Diabetes suffered by many

By Christina Weaver
Special to the Coastal Point

June Mertz, who lives in Ocean View, is one of the county’s statistics. Diagnosed in Pennsylvania 10 years ago, in her early 30s, she said. “I went to the doctor because I became real sluggish; but when I was told I had diabetes, I went into denial.”

Diabetes starts as a problem of the pancreas, a glandular organ located beneath the stomach and connecting to the small intestine. The pancreas produces insulin, a hormone that converts the sugars, starches and other foods humans take into their bodies into energy. Without insulin, or without enough insulin, the sugar level in the body rises (hyperglycemia) and causes symptoms that can affect almost every major organ of the body. Diabetes is an illness that has no cure. The goal is to treat it in order to keep the blood sugar level under control and to avoid complications.

There are three types of diabetes. The first is called Type I. It occurs most frequently in children and in young adults. In Type I diabetes, the body produces no insulin at all. Therefore insulin must be replaced. Indeed until 1922, when insulin was made clinically available, Type I diabetes amounted to a death sentence. Patients who require insulin have to learn how to give themselves shots, as insulin does not come in a pill form. Some are able to use an insulin pump with a permanent catheter placed under the skin that allows either a constant infusion or meal-associated bolus doses of the medication.

To keep a healthy balance of blood glucose and insulin, all Type I diabetics must become savvy about the calories they take in, the degree of energy their lifestyle requires, and the amount and type of insulin their doctor has prescribed. Too much insulin in the absence of sufficient food intake leads to low blood sugar (hypoglycemia) and can be just as dangerous — and potentially more immediately life-threatening — than hyperglycemia. It is sensible for insulin-dependant diabetics to wear a medic-alert bracelet in case they are found confused or faint and in need of a quick “sugar fix.”

Symptoms of Type I diabetes tend to develop rapidly. They include excessive thirst (polydipsia), as the body tries to dilute the increasing level of sugar in the blood and, the natural consequence, excessive urination (polyuria). The official name for diabetes is “diabetes mellitus.” Mellitus is from the Greek word, “sweet” and was used because it was noted, in ancient times, that bees and flies were attracted to the urine of diabetic people.

In Type II diabetes, the most common form, the body still produces some insulin but it is resistant or insufficient to accommodate all the calories consumed. Treatment often requires the prescription of pills (oral hypoglycemics) that stimulate the pancreas to produce more insulin. Eventually, some Type II diabetics require insulin. Gradual in onset, many people live undiagnosed for years, unaware their bodies are gradually but certainly being harmed. Symptoms that signal an immediate need to visit a doctor are:

• Frequent urination;

• Excessive thirst;

• Extreme hunger;

• Unusual weight loss;

• Increased fatigue;

• Irritability; and

• Blurry vision.

Type II diabetes tends to occur in older people, those with a family history of diabetes (especially a parent or a sibling), and those who are overweight and under-exercised. African-Americans and Latinos are slightly more at risk than others. Women who have had babies who weighed more than 9 pounds at birth or who have had gestational diabetes (the third type of diabetes) when they were pregnant are also more at risk.

Disturbingly, this illness is affecting more and younger people every year. The trend is becoming a personal dilemma for many and a costly public health challenge for society.

The American Diabetes Association warns that the more “at risk” factors a person has, the likelier they are to get diabetes, and the more faithfully they should get their annual physical. And while one can’t do anything about our genetics or age, the Association points out weight and exercise are under each person’s control.

Mertz has a history of diabetes on both sides of her family and is overweight. When diagnosed with Type II diabetes, she took the daily medication her doctor prescribed but made no effort to alter her lifestyle. Then, five years ago, when she moved to the area, she decided not to be satisfied with the status quo any longer.

“First I joined Over Eaters Anonymous and, gradually, I lost 70 pounds and felt better about myself,” she said. “Just by eating properly and exercising more, I was able to stop taking my diabetic medications for a while. Now, I need to take two different kinds of pills, and I watch my diet and check my blood sugar every morning.”

Mertz knows too well the complications of diabetes. “My grandmother went blind because of it,” she said, “so I get my eyes tested annually. And my uncle ended up with both legs amputated after getting infections in his feet.” Mertz goes regularly to a podiatrist to get her feet checked and her toenails clipped. “I’m very careful to put lotion on my feet,” she added, “so they won’t get dry and crack.”

One of Mertz’ friends has kidney failure due to diabetes and requires hemodialysis. The kidneys, eyes, gums, blood vessels, heart, peripheral nerves and even tendons are all subject to damage from diabetes. American Diabetes Association research, however, shows that early detection of symptoms and following your doctor’s treatment plan for diet, exercise and medication, can reduce the likelihood of getting these complications.

Fortunately, once diagnosed with diabetes, there are many resources to help patients. William Stoehr, pharmacist-in-charge at Bethany Beach’s Happy Harry’s said, “Pharmacists are always ready to answer any questions people have about their medications.” He indicated that the biggest mistake people make with their medications is not to keep them under cool, dry and dark conditions. “Kitchens are too hot and bathrooms are too humid,” he said.

At the Beebe Medical Center, Longneck Health Campus, classes for persons newly diagnosed with diabetes, as well as those who need a refresher course, are offered on a regular basis. Support groups for insulin pump users and persons with Type II diabetes, as well as those who need wound treatment, are organized through the Wound Care Center/Diabetes Management department.

Program director, Bonnie Cunningham noted that about 80 percent of people needing wound care have diabetes. She observed, “People may hit their leg on the kitchen table or stub their toe in the yard, and because they have diabetes, they don’t heal as quickly or may not sense pain in the foot or leg. What would be a minor problem for someone without diabetes, can become a major traumatic event for persons who have diabetes.”

Cunningham indicated that family members are strongly encouraged to attend diabetes classes with their loved ones. She added, “It is especially important for the person who does the cooking in the family to understand this illness.”

Mertz had a few final “words of wisdom” to share with Coastal Point readers. During the interview, when she looked at the two containers of her diabetes medicines, she exclaimed, “Oh, that’s why I’ve been feeling so jittery and dizzy lately.” A few days prior, her doctor had changed her prescription, but instead of taking the medications daily as ordered, she was taking them twice a day. “Tell them it’s important to always double check the label,” she said.

For more information about Diabetes, contact a doctor, call Beebe Medical Center Wound Care Services/ Diabetes Management at (302) 947-2500, or go to the American Diabetes Association Web site at www.diabetes.org.