Northern Illinois, Northwest Indiana responding to a deluge of diabetes diagnoses
BY RHONDA ALEXANDER For Sun-Times Media
It's about how you manage it: The kinds of lifestyle choices diabetics make play a large role in their quality of life. | File photo
DIABETES SELF-MANAGEMENT CLASS
Learn the latest in diabetes care with an emphasis on the positives. Take the initiative now to control your diabetes and not allow it to control you.
WHEN: 6-8 p.m. Dec. 3; 6-9 p.m. Dec. 10 and 17
WHERE:Valley West Medical Office Building, Sandwich, IL
REGISTER: Registration is required for this program and closes three days before the program date. A minimum number of participants is also required.
INFORMATION: 815.786.3684; www.valleywest.org/programs.
Dr. Jaime Ruiz-Montero bears witness to the pandemic effect diabetes is having on the Chicago area almost every single day.
Ruiz-Montero, an internist in East Chicago, Ind., treats as many as 20 out of 30 patients a day who have
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Type 2 diabetes — the most prevalent form of the disease.
“Every five seconds, someone is diagnosed with diabetes,” said Ruiz-Montero, who is president of medical staff at St. Catherine’s Hospital in East Chicago.
As of January 2011, the epidemic known as diabetes affects 25.8 million people in the United States. In Indiana, 711,200 adults are living with diabetes; In Illinois, 1.4 million people live with diabetes. Of that 1.4 million in Illinois, 1,132,600 people are living in the Chicago area, according to statistics reported by the Centers for Disease Control and Prevention.
What is diabetes?
Diabetes Mellitus is a disease where the body has difficulty processing glucose, protein and fat. The pancreas has a difficult time regulating the hormone insulin [Type 2] or it [the pancreas] don’t produce insulin at all [Type 1].
Type 1 diabetes is an autoimmune disease. Traditionally referred to as juvenile diabetes, the classification was changed to Type 1 diabetes in 1999 as this type can develop at any stage of life, but usually by age 28.
Insulin regulates the amount of sugar the body uses to function, which means, without insulin, the body doesn’t function.
Mary McAfee, internist at Rush-Copley in Aurora, used a great analogy to describe Type 2 diabetes.
“The bloodstream is an expressway that distributes sugar and insulin — both of which are on the expressway. In order for the body to use sugar properly, you have to get the sugar out of your bloodstream and into your cells (heart, skin, muscle, lungs, etc.)
“When you have Type 2 diabetes, insulin is on the expressway with all the exit ramps blocked off. It can’t get to the cells in the body that need it to function properly.”
Of the 25.8 million people who have diabetes in the United States, 7 million don’t even know they have the disease because they haven’t been diagnosed. Factors that impede a diagnosis include lack of medical insurance and lack of education about available resources that are free.
To make matters worse, 79 million people living in the United States have prediabetes — the condition where the body already exhibits signs of Type 2 diabetes yet the blood sugar levels are not quite high enough to tip the scales over into full-fledged Type 2 diabetes — and 2,459,800 of those with prediabetes are living in Chicago as of 2010.
It is estimated that 90 to 95 percent of those living with diabetes have Type 2 diabetes. Type 1 diabetes only affects an estimated 5 percent of the U.S. population.
African Americans, Asians, Native Americans, Pacific Islanders and Hispanics are predisposed to develop Type 2 diabetes due to genetics and lifestyle choices. Type 1, on the other hand, doesn’t appear to target any specific segment of the population.
Prediabetes has several risk factors. They include age (over 45), family history, weight, race/ethnicity (listed above), eating habits and activity levels (not exercising at least three times a week for 30 minutes each). Women who have given birth — if she had gestational diabetes (elevated blood glucose levels sustained during pregnancy) or delivered a baby that weighed over nine pounds at birth — are at risk of developing prediabetes.
When someone develops Type 1 diabetes, “the body attacks its own pancreas and stops producing insulin,” explained Betty Wickman, Diabetes educator and registered dietitian at Edward Hospital in Naperville.
It’s difficult to ignore symptoms of Type 1 diabetes because they can be severe enough to require hospitalization. People with Type 1 diabetes must be treated with insulin.
“The acids or ketones that form in your blood as a result of the body not producing insulin can make you very sick,” said Ronald Ackermann, an internist specializing in the treatment of diabetes at Northwestern University with offices in Chicago and East Humboldt Park.
These acids are essentially poisoning your blood. Symptoms such as nausea, vomiting, unusual weight loss, fatigue and irritability are all signs that a person can exhibit when they have Type 1 diabetes.
Those who develop Type 2 diabetes may exhibit no symptoms at all for many years. Feeling thirsty, drinking more fluids, frequent urination and cuts that won’t heal are some of the symptoms.
“One of the many symptoms of Type 2 diabetes is frequent urination because your system is working to get rid of the excess sugar in your body,” Ruiz-Montero said.
Wickman said that an important factor in a more timely diagnosis is paying attention to what’s happening in your body.
“Many people walk around with symptoms such as fatigue, feeling thirsty, urinating more and for women especially, recurrent urinary tract infections and yeast infections, not realizing that these are symptoms of Type 2 diabetes,” she said.
Managing the disease
“Diabetes is the ultimate disease of self-management,” McAfee said.
Insulin injections, diet and exercise are used to manage Type 1. Type 2 management includes diet, exercise and in many cases, medications ranging from pills to insulin injections.
For those who develop Type 2 diabetes, maintaining a healthy weight is essential.
“The more surface area the body has, the harder it is to manage sugar with the same amount of insulin. Losing weight creates changes in the body’s chemistry that make it more sensitive to insulin,” Ackermann said.
Gwen Franklin, dietitian and certified diabetes educator with Advocate South Suburban’s Diabetes Wellness Clinic in Hazel Crest recommends using as many resources available.
“Portion control, with more fruits, nonstarchy vegetables and the use of myplate.org are several ways to be proactive in managing diabetes,” Franklin said.
The Diabetes Wellness Clinic at Advocate South Suburban also utilizes a smart app and grocery store tours as part of their efforts to help patients manage this disease.
The CDC reports that there is currently no way to prevent Type 1 diabetes because scientists are still trying to pin down its cause. Clinical trials are being planned in an effort to discover the roots of Type 1 diabetes.
But lifestyle choices do play a role in developing a risk for Type 2 diabetes.
“Lifestyle choices determine whether or not someone who is already at risk due to genetics will develop Type 2 diabetes,” said Amy Hess Fischl, registered dietitian at University of Chicago Kovler Diabetes Center in Chicago.
Being overweight increases the risk significantly.
“For every 10 pounds of weight gained, the risk [of developing Type 2 diabetes] increases significantly,” said Northwestern University’s Ackermann.
For every two pounds of weight loss, the chance of developing diabetes is reduced by about 15 percent, Ackermann explained.
Can diabetes be cured?
Medical experts are predominantly of the opinion that once a diagnosis of diabetes is made, you will always be considered a diabetic — even if you are managing the disease really well.
“If it’s diagnosed early through screening, a significant percent, normally about one-third return to normal blood glucose levels,” Ackermann said.
But he did stress that this doesn’t mean you are no longer considered diabetic. All forms of diabetes improve with better lifestyle choices, but for those who have Type 2 diabetes or who are at risk of developing Type 2 diabetes, lifestyle choices that include managing weight can literally mean the difference in the quality of life.
Pamela Kontos, advanced practice nurse at Advocate South Suburban Hospital’s Diabetes Wellness Clinic in Hazel Crest, concurs.
“Healthy eating, exercise and maintaining a healthy weight are all behavior modifications that will improve the quality of life for individuals living with diabetes.”