Type 2 Diabetes - Could You Be at Risk?

Poised to celebrate his 41st birthday, Ed Sinisgalli of Howard Beach, Queens, had no reason to believe last year’s routine annual physical would net him anything but routine results. He was stunned to find that wasn’t the case.

His blood glucose (or blood sugar) level was 260. According to the American Diabetes Association, normal blood glucose levels are between 70–130 when fasting, or under 180 when not fasting He couldn’t argue with the numbers. Clearly, Sinisgalli had type 2 diabetes.

Diabetes educators are also disturbed by some new numbers. Susan Wilk, coordinator of the Diabetes Resource Coalition of Long Island says, “Twenty years ago, when I was first talking about diabetes in our Long Island communities our listening audiences were primarily senior citizens. Today the faces in the audiences and in our education programs include many more 30 to 40 year-olds.”

The American Diabetes Association has some disturbing numbers, too. They report one in five Americans has a high risk of developing type 2 diabetes, or may already have the disease.

WHAT IS TYPE 2 DIABETES?

Kenneth H. Hupart, M.D., Chief, Division of Endocrinology, Diabetes and Metabolism at Nassau University Medical Center says some type 2 diabetes patients do not produce enough insulin or the cells in their body are not sensitive to the insulin being produced. Type 1 diabetes, Hupart says, is an autoimmune disease where one’s body is not producing insulin.

Sinisgalli says, “I was shocked. I never thought I’d wind up with diabetes.” His reaction doesn’t surprise endocrinologist David Lieberman, M.D., of Great Neck. In fact, Lieberman says many patients will go to their doctor for an annual exam feeling fine. It is only after they are diagnosed with diabetes that they realize they were indeed experiencing some mild symptoms that are often easily overlooked.

THE SYMPTOMS

Lieberman says the most classic symptoms of diabetes are frequent thirst and urination. Sinisgalli says looking back he now realizes that he was very thirsty, but he never associated it with diabetes.

The American Diabetes Association says some other symptoms that may go unnoticed include:

• Extreme hunger
• Unusual weight loss
• Increased fatigue
• Irritability
• Blurry vision

Patients experiencing any of these symptoms should be evaluated for diabetes. But whether or not one is experiencing any symptoms Lieberman says all adults should be routinely checked for glucose levels by age 40—and many with certain risk factors should be screened well before that age.

ARE YOU AT RISK?

Hupart says there are many factors—and not all within a patient’s control—that can determine their risk for developing this disease. Some of these he says include, heredity; having relatives with this form of diabetes increases the chances of developing this condition. Women who have had gestational diabetes during their pregnancies are at a higher risk, as are women who have a condition called polycystic ovary syndrome. People with high blood pressure and individuals found to have high triglycerides when they have their cholesterol checked also have a higher chance of developing diabetes.

“However,” Hupart says, “There are other variables which each of us can modify that affects our chances of developing diabetes. Prominent among these risk factors are being overweight or obese, and living a sedentary lifestyle.”

WHAT YOU CAN DO ABOUT IT

Joyce Riegle, 57, of Bellmore, didn’t realize she was at risk when she was diagnosed with diabetes last year, but found after losing nearly 50 lbs., she was able to control her diabetes without medication.

When her doctor suggested she lose weight Riegle scheduled a visit with Doreen Small RN, MA, CDE, a clinical nurse specialist in diabetes management.

Small says she sees many patients who don’t realize just how much they can do to control their type 2 diabetes, delay its onset, and she believes, in many cases, prevent it from occurring at all.

Sinisgalli also sees Small on a regular basis. He lost 90 lbs. and is also controlling his diabetes through diet and exercise. “I have a routine of a 40 minute walk, six days a week,” says Sinisgalli.

Hupart agrees that many patients are able to control their diabetes with exercise, proper diet, and weight reduction. But he cautions, “Unfortunately diabetes is a progressive disease and with time, most patients will require medication prescribed by their doctors to continue to maintain a healthy blood sugar level.”

MEDICATIONS

As Tony Villante, 74, of North Merrick and Jim Reed, 61, of Oceanside found, sometimes diet and exercise just aren’t enough. In those cases doctors may prescribe medication. One of the most common drugs used to control type 2 diabetes is Metformin. Lieberman says, Metformin works as an insulin sensitizer, sensitizing the cells so that the insulin the body is producing can work better. Both Reed and Villante feel great and still follow sensible eating habits, but found medication was the little bit extra they needed to keep their blood sugar within normal ranges.

INSULIN MYTHS & MISCONCEPTIONS

For some patients with type 2 diabetes insulin injections are necessary, but doctors say patients shouldn’t let the myths and misconceptions surrounding insulin keep them from using it; especially when it can prevent suffering the very serious complications of diabetes that is not under control.

Insulin is a hormone made by the pancreas that regulates glucose levels in patient’s blood. And, according to the American Diabetes Association, it’s true that insulin cannot be taken as a pill because insulin would be broken down during digestion just like the protein in food.

But, Hupart says the first myth is that the injections are very painful. He says, “They’re not. The needles are so small and thin some people don’t feel them at all.” The other myth he explains is, “Once you go on insulin you have to stay on insulin your whole life.”

Lieberman says insulin can play a vital role in diabetes control. “It can protect the pancreas from burning out.” Lieberman adds, in type 2 diabetes, unlike type 1 diabetes, the patient can, once on a low dose of insulin work towards losing weight to get off insulin.

If you suspect you are at risk for type 2 diabetes, see your primary care physician.

TAKING CONTROL

Those wanting to find out more about type 2 diabetes and their risk for developing the disease can take an online risk assessment test at diabetes.org. More information is also available on the Web site for The Diabetes Research Coalition of Long Island at longislanddiabetes.org.

While Small says nobody wants to have diabetes, many of those who have received that diagnosis, and took steps to control their disease, reaped many unexpected rewards, like Ed Sinisgalli. He suffered from sleep apnea before his diagnosis. The loss of weight cured him of that malady. And he says, “I couldn’t breathe after walking up a flight of stairs.” Now, not only can he walk comfortably up stairs, he can do so while carrying his six-year-old son up to bed.

Riegle says she feels much better and has discovered a whole new way of looking at things. She also found a new way to look—complete with a brand new wardrobe for her new and improved body.

Reed also says his new lifestyle choices have improved his overall health. After all he says, “I’ve got a lot to live for.”

One in five Americans is at risk of developing type 2 diabetes, or may already have the disease.—The American Diabetes Association

Linda Delmonico Prussen is a freelance writer from Merrick.

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