Battling back on diabetes

jemorrison@charlotteobserver.comJuly 15, 2013 

  • Are you at risk?

    The CDC reports that only 7 percent of people with pre-diabetes are aware of their condition, and by the year 2050, as many as 1 in 3 American adults could have diabetes. The federal agency recommends speaking with your health care provider about pre-diabetes if you are 45 or older and have any of the following characteristics:

    • Overweight.

    • Parent or sibling with diabetes.

    • Family background is African-American, Hispanic/Latino, American Indian, Asian-American, or Pacific Islander.

    • Had diabetes while pregnant (gestational diabetes), or gave birth to a baby weighing 9 pounds or more.

    • Physically active less than three times a week.

    Source: Centers for Disease Control and Prevention

    Type 2 is not type 1

    Type 2 diabetes is often preventable, with exercise and diet playing a significant role. It should not be confused with type 1 diabetes, which typically occurs in children and young adults and for which there is no known prevention.

  • Prevention efforts

    YMCA of the Triangle will offer the CDC’s National Diabetes Prevention Program in the fall. Visit ymcatriangle.org.

    Diabetes resources in Raleigh: Visit the website of the American Diabetes Association at bit.ly/14U2aU3 or call 919-743-5400.

An estimated 79 million American adults have pre-diabetes, a condition characterized by higher than normal blood sugar levels that can turn into type 2 diabetes, one of the leading causes of death in America.

But for many people, early detection and determination can reverse the diagnosis and help them avoid devastating and expensive health complications.

Over the years, physicians realized that patients with higher-than-normal blood sugar levels were progressing to type 2 diabetes, said Dr. Marshall Silverman, a physician at Signature Healthcare in Charlotte.

And so, today many doctors are working harder to identify high-risk patients in hopes of slowing the progression of the disease or even reversing it.

It could take weeks, months, or even years of sustained diet and exercise to reduce glucose levels in the blood before a patient returns to better health. And not everyone will reverse a diagnosis, even if they put in their best effort, Silverman said. Doctors agree that tackling obesity is the first step toward managing diabetes. Left untreated, complications can include damage to the heart, eyes, kidneys and nerves as well as the loss of limbs and death.

Genetics and age are two risk factors that can’t be overcome, Silverman said. But focusing on lifestyle issues that can be changed will reduce the likelihood that a person will develop the complications that come with elevated blood sugars.

“For these people, their lifestyle is their medication,” he said.

A success story

African-Americans are far more likely to struggle with diabetes than the overall population. Compared with non-Hispanic whites, African-Americans are more than twice as likely to die from diabetes.

Deborah Bouler, 52, is pre-diabetic and has seen firsthand what the disease can do.

“I’ve known several people to die from diabetes, and I didn’t want to be one of those statistics,” she says. She watches as friends and family with diabetes continue to struggle with their weight.

But she is one of the success stories.

By changing her diet – substituting baked fish and chicken for fatty beef and pork, and beginning to exercise, the northwest Charlotte woman has already lost nearly 20 pounds. Just three months after learning she was pre-diabetic, her blood sugar levels have returned to normal.

She made the change as a patient at Carolinas Medical Clinic-Biddle Point, which has a full-time diabetic educator and hosts group diabetes classes once a month for Medicaid patients. The clinic also works with the YMCA to offer deeply discounted gym memberships.

“If you can just lose 7 percent of your body weight, you will reduce your risk of becoming diabetic by over 50 percent,” says Dr. Sveta Mohanan, who treats patients at the clinic.

“Our patients want to do these things – they want to be conscious about their health,” Mohanan said, but living in poverty makes it tough. “You exercise, but you don’t know where you’ll eat. Your water is turned off. What do you do with your children?”

Bouler, a home health care nurse, has tried to make healthy habits part of her routine.

“I’m usually up and at it by 6 o’clock,” she says. “I get up, check my blood sugar and take my meds. I usually eat fruit, or sometimes I skip breakfast, but I try to get a 20-minute walk in before work.”

Ignoring the signs

Maxine Phillips, a life and career coach in Raleigh, knew that she’d put on a few pounds over the years, but the wife and mother had too much on her plate to worry about her expanding waistline. That was until she was diagnosed with type 2 diabetes in 2009.

Phillips, 58, was under a lot of stress in the years before she found out she was diabetic. The budding businesswoman had returned to school full time, and she was the primary caretaker for her diabetic husband. When she started feeling thirsty all the time and realized she was urinating more frequently, Phillips finally approached her doctor.

“In my 20s, I ate very well and exercised very well. I never had a weight problem or any health problems, but when you stop being conscious of your food choices, that’s when it happens,” she said. “My body was giving me the signals, but … I was so busy doing other things.”

Her blood sugar levels were so high that her doctor expressed surprise that she could even walk. “I thought ‘Oh my goodness. I’ve allowed my body to become sick,’ ” she said.

She made small changes to her diet and began to exercise. But just four months after her diagnosis, life dealt Phillips another blow. Her husband of 35 years fell ill and died from diabetic complications. Her mother, also diabetic, passed away in February.

In the nearly four years since her diagnosis, Phillips has lost six dress sizes and her blood sugar level has improved to the point where it’s only slightly above normal. She has no plans to stop there.

Last year, Phillips became an ambassador for the American Diabetes Association. She speaks at churches and local health fairs and uses her story to connect with others who may be pre-diabetic or diabetic without knowing it.

“I’m surprised by how many people in North Carolina are undiagnosed. But the thing about it is, we don’t have to die from diabetes,” she said. “We can reverse it.”

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