The Silent but Progressive Disease

by BY ELIZABETH PASI
REX HEALTHCARE
December 2008

"I kept drinking water — I probably had more than ten full glasses of water, way more than I usually drink. I didn’t understand what was happening." This is how medical student Arjun Nanda from Florida felt before he was diagnosed with Type II diabetes a little over a year ago. The disease came on suddenly for him. He was not obese. He ate very healthy and exercised frequently. When he was diagnosed, his initial thoughts were, "Why is this happening to me?" Upset and in denial, Nanda was just like the 5.7 million people who do not even realize they have diabetes. It is often a silent disease. The American Diabetes Association estimates that there are 23.6 million children and adults who have diabetes in the United States.

Rose Langley RD, LDN of the Rex Healthcare says "Diabetes mellitus is a metabolic disorder in which blood sugar or glucose levels are abnormally high because the body does not make enough insulin to meet its needs or it doesn’t use what it makes efficiently." Symptoms are different for each individual living with diabetes. Besides extreme thirst, Nanda experienced tiredness throughout the day and blurry eyesight. Symptoms of this nature should always be checked by a physician because diabetes is often a silent disease, and not many know they have diabetes until it is too late.

The American Diabetes Association estimates nearly 57,000 people in the United States have pre-diabetes. This condition exists when blood glucose level is high but not high enough to be diagnosed as diabetes.

"Pre-diabetes is prevalent in the United States and is caused mostly by obesity," explains Langley. "If blood glucose levels are higher than 99 it is considered to be a pre-diabetes stage. People with pre-diabetes can prevent Type II diabetes with exercising and diet. Medication can be avoided if the patient exercises."

Obesity is very prevalent in the United States. However some people with pre-diabetes are not obese and have no idea that they even have the condition. This is why it is very important to be educated and in control of your health.

Symptoms of Diabetes

• Frequent urination
• Excessive thirst
• Extreme hunger
• Unusual weight loss
• Increased fatigue
• Irritability
• Blurry vision

Being diagnosed with diabetes does not mean your life is over. Many people with diabetes live a normal and healthy life. Nanda came to this realization after the initial shock. "I learned how to deal with the illness and it became a routine. I don’t even think about it anymore. I told myself that it could be much worse. I am happy I was diagnosed early and I also know that if I take care of it, I will live a normal, healthy life just like everyone else."

Langley has been working with patients for 20 years and suggests that patients enroll in a Medical Nutrition Therapy class, a patient-oriented approach to care where plans are tailored to each patient. The program is offered at the Rex Diabetes Education Center.

"Rex Diabetes Education Center strives to educate members of our community about diabetes and all aspects of good health," explains Langley. Registered dietitians, who are also certified diabetes educators at Rex Hospital help each patient with diabetes manage their illness. The Rex Diabetes Education Center can be reached at 919.784.3756. They have two locations, one at 4420 Lake Boone Trail at the Rex Hospital main campus and at 1515 S.W. Cary Parkway.

Rex Diabetes Education Center is proud to be recognized by the American Diabetes Association for meeting the National Standards for Diabetes Self-management Education. The certified diabetes educators at Rex assist people of all ages in developing the right individualized plan for managing the challenges that come with having diabetes.

Importance of Nutrition
Nutrition is essential when dealing with diabetes. Some patients living with diabetes think that they cannot eat what they used to eat before they were diagnosed. The key to eating carbohydrates or anything when dealing with diabetes is portion control and limiting yourself. "People with diabetes can eat mostly anything," states Langley. Her advice includes:

• Avoid simple carbohydrates
• Include carbohydrates with fiber
• Chose low-fat items

Exercise with Diabetes
Exercise is just as essential as nutrition, if not more. Some diabetes patients think their condition makes it more difficult to exercise. Diabetes patients should talk with their physician before beginning an exercise program. A stress test may be needed to see how your body reacts prior to starting a fitness program but it is worth it as physical activity can increase blood glucose, blood pressure and cholesterol.

Nanda agrees, "Exercise was not only good for his body but also for his self esteem," he explains.

Diabetes in the Family
Patients with diabetes are not the only ones affected with the illness. Family members and friends are also affected. Pam Wright of Cary is a mom to Jeffrey Wright who was diagnosed in 2001. For Pam and Jeffrey it was a shock to them because his diagnosis was so sudden.

Like Nanda, Jeffrey experienced extreme thirst, frequent urination and he was very sick to his stomach. He was in extreme denial at first but now he is dealing with the disease. Pam’s best advice to other family members: "Get educated and be patient, remember you can live a healthy life with diabetes."

"You do have complete control — You just have to take advantage of that," concludes Nanda.