When Anita Drapeau learned about 10 years ago she was pre-diabetic, she was told a better diet, exercise and more healthful lifestyle could prevent her developing from Type 2 diabetes.
“I’ve been prediabetic for quite a long time, but I was not more careful initially,” said Drapeau, 67, of East Jordan.
Last spring, a regular blood-sugar test revealed her levels had exceeded the threshold and that she had indeed developed Type 2 diabetes. It prompted her to take the disease more seriously and to start a health and diet program offered by Charlevoix Area Hospital.
“It’s a very mild case, but I am on oral medication and the program helps you to get your mind organized to deal with this,” said Drapeau. “The first thing that I learned is that diabetes is about the relationship between what food you take in, what energy you put out, exercise, and how well you use insulin.”
It’s a learning experience an estimated 23 million-plus diabetic Americans, like Drapeau, are discovering, too.
With November recognized as Diabetes Awareness Month nationwide, the Centers for Disease Control is reporting that 1.6 million new cases are diagnosed in people 20 and older each year. It’s a costly disease: Americans with diabetes — about 8 percent of the total population — nearly doubled their spending on drugs for diabetes in just six years, with the bill last year climbing to more than $12.5 billion.
“If I manage to lose weight I could possibly get off the medication, but not necessarily,” said Drapeau. “My cells don’t accept insulin the way they should. I like to think it would entirely go away, but that’s not likely. Other than maintaining diet and exercise, the other thing in my case is I need to lose weight, which is true for most Type 2 diabetics.”
Why diabetes happens
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
Amanda Leinonen, registered dietitian with Charlevoix Area Hospital, said diabetes develops when cells in the pancreas don’t function as they should to release enough insulin that helps get sugar into the cells for the body to use.
“Insulin is the key to the door on our cells,” Leinonen explained. “Without insulin, we can’t get the sugar in, or the energy, and the sugar just builds up in our blood and we end up with too much.
“Eventually, that can cause problems such as heart attacks. It’s almost like cholesterol.”
One common problem suffered by diabetics is neuropathy, particularly in the feet, because the sugar builds up in the smaller vessels and causes nerve damage, sensitivity and pain. Diabetics also often have accompanying eye problems as well, again because of the sugar buildup in the small blood vessels that travel to the eyes.
Leinonen’s role as a dietitian is to inform patients about the importance of a healthful diet in managing diabetes and to provide meal plan suggestions and dietary information so diabetics know the challenges they face.
“Really sticking to a meal plan and exercise are your keys right there,” she said.
She informs patients about the importance of getting a certain amount of carbohydrates at each meal. “A big misconception is that sugar and carbs are bad for diabetics, but we all need carbohydrates,” Leinonen said. “I really try to stress that we need to balance the diet. Every meal should be the same amount of carbs, and eaten the same amount of hours apart. It’s creating a routine.”
Protein is also important at each meal, Leinonen said, as it takes longer to digest and extends the digestion of the sugars.
Since she began following the dietary suggestions of Leinonen and the nursing staff with Charlevoix’s diabetes program, Drapeau said her need for daily naps has subsided and she has more energy throughout the day. She feels good when she gets up in the morning, as the medication is controlling middle-of-the-night glucose releases, and her grocery choices have changed to include meat, vegetables and fruits rather than packaged meals and snacks.
“You have to manage it,” Drapeau said.
Drapeau does not require insulin shots, though many diabetics do. Leinonen said most of those who do use insulin need to inject it twice or more a day, depending on the severity of the diabetes. All diabetics need to monitor their blood sugar levels with finger pokes.
Those 40 and older are at higher risk for developing diabetes, she added, though the age of patients continue to get younger. Diabetes is not a fatal disease in and of itself. “You cannot die of diabetes, but people do often die from the complications. Heart disease runs hand in hand with diabetes,” Leinonen said.
However, proper management, diet, exercise and menu-control can go a long way toward giving diabetics a normal, energetic lifestyle, she added. “Things are never to be normal, you’re always going to be checking your blood sugar, but you can definitely be active,” Leinonen said. “If they really take control of their diabetes and really try to work with it, I want people to know they can have a healthy life.”
Diabetes details
Diabetes is one of the fastest-growing health conditions in the United States. It’s estimated that more than 23 million Americans suffer from either Type 1 or the much-more common Type 2 diabetes. There are also cases of pre-diabetes and gestational diabetes.
The differences:
Pre-diabetes means that the cells in your body are becoming resistant to insulin or your pancreas is not producing as much insulin as required. Your blood glucose levels are higher than normal, but not high enough to be called diabetes. A diagnosis of pre-diabetes is a warning sign that diabetes will develop later. The good news: You can prevent the development of Type 2 diabetes by losing weight, making changes in your diet and exercising.
Type 1 Diabetes: A person with Type 1 diabetes can’t make any insulin. Type 1 most often occurs before age 30, but may strike at any age. Type 1 can be caused by a genetic disorder. The origins of Type 1 are not fully understood, and there are several theories. But all of the possible causes still have the same end result: The pancreas produces very little or no insulin anymore. Frequent insulin injections are needed for Type 1.
Type 2 Diabetes: A person with Type 2 diabetes has adequate insulin, but the cells have become resistant to it. Type 2 usually occurs in adults over 35 years old, but can affect anyone, including children. The National Institutes of Health reports that 95 percent of all diabetes cases are Type 2. Why? It's a lifestyle disease, triggered by obesity, a lack of exercise, increased age and to some degree, genetic predisposition.
Gestational diabetes (GD) affects about 4 percent of all pregnant women. It usually appears during the second trimester and disappears after the birth of the baby.
Like Type 1 and Type 2, your body can’t use glucose effectively and blood glucose levels get too high. When GD is not controlled, complications can affect both you and your baby. Your doctor will help you work out a diet and exercise plan, and possibly medication. Having GD increases your risk for developing it again during future pregnancies and also raises your risk of Type 2 diabetes later in life.
Source: American Diabetes Association
Are you at risk?
Take a quick online quiz to determine if you are at risk for developing diabetes: http://www.diabetes.org/risk-test.jsp
Common symptoms, as noted by the American Diabetes Association, are:
Frequent urination
Excessive thirst
Extreme hunger
Unusual weight loss
Increased fatigue
Irritability
Blurry vision
If you have one or more of these diabetes symptoms, see your doctor right away.
Local resources
TIPDON is the Northern Michigan organization dedicated to helping diabetic patients.
Visit www.diabetesinmichigan.org/HomeTIPDON.htm or call (231) 237-9681 or (800) 847-3665, for more information.
Information on screenings, risk factors, community events and support groups related to diabetes management can be accessed through TIPDON.