Diabetes is a manageable disease

After a family backpacking trip a couple weeks later, he weighed 66.

"It came on pretty quickly," said Gildon, now 28, reflecting on what led up to his eventual diagnosis: diabetes.

He's among the 26 million people in the United States with diabetes, according to the American Diabetes Association, which acknowledges November as American Diabetes Month.

The recently published Diabetes Report Card 2012 from the Center for Disease Control (CDC) listed Oklahoma as having had the highest increase in adult diabetes from 1995 to 2010, with nearly one in 10 Oklahomans having the disease.

Diabetes is a group of diseases characterized by high blood glucose, or blood sugar, the CDC's report explained. With diabetes, the body either doesn't produce enough insulin or is unable to use its own insulin effectively.

Glucose builds up in the blood and causes a condition that, if not controlled, can lead to serious health complications and even death, the report said.

At the time he was diagnosed, Gildon wasn't familiar with diabetes.

On the way home from that aforementioned backpacking trip, Gildon kept asking his parents to make pit stops every 20 or 30 minutes. He was also thirsty.

Eventually, he started feeling bad. After the family made it home, their physician said Gildon might have flu, then wrote him a prescription.

That evening, he became sicker still, and couldn't keep water or Sprite down. That's when his mother took him to the emergency room.

A normal glucose level is in the 80-100 range, Gildon said. That night in the hospital, his hit 999.

Signs and symptoms of diabetes can be subtle and increase over time, said Dr. Laura J. Chalmers with the Harold Hamm Oklahoma Diabetes Center at the University of Oklahoma, 4444 E. 41 St.

Those signs include being more thirsty, urinating more often, waking at night to drink and go to the bathroom, and weight loss, Chalmers said. The appetite may also be increased, and some people will have nausea and vomiting.

Gildon was diagnosed with juvenile diabetes, or type 1 diabetes (T1D), one of the three most common forms of diabetes, according to the CDC. Another, type 2 diabetes (T2D), makes up for about 95 percent of diagnosed diabetes in adults; the third, gestational diabetes, develops and is diagnosed as a result of pregnancy in 2 to 10 percent of pregnant women.

With T1D, the body is unable to produce insulin, a hormone secreted by pancreas to regulate blood sugar, Chalmers explained. Treatment for T1D is insulin.

In T2D, there is insulin resistance, she continued. Treatment for T2D involves weight loss, dietary changes and medications that help the body secrete insulin and overcome the insulin resistance. In some situations, patients with T2D require insulin.

Onset of T1D is typically before age 20 but presentable from approximately 6 months of age into adulthood, Chalmers said.

Annette Jones was 24 and pregnant with her youngest daughter when she was diagnosed with gestational diabetes.

"When women get gestational, it usually goes away after delivery," said Jones, alluding to the 2 percent of women who remain diabetic after pregnancy.

Jones has had diabetes for 27 years, more than half her life. Like Gildon, she wasn't too familiar with diabetes, other than having family members who were diabetic - but she was too young to understand what that meant.

"I knew there was not a cure and that you had to take shots," she said.

Lori Maisch was 45 when she was diagnosed with T1D. She had lost 25 pounds from May to September that year - "all the yard work I had been doing," she thought.

Constantly thirsty and going to the bathroom every 15 minutes, even at night, Maisch finally attracted the attention of someone in a doctor's office: her neighbor, who noticed her "sweet odor."

"It's the same scent I smell on patients that have diabetes," Maisch recalled her neighbor saying. "That prompted me to make an appointment with my primary care physician, be tested and diagnosed."

More than one diabetes

Misconceptions abound regarding diabetes, Chalmers said.

For example, T1D is treated with insulin and carbohydrate counting, she explained. Patients with T1D should have a healthy diet but are allowed to have cake, ice cream and other sweets within reason - as long as they take their insulin to cover the carbohydrates in the food they consume.

Maisch used to be one of those folks with preconceived notions about diabetes, she said. Since her diagnosis, people assume she has T2D because she's an adult.

"Then they say, 'I thought that only happened to children,' " she said. "Some will say, 'Oh, if you eat right and exercise more, you can control it.' No, that's type 2 - I am insulin-dependent."

Or she might have people tell her she can't have certain foods, like birthday cake, refusing to cut her a slice because "you can't have it," Maisch said. "I just need to adjust my insulin to eat it."

Most people don't know that there is more than one kind of diabetes, Jones said. Others she's met don't think that it's a big deal because diabetics take insulin.

"They don't realize the deadly consequences that occur with this disease," she said. "I have actually had people say to me, 'You have diabetes? You're not even fat.' I could go on and on."

Sometimes, people with diabetes might have a change in mood, experiencing "highs and lows," as Maisch said.

"If I am having either, I can come across irritable or out of it," she said. "I don't mean to but can't help it sometimes. I've found a lot of people don't understand that part of the disease."

Having diabetes can be expensive, too. Even with insurance, the two insulin shots Maisch needs each month are $100 each. Plus, she has test strips and syringes to buy. In all, it's about $400 out of her own pocket each month.

"I used to be more impulsive," Maisch said, "but now am more mindful regarding my meals and making sure I have my T1 pouch - blood glucose monitor, test strips, glucose tablets, insulin, syringe - every time I leave the house."

It takes planning

Another challenge is always having to be more prepared than the average person.

Like if a buddy of his asks him to go on a spur-of-the-moment bike ride, Gildon has to know what his blood sugar is, possibly take extra food with him in case he takes too much insulin or exercises too heavily.

If he goes on a long trip, he has to think ahead in case his insulin pump breaks - what would he do then? Gildon has to have a back-up plan.

When he'd go on a Boy Scout camping trip, Gildon and his dad crafted a case out of PVC pipe for his insulin so he could keep it in his sleeping bag on freezing nights - and insulin doesn't freeze.

One of the main challenges for Jones was changing her eating habits, like cutting back on carbs.

"Simplicity is gone," she said. "I can't go anywhere - store, work, park, ride my bike - without a plan, a snack or juice, something to treat low blood sugar."

Jones has to have her blood monitor with her at all times, and she checks her blood at least four, sometimes eight times a day.

Like Gildon, she wears a pump 24-7. "It is still better than six to seven shots a day," Jones said - but added, "I don't feel free."

Such adjustments aside, a normal, active life is achievable for most diabetics.

Jones wanted to have another baby after her second daughter, but the doctor said it was "probably best" she didn't.

"This was 27 years ago, so that mentality has changed now," said Jones, who has three beautiful daughters.

"God worked everything out," she said. "Maybe not the way I had planned it, but just perfect anyway."

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Stop diabetes before it starts

American Diabetes Month takes place each November in order to raise awareness of this disease.

According to the American Diabetes Association (ADA), it is estimated that nearly 26 million children and adults in the United States have diabetes. Another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes.

To stop this disease before it starts:

Get moving. Physical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes. The ADA recommends a half-hour of mild aerobic activity five times per week.

Eat more whole grains. White bread, white rice and potatoes have a high glycemic index, which can cause spikes in blood sugar and insulin levels. Whole grain foods help with diabetes prevention because they slow down carb absorption.

Limit your sugar intake. Be sure to read nutritional labels and steer clear of anything that lists sugar, sucrose, corn syrup or other sweeteners, such as evaporated cane juice or molasses, as one of the first ingredients.

Stop smoking. According to a Harvard School of Public Health study, smokers are about 50 percent more likely to develop diabetes than nonsmokers. New research shows that inhaling secondhand smoke may also lead to an increased risk of diabetes.

Get more sleep. Not getting enough sleep increases hunger, which leads to weight gain and, therefore, raises your risk of getting diabetes.

Check your glucose levels. The ADA recommends blood glucose screening for everyone age 45 and older. Generally, this testing is repeated every three years. But if you have known risk factors (like high blood pressure or obesity), discuss them with your doctor.

For more, visit the ADA's website tulsaworld.com/diabetes

And to learn more about Hillcrest's Center for Diabetes Management, visit tulsaworld.com/hillcrestdiabetes

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Support for diabetes

After being diagnosed with type 1 diabetes and not having a support system in place, Lori Maisch went into action.

She looked at the American Diabetes Association, JDRF (formerly the Juvenile Diabetes Research Foundation) and local support groups.

"I found that there were great meetings for type 2 (diabetes), for children with type 1, but none specifically for adults with type 1," Maisch said.

So she formed a group called T1Tulsa for adults older than 18 living with type 1 diabetes. They meet once a month. Sometimes they have speakers; sometimes they just visit and learn from one another.

"It is a special meeting for me, as it is the one time month I can look around the room, say anything, and everyone gets it," she said.

If you're interested in T1Tulsa, email Maisch for meeting details, T1Tulsa@yahoo.com.

Original Print Headline: Diabetes a race that can be won

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Jason Ashley Wright 918-581-8483
jason.wright@tulsaworld.com

Source: http://www.tulsaworld.com/site/articlepath.aspx?articleid=20121129_17_D1_CUTLIN563065

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