Diabetes Awareness

About Diabetes

Diabetes is a high sugar (glucose) level in your blood. It is often diagnosed in people without symptoms, but classic symptoms are feeling very thirsty, urinating frequently, and losing weight despite eating high quantities of food.

Your doctor can diagnose diabetes with a blood test. If a fasting (no food for over eight hours) sugar in your doctor’s office is greater than 126, random sugar greater than 200, or average blood sugar over three months (hemoglobin A1c) is greater than 6.5%, this may suggest the diagnosis of diabetes. Your doctor will likely repeat the blood test to confirm the diagnosis.

2011 Diabetes Report: Are you at Risk?

By Etie Moghissi, MD, FACP, FACE

According to the 2011 CDC (Center for Disease Control and Prevention) report diabetes mellitus affects nearly 26 million Americans. About seven million Americans are undiagnosed. Another 79 million Americans over age 19 have prediabetes, a condition in which blood sugar (glucose) levels are higher than normal but still not high enough to be diagnosed as diabetes. This condition is now believed to affect 30% of Americans who are over 20 years old. Prediabetes raises a person’s risk of type 2 diabetes, heart disease, and stroke. About 27% of people 65 years and older have diabetes and 50% have prediabetes. The rate of diabetes and pre-diabetes are even higher in many racial and ethnic minorities.

These are alarming statistics. As a society and as individuals we need to find a way to prevent diabetes and to manage the illness in those already affected.

The good news is, diabetes can be prevented!

Diabetes can be prevented by changes in lifestyle, good nutrition, increased physical activity, and moderate weight loss. Clinical trials show that losing 5%-7% of body weight—that’s 10 to 14 pounds for a 200-pound person—and getting at least 2½ hours of moderate physical activity each week reduces the risk of type 2 diabetes by nearly 60% in those at high risk for the disease. We know that remaining smoke free, increasing intake of whole grains (such as whole wheat bulgur, whole wheat couscous, brown rice, steel-cut oats, rolled oats and whole rye) and cutting back on refined carbohydrates and sugary drinks can help lower your risk for diabetes. White bread, white rice, white pasta, and potatoes cause increases in blood sugar, as do sugary soft drinks, fruit punch, and fruit juice. Over time, eating a lot of these may increase your risk for type 2 diabetes.

What are the risk factors for diabetes?

Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of diabetes during pregnancy, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

Take charge of your health! - Get Tested!

It is important to find out early if you have prediabetes or type 2 diabetes because early treatment can prevent the serious problems caused by high blood sugar.

Remember that there is no such a thing as “borderline diabetes.” That would be like being “borderline pregnant!” Ask your doctor if your blood sugar is normal or in the diabetes or prediabetes range.

Here is what you can do to stay healthy:

If you are in the prediabetes category:

Modify your lifestyle, eat a little less at meal time, plan your meals ahead of time so you do not grab rich snacks on the road, and eat more fruits and vegetables and less salt and saturated fat. Replace soft drinks with water and limit juices. Increase your physical activity to moderate intensity for at least 30 minutes on five or more days of the week. Make sure your blood pressure and your cholesterol are in the normal range. Talk to your doctor and set goals.

If you have been diagnosed with type 2 diabetes:

It is important to know that by controlling your blood sugar early and aggressively you may be able to preserve your insulin-producing cells in the pancreas, called beta cells, so your diabetes will not progress. By the time diabetes is diagnosed almost half of the beta cell function is gone and over time people with type 2 diabetes will need to take insulin to control their blood sugar.

People with diabetes must take charge of their day-to-day care and keep their blood sugar levels from going too low or too high. Staying informed is essential in managing your diabetes to prevent long-term complications.

The Basics:

  1. Healthy eating and physical activity are the cornerstones of managing type 2 diabetes. See a nutritionist to help you create a meal plan that is right for you. Many people with type 2 diabetes need to take diabetes medication, too. There are many choices of medications. Some are taken by mouth and some are injectable. Ask your doctor which one is best for you. Understand the risks and the benefits of what he or she recommends.
  2. Know your “numbers.” Ask your doctor
    • What are my blood sugar, blood pressure, and cholesterol numbers?
    • What should they be?
    • What actions can I take to reach my goals?
  3. Check your progress by keeping track of your blood sugar and your A1c.
  4. See your doctors regularly and get ready for each visit by writing down your questions ahead of time so you make the most of your visit.
  5. Get your eyes examined on a yearly basis if your eyes are healthy. If you have problems with your eyes, work with your eye doctor to make sure they remain stable.
  6. Protect your kidneys: Keep your blood pressure under control and get screened for kidney problems. A blood test called glomerular [gloh-MER-yuh-ler] filtration rate (GFR) and a urine test for protein called microalbumin [migh-kro-al-BYOO-min] are important as a part of your annual check-up (See the Kidney Connection article in this magazine for more information).
  7. Protect your heart: Make sure that your cholesterol is under control. Stop smoking and ask your doctor if you should take a daily aspirin.
  8. Get an annual flu shot and make regular visits to the dentist.
  9. Take your medications as prescribed.
  10. Stay in touch with your support system, family and friends, and smile often!

For more information visit http://www.cdc.gov/diabetes/consumer/learn.htm and http://www.yourdiabetesinfo.org

Dr. Etie Moghissi is board certified in endocrinology, diabetes and metabolism and is in private practice in Marina del Rey, California. She is a Clinical Associate Professor of Medicine at UCLA. Dr. Moghissi is a recognized expert in the field of diabetes and is actively involved in direct patient care as well as in professional medical education. She has published in peer-reviewed medical journals including Endocrine Practice and Diabetes Care. She serves as Vice President of the American Association of Clinical Endocrinologists.

Defying the Odds:Phil Southerland’s Story of Living with Type 1 Diabetes and Founding Team Type 1

It can be frustrating when someone says you can’t do something because you’re physically challenging. Often times this “can’t” spurs people to defy the odds and find a way to make it happen regardless. That was the case with Phil Southerland. At just seven months old, Phil was diagnosed with type 1 diabetes. The doctor told his mom that he probably wouldn’t live to the age of 25. But Phil had other plans for his life.

Growing up with diabetes can be a challenge for any child, but Phil learned to control his condition at a very young age, even managing his own treatment regimens. This included checking his blood sugar multiple times a day, taking insulin and managing his diet, and especially exercising. He didn’t let diabetes stop him from doing things he loved to do, like riding his bike.

Phil’s family was always very health conscious, so he felt sheltered from the temptations of junk food during much of his childhood. But temptation got the better of Phil when he was 12, and he tried a candy bar. He immediately hecked his blood sugar after eating the candy and saw that his levels were very high. Phil hadn’t been in this situation before, so he thought he’d go for a bike ride to see if exercise would help. After his ride, he checked his blood sugar again and it had decreased. Phil was impressed how the bike ride had impacted his blood sugar levels and helped his insulin work.

“I recognized how important exercise was for my diabetes management,” Phil says. “Exercise and diabetes really go hand-in-hand.”

That bike ride began a lifetime of cycling for Phil. He was an avid cyclist through college. After one event, another cyclist, Joe Eldridge, approached Phil after he noticed Phil testing his blood sugar. Joe also had type 1 diabetes and the two bonded over the role diabetes plays in their lives and sport. Consistency had always been an important part of Phil’s diabetes management. He tests his blood sugar before and after he rides to maintain control. Joe, however, struggled to keep his A1c under control. Seeing Joe’s inconsistent management of his condition was very distressing for Phil.

“I realized that my friend could die,” Phil remembers. “I knew that I had to intervene.”

So Phil decided to create a challenge; the person with the highest blood sugar would buy dinner. For several weeks, Phil was the clear winner. But the motivation was there. After three months, Joe was finally able to beat Phil in the blood sugar game, and ultimately Phil had to buy dinner. Over the next six months Joe’s A1c dropped from 11.0 to 6.4.

Phil and Joe remained friends through college. During his senior year, Phil was assigned to a class project to create a business. After raising $400, Phil and Joe started Team Type 1, a group designed by Phil and Joe to raise awareness of diabetes. Phil ordered Team Type 1 t-shirts and began selling them to raise money for diabetes awareness. He passed out business cards to spread the word about Team Type 1. Soon after, Phil and Joe participated in a race together and continued to spread the word of Team Type 1 and diabetes awareness. As more people began to hear about Team Type 1, the project took on a life of its own. Phil was defying the odds.

The next step: identify cyclists with type 1 diabetes and build a team. Phil and Joe recruited a team and the group participated in the 2005 Race Across America. Team Type 1 gained prominence for its mission and perseverance with diabetes.

The Team became very successful. They won the Race Across America event four times and hold the record for the fastest trans-continental crossing for the Race Across America. Phil’s vision has come to life and he’s embracing it. His passion for cycling and managing his diabetes has carried him through.

“Exercise is life,” Phil says.

Today, Team Type 1 has grown to become a multifaceted athletic initiative, with seven programs and 70 athletes with type 1 diabetes who regularly race in events across the world. The Team continues to expand, adding new team members and striving toward the ultimate goal of reaching the sport’s grand stage, the Tour de France.

“Team Type 1 has become a global movement to show the world that anything is possible with good control,” Phil describes.

Phil and the Team are currently expanding the outreach of the program internationally. He frequently travels abroad to advocate for diabetes supply coverage and meet with key opinion leaders to raise awareness for diabetes control. Phil spends about 250 days a year traveling to promote diabetes management. He recently visited with leaders from the Macedonian government to promote coverage of supplies. Through Team Type 1’s efforts, the Republic of Macedonia is now providing four free test strips a day to diabetes patients in the country. This is far above what doctors anticipated from someone who was not expected to live to be 25.

“Our goal [with Team Type 1] is to get the world active,” explains Phil, now 29 years old.

When Phil’s not on the road advocating for governmental assistance in diabetes management, he’s traveling to races to cheer on the Team and watch them compete. Team Type 1 remains a successful enterprise that is growing in scope, reach and impact. Phil turned his death sentence into a drive to raise awareness about diabetes and the importance of management and control.

As if running a global sports organization wasn’t enough to keep him busy, Phil also wrote a memoir about his life with type 1 diabetes and Team Type 1 entitled Not Dead Yet. He hopes that his story will inspire others to push the boundaries.

“I think I have the best job in the world, to have the opportunity to ensure that my brothers and sisters with diabetes have the resources they need to manage their condition,” Phil reflects. “It’s a once in a lifetime opportunity.”

To learn more about Phil and Team Type 1 visit www.teamtype1.org.

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