As part of the Durbin Lions Club Diabetes Awareness event, Pocahontas Memorial Hospital diabetes educator Terry Wagner gave a presentation at the Green Bank Senior Center Thursday, to share information about diabetes symptoms and ways to control the disease.
Wagner explained the three types of diabetes – Type 1, commonly known as juvenile, Type 2 and gestational diabetes.
“Type 1 diabetes is an auto-immune disease so they don’t really know for sure how you get it or what contributes to the development of it,” Wagner said. “[It] is the one that years ago you heard called juvenile diabetes because kids usually got it. We don’t call it that anymore because we see even people in their forties getting Type 1 diabetes.”
With Type 1 diabetes, for unknown reasons, the body’s immune system attacks the cells of the pancreas that make insulin. Without insulin, the body is unable to properly process carbohydrates.
“Those people [with Type 1 diabetes] can no longer make insulin at all,” Wagner said. “We know that people with Type 1 diabetes in their family have a higher tendency to have Type 1 diabetes. That’s the only risk factor that we know of for sure. Those people have to take insulin to survive.”
Type 2 diabetes is the most common of the three and is caused by several factors.
“If anyone in your family has had Type 2 diabetes, you’re at a risk of developing that,” Wagner said. “The other is being over the age of forty-five. Everyone that develops Type 2 diabetes is not over the age of forty-five – we even see it in children now – but being over the age of forty-five is a high risk factor.”
While those risk factors are uncontrollable, there are things that individuals can change, including diet and exercise, that will lower the risk of developing Type 2 diabetes.
“If we’re inactive, we’re more likely to develop Type 2 diabetes,” Wagner said. “Being overweight, having hyper-tension – high blood pressure – is another risk factor. The important thing to remember is to lower the risk factors you can. There are some you can’t, but the ones you can, work as hard as you can on those because you want to eliminate as many risk factors as possible.”
Gestational diabetes is developed in women during pregnancy. Wagner said a woman can be diabetes free, but once she becomes pregnant, she develops gestational diabetes. Once the baby is born, the diabetes goes away, but the risk factor remains.
“Women are at an increased risk of developing Type 2 diabetes later in life if they have gestational diabetes,” Wagner said. “It makes a really high risk factor.”
Other causes of diabetes include stress in your life and some types of medications including steroids.
If an individual is unsure if they have diabetes, it is a rather simple test to take. A blood glucose level test will determine if a person is at risk or already has diabetes.
“Normal glucose levels for someone who has no diabetes – a fasting glucose level – should be below 100,” Wagner said. “If your blood glucose level is between 100 and 125, you have a condition we call pre-diabetes. You do not have diabetes but you’re at a very increased risk of developing diabetes within the next five years. Anyone who has a fasting glucose level of 126 or higher has a diagnosis of diabetes.”
On the other hand, if an individual’s blood glucose level is less than 70, it means they have hypoglycemia.
“Anything below 70 is too low,” Wagner said. “It’s too low. It’s an emergency. It needs treatment immediately. What you need to do is, we call it the rule of 15. You need something with 15 grams of carbohydrate. You want this to be pure carbohydrate, a fast acting carbohydrate. You take something with 15 grams of carbohydrate, wait 15 minutes, check your blood sugar again. You repeat that until you get to the safe range which is above 70.”
Good carbohydrates for hypoglycemia include orange juice, Life Savers, hard candy, regular soda and even cake icing. It is important to find a carbohydrate that does not have fat in it. A food with too much fat in it makes the body work too hard and will not raise the blood glucose level fast enough.
Wagner said it is also important to follow the rule of 15 because it is possible to raise the blood glucose level too quickly.
“What will happen, you can get the blood glucose level too high,” she said. “It’s kind of scary when your blood sugar drops too low. The tendency is to eat or drink until it comes back up and that’s why we really caution – go with the 15 grams of carbohydrate, wait 15 minutes and then 15 more grams – because it can be really scary. If you get too much, in two to four hours, you may have a 300 to 400 blood glucose level and you don’t want that.”
Those concerned about developing diabetes may also have an A1C test which is another way to diagnose the disorder.
“It’s a blood test that gives us an average of what your blood glucose levels have been over about a three-month period,” Wagner said. “We have red blood cells in our blood stream called hemoglobin and the purpose of those red blood cells is to carry oxygen to all parts of our body. When you have glucose in your blood stream, it sticks to those red blood cells. It stays there for the life of that red blood cell.
“Those red blood cells live about 60 days, two or three months, somewhere in that area,” she continued. “That’s how this test can give us an average of what your blood glucose levels have been for that period of time.”
An A1C level of 5.7 to 6.4 indicates pre-diabetes and a level of 6.5 or higher is a diagnosis of diabetes.
The biggest misconception of diabetes is that you have to cut some foods completely out of your diet, but that is not true, Wagner said. It is important to have a well-balanced diet which can include sweets, in moderation.
“There’s no food that you can never have again,” she said. “I don’t believe in totally eliminating any group of foods for someone because they have diabetes. We need a variety of foods. We need to learn to manage serving sizes so that we don’t have more than what we should have at one time.”
It is important to monitor the intake of carbohydrates and the amount eaten per meal. Carbohydrates break down into glucose and if there is too many carbohydrates in your diet, the body will have too much glucose.
“A good way to do that, for general rule – unless you’re a child growing – is three-to-four servings of carbohydrate at a meal for women and four to five servings of carbohydrate at a meal for men,” Wagner said. “That won’t fit exactly for everyone and that’s why if you have diabetes, it’s really good that you meet with a dietician or a certified diabetes educator to get your own meal plan and your own prescription.”
One serving of carbohydrate is equal to 15 grams, so for each meal women may have 45 to 60 grams of carbohydrate and men, 60 to 75 grams.
While it is possible to choose one carbohydrate, like pasta, and just eat that, it is also important to have a healthy, well-balanced diet.
“You could eat nothing but Reese Cups or Snickers bars at every meal and if you did not go over that amount, you could control your diabetes very well, but you wouldn’t be very healthy because we know we need healthy foods,” Wagner said. “We need fruits and vegetables and proteins and all those things in our meal plan every day.”
A healthy meal plan can include candy bars and other sweets, but only in moderation and not as part of every meal.
“You can work those into your meal plan occasionally,” Wagner said. “I wouldn’t recommend you do that every meal, every day, but I think that you tend to be more successful if you do find a way to work those things in and enjoy them occasionally. Just know that isn’t cheating on your meal plan, it’s not doing something harmful to yourself.”
Diabetes can cause other medical issues including an increased risk of heart disease, blindness and nerve damage.
“We have all heard the horror stories,” Wagner said. “There are, in fact, complications that can occur. One of those, we start with the eyes. It’s a condition called diabetic retinopathy and it happens when we have high glucose levels. The tiny little vessels in the back of the eye in the retina rupture, hemorrhage out and can lead to blindness. There’s no symptoms to that until it’s very far advanced.
“You could also get heart disease,” she continued. “Keeping the blood glucose levels, again, and the blood pressure in the target range can help decrease your risk of that. The kidneys are affected a lot of times from diabetes. The nerves can become damaged and one of the things we see most often with nerve damage is losing sensation in your feet and hands. You may not notice that you have an injury to your foot or a wound developing there.”
To keep other ailments at bay, Wagner said it is important to keep the blood glucose level regulated.
After the presentation, attendees played diabetes-themed bingo and had a diabetes friendly lunch.
The event was organized by the Durbin Lions Club as part of the Worldwide Week of Service.
PMH and the Marlinton Lions Club held a Diabetes Awareness Day at the Marlinton Senior Center Friday. Wagner was again the speaker.
Suzanne Stewart may be contacted at firstname.lastname@example.org