabetes is 77% higher among African-Americans vs.
non-Hispanic white Americans
Source: Centers for Disease Control and Prevention: National Diabetes Fact Sheet:
National Estimates and General Information on Diabetes and Prediabetes in the
United States. Altanta, Ga., U.S. Department of Health and Human Services, 2011
14. Planned Intervention
Use funding to help pass the Child Nutrition
Reauthorization bill
This bill contains many important programs such as:
Summer Food Service Program
Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC)
National School Lunch Program
15. Summer Food Service Program
Provides free meals to low-income children during
summer months
Reimbursable meals must meet federal nutrition
standards
16. Provides nutritious foods, nutrition education, and
screening and other health referrals
Target population includes pregnant women,
breastfeeding women, postpartum women, infants,
and children up to their fifth birthday
WIC
17. National School Lunch Program
Provides nutritious meals during the school day for
low-income children
Must meet certain nutrition standards
19. Time Needed
Every 5 years, Congress meets to reauthorize
childhood nutrition programs
On September 30, the child nutrition bill will expire
and Congress will meet to discuss new legislation
Therefore, this funded campaign should begin as
soon as possible
20. Defense
Ethnic minorities often live in “food deserts” and are
unable to make healthy diet choices, which can
contribute to obesity and diabetes
Many of the patients on my panel were African-Americans
with diabetes, which put them at a higher risk for CVD
Programs such as the Summer Food Service
Program, WIC, and the National School Lunch
Program ensure that low-income children receive
nutritious meals
Low-income children are disproportionately from racial
minorities
This intervention applies to a large population
Editor's Notes
Around 21 million Americans have diabetes
This number continues to grow
Up to 35% of the US adult population has pre-diabetes
African-Americans and other minorities are disproportionately affected
