Diagnosis: Diabetes

Mary Prusa has always been an avid exerciser. So when she joined a new health club and started losing weight – she thought she had finally found the magic bullet. But the weight kept coming off. Within a couple of months, she had shed 30 pounds. She also developed an uncontrollable thirst, frequent urination and became so fatigued she could barely walk up the stairs.
Something wasn’t right.
    Her daughter urged her to see a doctor. When she did, blood tests revealed her blood sugar was soaring at dangerously high levels of 400 and more. A normal blood sugar ranges in the 70s to 90s. Prusa’s symptoms were also classic of advanced diabetes.
Prusa was diagnosed with acute onset of type 1 diabetes. Type 1 diabetes occurs in just 5 to 10 percent of the population and is far less common than type 2 diabetes. Type 1 diabetes results from the body’s failure to produce insulin and often appears in childhood. In some cases, as with Prusa, it can come on suddenly later in life.
Type 2 diabetes, on the other hand, is one of the fastest growing diseases in the country and is slightly more common among women than men. It is estimated that approximately one quarter of the population is living with pre-diabetes or full-blown diabetes.
Type 2 diabetes is primarily a by-product of obesity and a sedentary lifestyle.  In the past, most type 2 diabetes cases did not develop until about age 40. However, because of today’s unhealthy lifestyle habits, the disease is appearing in patients at much earlier ages. Approximately one-quarter of the 2 million new cases that developed in 2010 were in ages 20 to 44, says Andjela Drincic, MD, endocrinologist and medical director of the Diabetes Center at The Nebraska Medical Center.
“The good news is that since type 2 diabetes is often caused by obesity, poor diet and a sedentary lifestyle, it is also preventable,” says Drincic. “Studies have shown that the amount of weight loss needed to prevent diabetes is just 5 to 7 percent of a person’s total weight. That equates to just 10 to 14 pounds in a 200-pound person.”
Studies have also shown that those individuals who are prediabetic (when a person’s blood sugars are higher than normal but not high enough for a diagnosis of diabetes) can achieve a 60 percent reduction in progressing to diabetes by simply exercising and losing weight, says Drincic.   
Diet, weight control and exercise are also the most effective steps one can take to manage diabetes. Careful management of diabetes is critical for curtailing additional complications such as heart disease, stroke, kidney failure, blindness and cancer.
And a little bit of exercise goes a long way.    
“Exercise is the best medicine we have for diabetes,” says Joni Pagenkemper, a dietitian with Creighton Medical Associates. “All it takes is 30 minutes of walking five days a week. This can be done all at once or even in small chunks throughout the day.”
 Exercise helps the muscles make better use of the body’s own insulin, therefore reducing one’s dependence on insulin medications. “It increases insulin sensitivity, which carries over for 24 to 48 hours,” says Pagenkemper. “It also lowers triglycerides, increases good cholesterol levels, lowers blood pressure, and reduces heart risks.”
To take full advantage of the benefits reaped from exercise, Pagenkemper suggests going for short walks after meals, which can have an immediate affect on lowering blood sugars.
    Aerobic exercise combined with resistance training has been show to further boost one’s sensitivity to insulin.  “The more muscle you have, the better your body uses glucose, which lowers blood sugars,” says Rebecca Newberry, a nurse practitioner at the Methodist Center for Diabetes and Nutritional Health.    
Taking control of your diet
When evaluating your diet, watching your carbohydrate intake is the most important step you need to take, says Newberry. She suggests eating three meals a day and to maintain a consistent carbohydrate intake at each meal. This should consist of three to four carbohydrates at each meal from four primary categories:  bread, rice and pastas; dairy products such as milk and yogurt; starchy vegetables such as corn, potatoes and peas; and fruits. Combine these foods, which are necessary for energy, with proteins, which will help you feel full longer.
    “For most people with diabetes, it’s about portion control,” says Pagenkemper. “Everything should be eaten in smaller portions and in moderation. Sugared beverages like pop, juices, lattes and Kool-aid should be avoided, unless needed in small amounts to treat a low blood sugar.” >>>
    Learning to manage your diabetes and balancing the right types and amounts of foods can be overwhelming at first, notes Pagenkemper. That’s why she recommends that everyone who is diagnosed with diabetes participate in diabetes education. “All data shows that getting education improves management of the disease and helps prevent long-term complications,” says Pagenkemper.
    Prusa, who is now able to keep her blood sugars in acceptable ranges, says she attributes her success to the educators at the Diabetes Center at The Nebraska Medical Center. “It was a little overwhelming at first, but then I started seeing the educators at the Diabetes Center every week. They helped me get my sugars under control and taught me how to monitor my carbs. The education was huge in helping me learn how to manage my condition.”