Living well with diabetes: A brief introduction to a complicated condition

BY MICHAEL RICONDA

As the American population has grown older, heavier and more sedentary, diabetes has emerged as a major health concern. Finding assistance, however, can be a challenge to those who have little to no knowledge on the condition.

At this time, there is no cure for diabetes. However, once understood, diabetes can be managed to the point that it has only a minimal impact and a patient can still enjoy a healthy, productive and fulfilling life.

As a condition, diabetes can be tricky to identify and even dangerous if it is not recognized in time for preventative treatment. Diabetes is caused by improper functioning of the pancreas, the gland which produces the hormone insulin. A healthy level of insulin in the blood allows the body to break down glucose-a particular type of sugar-and keep blood sugar levels under control.

When the pancreas cannot produce insulin or produces insulin which the body cannot use, blood sugar levels become unstable and diabetes is the result. These fluctuations lea to symptoms that include circulation problems, sometimes to the point of extremity amputation, irritability and fatigue, frequent urination, extreme thirst and hunger, weight fluctuation and vision impairments ranging from blurred vision to blindness.

Diabetes comes in two forms. Type 1 diabetes, also known as juvenile diabetes, often occurs congenitally when the body does not effectively produce insulin. Alternately, Type 2 diabetes emerges later in life, often as a result of obesity.

The sometimes subtle symptoms-easily mistaken for the side effects of medications, the aging process or other illnesses-make diabetes shockingly easy to be missed by sufferers. Current figures show about 7 million Americans-about 2.23 percent of the entire U.S. population-are living with undiagnosed and presumably untreated diabetes.

Katherine Brown, a registered nurse with the VNSNY CHOICE Health Plan, explained diabetes can be easily identified with simple blood tests, but it is up to patients to make the call to their doctor.

“If I would encourage people to do anything it’s to get an annual physical and have your blood glucose checked,” Brown said. “You can be proactive, because once you know you have diabetes you can make the appropriate changes to your lifestyle.”

Undiagnosed cases are only part of what has become a nationwide health concern; 25.8 million Americans-about 8.3 percent of the population-live with diabetes. Rockland’s diabetes rates stand slightly higher than the national average at 8.7 percent.

So how do you know you might be at risk for diabetes? Though complete prevention is possible, patients can evaluate their individual risk and adjust their lifestyles to avoid developing the disease. As diabetes often runs in families, genetic predisposition is often a risk factor. Those with diabetic parents or siblings are often in danger of developing the disease and should always be wary.

There is little to prevent the impact of heredity, but this is not to say environmental factors have no role. Obesity, which places strain on the pancreas and forces the production of more insulin to break down blood sugar, is another major risk factor. Consequently, a rising rate of obesity in the United States has created an upsurge in diabetes.

Treatment can prove difficult, but healthy blood sugar levels and the prevention of long-term damage are worthy rewards. Diet is easily one of the most important facets of any treatment program. Healthy, well-portioned meals rich in fruits, vegetables and whole grains keep blood sugar and body fat low, though occasional intake of healthy, high-glucose foods such as fruit juices can also help balance out low blood sugar.

“An ideal blood sugar is 80 to 120 milligrams,” Brown said. “The person who has diabetes needs to be very much in touch of their body and if they are experiencing any symptoms.”

Physical activity is an excellent supplement to a good diet. A regular exercise program which keeps patients active most days of the week can be an enjoyable addition to diabetes upkeep, but pacing is important, particularly with older patients who might not be as physically capable.

“Oftentimes, people who are diabetic have a very sedentary lifestyle, so what you do is you try to progress them slowly,” Brown said. “It is recommended to start with walking.”

Prescription insulin enters the picture when exercise and proper diet are not enough to keep diabetes under control. Different devices such as pumps and syringes can be custom fitted to accommodate the specifics of patients’ insulin needs, particularly in severe diabetics.

All of this might seem daunting, but the alternatives are by no means pleasant. Left untreated, the disease can lead to heart disease, kidney failure, blindness and nerve damage which might necessitate the amputation of digits and limbs.

Clearly, such prospects are alarming. Thankfully, Rockland has no shortage of professionals who can assist those with diabetes. Steps to a Healthier Rockland, a program sponsored by the County’s Health Department, offers a risk test, outside resources for patients, healthy living tips and other educational materials.

In addition to online information and outside resources, the Department of Health has two separate classes focusing on diabetes. The Diabetes Prevention Program (DPP) aims to educate people who do not have diabetes but are at a high risk level, while the Diabetes Self Management Program (DSMP) focuses on healthy living habits for those already living with the disease.

The program seems to be effective. According to the Health Department’s Public Health Education Coordinator Shelley Chanler, participants in both programs saw significant weight loss and increases in physical activity levels.

“Eight participants who completed 16 weeks of the first program series have lost over 136 pounds in seven months and the 10 participants in our second program series have lost over 90 pounds in 4 months,” Chanler stated. “Both groups are working at increasing their physical activity levels to 150 minutes and more per week.”

Patients with juvenile diabetes have local support as well. The Juvenile Diabetes Research Foundation’s Northern New Jersey-Rockland chapter recently announced it will hold its next support group meeting at Nyack Hospital on May 20. Meetings are held on a monthly basis.

For more information on DPP, which will begin its next set of classes on June 23, call 845-364-2502. For more information on DSMP, call 845-364-2501.

Steps is available by phone at 845-364-2500.