When Evelyn Smith went on her annual spring diet back in 1998 and lost more than the 10 pounds she’d intended, she figured her fierce exercise routine had simply burned off some extra calories. But then, the 33-year-old Philadelphian started waking up in the middle of the night with “cotton mouth” and mixing up computer codes at work.

“My mind was foggy. I couldn’t comprehend anything,” says Smith. “I typed my symptoms into the Internet,” she says, “and diabetes came up.”

African Americans are at alarmingly high risk for the Type 2 form of diabetes for which Smith eventually tested positive: It afflicts one out of 10black adults and one out of four black women over 55. It is our fifth leading cause of death. Diabetes also tends to run in families; Smith’s grandfather lost the lower part of a leg to the disease, and his obese twin sister was diabetic, too.

Bad food and sedentary habits are also two of the biggest risk factors—but Smith herself had always been fairly fit. “I didn’t have the best diet, but it wasn’t the worst,” she says. But after tests confirmed that Smith had Type 2, the self-described carbohydrate addict with a syrupy sweet tooth realized that while her weight hadn’t been climbing, her blood sugar had been creeping up.

Maudene Nelson, RD, a diabetes educator, explains, “Most black people with Type 2 diabetes are heavy. But a person doesn’t have to be heavy to have diabetes.” (African Americans’ extra risk appears to be related to poverty and access to health care, but there are also genetic theories.)

Smith learned the hard way that her body has trouble producing or processing insulin, the hormone that converts food into energy.

Left untreated, the disease is a slow, silent killer. Excess blood sugar or insulin can damage nerves and blood vessels, tax the liver and kidneys and make arteries harden, circulation slow way down and blood pressure climb. For these very reasons, diabetics are twice as likely as others to die of heart disease and are five times more vulnerable to strokes. The stroke that hit soul star Luther Vandross in 2003, when he was 51, came after 33 years as a diabetic—a severe strain that one day his body just couldn’t take.

Serious vision problems, even blindness, can also develop, and it’s not uncommon for diabetics to need dialysis or even amputation of a limb, finger or toe.

Rev. William D. Tyree III; 44; pastor, First Baptist Church, Norfolk, Virginia

How he found out he was diabetic: “I was getting up to urinate in the middle of the night, which wasn’t my pattern. And when I stood up to preach one Sunday, I couldn’t discern faces beyond the third pew. My blood sugar was over 400."

Risk factors: Family history, excess weight, sedentary lifestyle, poor diet. “I figured I’d get diabetes when my parents got it, which was in their early sixties,” he says. “I was scared when I learned I had it at 38, especially as I learned more about the complications.”

What he did about it:
He started cycling about 15 miles a day, lost weight and improved his eating habits.“Fifteen pounds makes a big difference in my blood-sugar levels,” he says.

And now: His congregation now gets free diabetes counseling from area doctors, samples healthful cooking and “cycles for Christ” at Rev. Tyree’s side.    —HB