Viola Davis usually has an answer for everything. That’s according to the actress herself. “I’m someone who always has a solution,” Davis tells SELF. But a year and a half ago, when Davis’s doctor told her that she had prediabetes, she was at a loss. “I was shocked,” Davis says. “I didn’t know what to do.”
Prediabetes is a serious health condition in which a person’s levels of blood glucose (also known as blood sugar) are consistently elevated, but not to the point of having type 2 diabetes. It’s diagnosed via blood tests that can determine if a person’s blood glucose levels have entered prediabetic territory, according to the National Institute of Digestive and Kidney Diseases (NIDDK). This happens when your body has issues processing or creating insulin, a hormone released by your pancreas to help glucose from food enter your cells and give you energy. Because this leads to high blood sugar, having prediabetes does increase a person’s risk of developing type 2 diabetes down the road, which can then lead to related health issues such as heart disease, according to the NIDDK.
Given how dismaying this information can be, it’s no wonder that Davis was stunned when her doctor said the result of her HbA1c—a blood test indicating your average blood sugar over the past three months—was high enough to put her in the prediabetes range.
Davis, 53, was already quite familiar with diabetes, the actress tells me a couple of hours before the premiere of A Touch of Sugar, a documentary about the impact of type 2 diabetes in the United States. Davis is a spokesperson for the documentary, which was created in collaboration with the pharmaceutical company Merck.
In fact, the illness is prevalent in Davis’s family. She ticks off a long list of people close to her affected by the disease, ranging from siblings to grandparents to in-laws. But Davis never thought it would happen to her. “I always felt like I was the lucky one in the family because I was ‘the healthy one,’” she says.
Now, Davis is one of the 84 million American adults living with prediabetes.
Prediabetes by the numbers
That 84 million figure comes from the 2017 National Diabetes Statistics Report, released by the Centers for Disease Control and Prevention (CDC). The report culled data from various large-scale population-based surveys and studies in order to determine the prevalence of prediabetes and diabetes in different populations. According to the CDC, these statistics show that more than one in three American adults has prediabetes.
You can have prediabetes for years without signs that anything’s amiss. This was the case for Davis. “I felt healthy. I feel healthy—even now, I feel great,” she says. “But it got me.” (More rarely, people do experience prediabetes symptoms like acanthosis nigricans, or darkened skin in areas like the armpits and neck, along with skin tags, the NIDDK says.)
Still, the Oscar winner considers herself fortunate to be in the minority of those who even have a prediabetes diagnosis. Of the 84 million people with this condition, 90 percent aren’t aware that they have the condition, per the CDC. “I actually talked to a friend of mine who said, ‘I’m sure my numbers are elevated, but I’m not going to check,’” Davis says. “Sometimes it takes a diagnosis to wake people up.”
That’s precisely what Davis experienced after her diagnosis. Looking back now, it’s so clear to her, she says. While she was busy with life—clocking 16-hour days on the set of How to Get Away with Murder and letting “self-care get put by the wayside”—a cluster of prediabetes risk factors was quietly assembling into what Davis calls her personal “ticking time bomb”: Being over 45, having an immediate family member with type 2 diabetes, and being African-American.
Race as a risk factor
According to the CDC’s 2017 National Diabetes Statistics Report, black non-Hispanic adults have the highest rates of prediabetes, with a prevalence of 36.3 percent in the years 2011 to 2014. But all of the racial groups had a prediabetes prevalence over 30 percent, which makes sense given that this health condition affects a third of the adult U.S. population overall.
Disparities come more sharply into focus when you look at rates of diagnosed diabetes: 12.7 percent of black non-Hispanic adults had diagnosed diabetes in the years 2013 to 2015, compared with 7.4 percent of white non-Hispanic adults. (Only American Indian/Alaska Native people outpaced African Americans, with a diagnosed diabetes prevalence of 15.1 percent.)
Even with such significant rates of prediabetes and diabetes, Davis says these health issues are often not talked about enough in African-American circles. “There’s just a silence within our community about diabetes in general,” Davis says.
When I ask Davis why she thinks this is, she leans back and sighs. The question is big and the answer is complicated. In Davis’s opinion, part of the issue is that some black people were simply never told that diabetes is, in fact, a serious illness. For many, it’s more of a fact of life. “They don’t see [diabetes] as a disease,” Davis says. “They just see it as ‘the sugar.’”
Some of this may come down to a lack of communication from doctors. The CDC report found that only 10.5 percent of black non-Hispanic people with prediabetes reported an awareness of the condition, with many reporting that no doctor ever told them they had it. (Awareness percentages for other racial groups with prediabetes were all between 7 and 12 percent.)
Davis is also intimately familiar with how carbohydrate-heavy feasts often sit at the center of tradition in many African-American households. Since carbohydrates like sugar provide glucose for energy, they can drastically affect blood sugar. “It’s the foods in our culture that we associate with comfort: the cornbread, the rice, the dumplings, the candy,” she says. Davis and her siblings grew up with an additional (albeit less conventional) method of eating carbohydrate-rich cornstarch straight from the box: “I think about it now, and oh my god. Cornstarch!”
Davis also thinks overarching cultural attitudes about body weight and health in the African-American community may play a role here. She has mixed feelings about this.
“We have a different definition of overweight in our community,” she says, giving a nod to the fact that, due to a general appreciation of bigger bodies in the African-American community, there’s less pressure for black women to conform to a Eurocentric standard of thinness.
“There’s a part of it that I love, and there’s a part of it that can be detrimental,” Davis says. While the connection between weight and health is incredibly nuanced, research does indicate that the association between obesity and diabetes risk is there. (Here’s a SELF investigation on the connection between weight and health.)
Hope after a prediabetes diagnosis
It’s actually possible for some people to reverse prediabetes by changing their health habits, typically in a way that results in less carbohydrate consumption, along with some possible weight loss, too.
After she got her bearings post-diagnosis, Davis made some serious lifestyle changes, including cutting down on sugar in creative ways. She’s swapped in alternative sweeteners like stevia; vodka and soda water with a splash of lemon has become her go-to cocktail instead of drinks with sweet mixers. With some experimenting in the kitchen, she’s figured out how to enjoy the carb-rich foods she grew up with while still looking after her health. “Even cornbread, you can make it with almond flour,” she says. “Collard greens, you can make with smoked turkey, chicken broth, hot sauce.” (Here, she points to my recorder: “Turn that off, and I’ll give you the recipe.”)
But the ongoing burden of managing a chronic condition has been hard for Davis. “It is exhausting,” she says. “I’m still trying to keep [the changes] up.”
As she explains, it’s not enough to know what you have to do; you have to actually act on that information. “I know about carbs, how they break down, sugar … your pancreas, exercise,” Davis says. “But I think knowing and doing maybe are two different things—knowing and doing and keeping it up when you’re busy.”
If there’s anything to take away from Davis’s story, it’s that living with a chronic health issue is a journey. It can be hopeful but hard, a winding road with pitfalls and progress along the way. “This is something that I can talk about,” Davis says. “That’s a place where I can serve, and I can serve with authenticity.”