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Are you at risk for diabetes?

March 14, 1997

If you don't know, it's time to find out

By KATE COLEMAN

Staff Writer

Ellen Scott says she was extremely tired the summer before last. She wrote it off to stress and being older than 40. She was very thirsty and was drinking and urinating more than usual.

These are classic symptoms of diabetes, but Scott, now 45, didn't put them all together. A blood test during a routine gynecological exam showed an elevated level of sugar in her blood. Scott, like half of the 16 million Americans with the disease, didn't know she had diabetes.

Diabetes affects the body's ability to use food by changing its ability to produce or use insulin, a hormone made in the pancreas. Insulin enables blood sugar - glucose - to pass from the blood to the cells where it's used for energy. Without enough insulin, glucose builds up and damages the blood vessels. This can cause problems that can be serious, sometimes leading to blindness, kidney failure, heart attack, stroke and amputations. Diabetes is the fourth-leading cause of death in the United States.

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Types of diabetes

There are are two types.

Type I, or insulin-dependent, diabetes occurs when the body stops making insulin or makes only a tiny amount. This type of diabetes used to be called juvenile-onset diabetes because it occurs most often in children and young adults. But it can occur at any age.

Type II, or noninsulin dependent, diabetes is far more common, accounting for 90 to 95 percent of all cases. It occurs when the body doesn't effectively use the insulin it produces. It most often is seen in people who are older than 40 who have risk factors which include a family history of diabetes, being overweight, underactive or a member of a minority group such as African-American, Hispanic or Native American.

With diabetes, early detection is important. Although there still is no cure, the disease can be managed and complications can be prevented.

"The most important thing for a disease that is a silent killer is to know what's going on," says Dr. Stephen Lippman, a Hagerstown endocrinologist.

When blood sugar levels are brought close to normal, the incidence of complications decreases, he adds.

Therapy options

There are many therapy options for people with Type II diabetes, including diet and exercise, 20 medications that have been around for a while and three new classes of drugs - one of which will be available in a couple of weeks, according to Lippman.

The sedentary lifestyle of many Americans, including their obesity-inducing diet, is a factor in the increased incidence of diabetes. The fact that a healthful diet and adequate exercise can moderate the disease often is a deterrent to genetically obese people seeking diagnosis and help, according to Lippman. Not everyone can be like Oprah and have a personal trainer and chef, he adds. But there are medical options available, and he says people shouldn't be intimidated about seeking help.

Hagerstown resident Joyce Stottlemyer, 38, was diagnosed with Type II diabetes in September 1996. She was very tired, and her emotions were up and down. She thought she might be depressed. Stottlemyer says she was at risk because she is overweight and because of her family medical history. She is managing her diabetes through medication, diet and exercise. She says she hates to exercise, but it's working for her. She has lost 30 pounds so far and has been able to reduce the amount of medication she takes.

People with Type I diabetes need insulin every day. The prospect of daily injections is intimidating. But the needles used are so fine and tiny they really don't hurt, according to Lippman, who provided a graphic demonstration by repeatedly sticking himself through his clothes in the stomach, arm and thighs - without flinching.

Other options

There also are other options for insulin-dependent individuals. Elmeda Hill of Hagerstown has been wearing an insulin pump since last December. The device allows her to control the amounts of insulin her body needs. She was diagnosed with Type I diabetes 17 years ago. She says she initially was bitter about it. It takes a lot of time, monitoring and discipline to manage diabetes. Hill must prick her finger seven times a day - before and after each meal and at bedtime - to test her blood glucose with a special strip and computerized monitor. A laboratory test - the Hemoglobin A1C test - is recommended every three to six months. It provides a round-the-clock blood sugar level average.

Hill watches her diet and exercises regularly on her stationary bicycle and treadmill.

"It's a lot of work, but it does pay off," she says.

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