DIABETES DANGER ZONE
Experts, sufferers offer advice during American Diabetes
Month
November 26, 2004
By Karen Ravn
The holiday season, with its focus on food, is also
a time to heed the advice of diabetes experts.
November is American Diabetes Month and while many
of us may overindulge and under-exercise beyond the
holidays, obese couch potatoes aren't the only ones
who can wind up in the diabetes danger zone.
Consider Elisa Larez. Maybe she was a few pounds more
than ideal, but not many. And she walked the Recreation
Trail often, if not every day. Still, when she went
for a physical last year she had at least two big strikes
against her: she is over 60 and she is Mexican-American.
The older you are, the greater your risk for diabetes.
Nearly 20 percent of all Americans over 60 have the
disease. And Mexican-Americans, of any age, are more
than twice as likely to be diabetics as non-Hispanic
whites of the same age.
Tests showed that Larez's blood sugar was "way
high," she said. Not high enough for a diagnosis
of diabetes. But high enough to put her in the pre-diabetes
category.
Some experts find this category a not-too-useful euphemism.
"It's like calling someone almost pregnant,"
said Dana Armstrong, program director and co-owner of
the Diabetes Care Center, an education, treatment and
research facility in Salinas.
Studies have shown that people with pre-diabetes are
already at increased risk for two of the major potential
consequences of diabetes: heart disease and stroke.
Larez knew what diabetes could do. She'd lost a son
to the disease years before.
"When they're young, they feel fine," she
said, "and they don't want to restrict themselves.
It's only when it's done all its damage that they feel
bad."
She felt fine herself, but she wasn't about to wait
for diabetes to do its damage.
She went on a high-fiber, low-fat diet.
"You have to count your carbs," she said.
"Once you know how many you get to have, then you
pick and choose how you want to get them."
She also hit the trail with a vengeance. And the swimming
pool. And the yoga mat.
"Exercise, exercise, exercise," became her
mantra.
In a matter of weeks, Larez lost 18 pounds. And her
blood sugar dropped back into the healthy range.
Complicated, incurable disease|
Diabetes is a complicated, incurable disease that results
from various problems with the hormone insulin. In type
1, the body isn't good at making it. In type 2, which
is much more common, the body isn't good at using it.
Gestational diabetes, which comes during pregnancy and
usually goes away afterward, is similar to type 2.
Why is insulin so important?
When we eat, our bodies break the food down into sugar,
which our blood carries around and passes out to our
cells. They need it for energy. But the sugar can't
get into the cells by itself.
"Insulin is like a key that unlocks the cell door
so it will let the sugar in," Armstrong said. "In
type 1, people don't have any keys. In type 2, people
have keys, but they don't work very well."
In type 1, sugar starts piling up. In type 2, both
sugar and insulin do. The body needs to get rid of it
all.
"So it says, 'I know. Let's give this stuff to
the kidneys,''' Armstrong explained. This makes extra
work for the kidneys, so they need extra fluids. That's
why one symptom of diabetes is increased thirst. And
why another is increased urination.
A third symptom is somewhat counterintuitive. Weight
gain can be a contributing factor when someone develops
diabetes. But once a person has diabetes, it can actually
turn the tables and lead to weight loss. That's because
sugar leaves the body without being used, taking with
it all its calories.
The causes of diabetes are complex, said Dr. James
Chu, a board certified endocrinologist and diabetes
specialist at the Diabetes Care Center. "They're
partly genetic, partly environment."
Among Latinos and other minority groups this can play
out in interesting ways. For example, genetically, Mexicans
are more predisposed to type 2 diabetes than non-Latino
whites, Chu said. (The reverse is true of type 1). So
diabetes rates among Mexicans in Mexico are higher than
among whites in the United States.
Bad diets|
However, Mexican-
Americans tend to adopt a typical American lifestyle,
and often that means eating too much fat and getting
too little exercise. So rates among Mexican-Americans
end up even higher than the rates among Mexicans in
Mexico.
Chu said that type 2 diabetes is part of a syndrome
that also includes high blood pressure and a cholesterol
pattern that tends to cause clotting.
"Those three are the axis of evil," said
Larez, speaking from experience.
All three stem from weight gain and a sedentary lifestyle,
Chu said, and if you have any one of them, you should
check for the others.
The Diabetes Care Center offers free diabetes screening.
"It only takes a few minutes and is just a finger
stick," said Gary Wolfe, the director of research
there. "Really pretty easy. Depending upon the
result, we then refer the patient back to their primary
care physician for follow-up. Because of the high incidence
of diabetes, everyone should be screened."
Larez agreed. "Go for a check-up," she advised.
"This is something you can have a handle on if
you want to."
Sometimes, she said, she misses the freedom of her
old eating habits. "I do like sugar. And I miss
the frijoles and beans and potatoes."
Once in a while she allows herself a treat, but not
very often.
"It's hard being so careful," she said, "but
it's one or the other. And the alternative isn't very
promising."
Source:www.montereyherald.com
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