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Living with Diabetes

Millions at risk could avoid living with diabetes with preventative diet and exercise.

Lynn Nicholas, CEO of the American Diabetes Association (ADA), although not diabetic, will change her lifestyle for 11 days to mirror the life of a diabetic to gain an understanding for those who live with the disease.

"I'm doing this to help in my personal life so I do have a better understanding of the physical demands, and have more empathy to the regimen and routine of what people have to do," said Nicholas.

To start the program Nicholas set up an appointment with two diabetes health care professionals at INOVA Fair Oaks Hospital's diabetes center to discuss how to live with the disease.

"It's an interruption in your routine, in normal life," said Mary Archer, registered dietitian with the diabetes nutrition education program at INOVA Fair Oaks Hospital about the rigors of maintaining the disease.

Nicholas met with Archer and Cathy Tibbetts, INOVA diabetes nurse educator and president of health care and education at ADA, going through the same routine a real patient diagnosed with Type 2 diabetes would go through.

ACCORDING TO THE ADA, 18.2 million people in the United States have diabetes, the majority of those diagnosed — 17 million — have Type 2 diabetes.

Although roughly 13 million of those cases have been diagnosed, about 5 million people are unaware they have the disease, said Tibbetts, adding that without treatment it can cause major health problems and even death.

"The ADA tries to offer professional education for physicians to reach out and be up to date," said Tibbetts, adding within the last year they discovered some pre-diabetes patients could prevent the disease if they knew they were more susceptible to the disease.

"There are new guidelines with pre-diabetes," she said. "We now know in almost 60 percent of those cases of having abnormal blood sugar, if those people get involved in a program, they can avoid diabetes."

During the appointment, Tibbetts explained that diabetes is a disease in which the body does not produce or properly use insulin — a hormone used to convert sugar, starches and other foods into energy for daily life.

Although Nicholas, having worked in the medical field for years and as CEO of ADA, knew many of the symptoms that diabetics face, Tibbetts ran through the symptoms as if Nicholas knew nothing.

The four major types of diabetes are: Type 1, Type 2, Gestational diabetes and pre-diabetes.

In the session, Tibbetts focused on the most prominent, Type 2, which results from a body's insulin resistance — the body fails to properly use insulin, combined with a relative insulin deficiency.

Tibbetts listed the various symptoms which include frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability and blurry vision.

Along with educating Nicholas about the disease, Tibbetts had Nicholas run through testing her blood sugar, explained the reason for taking medication (Nicholas will take Tic Tacs) and how to give herself a nightly insulin shot — which some diabetes patients need.

"We're trying to develop a treatment plan to counteract the Type 2 symptoms and reactions," said Tibbetts, adding people tend to resist insulin shots, but once they begin the shot realize the benefits. "We don't encourage others to give the shot, we want you to do it to be self-sufficient."

Tibbetts explained to Nicholas and her husband who was there for support, that staff at the diabetes center also sympathizes with their patients about the inconveniences the disease creates.

"We're required to do the same diabetes exercise once a year," said Tibbetts explaining INOVA diabetes personnel will get a surprise email telling them for the next week they have to live their life like they have diabetes to better empathize with patients.

WHILE NICHOLAS WAS learning how to monitor her glucose levels through a drop of blood and the proper levels her blood sugar should be between, Archer was in another room creating a meal plan.

"The easiest way to do this is through carb counting," she explained to Nicholas. "There are no food restrictions any longer because a carb is a carb, is a carb ... basically carbohydrates are what you're tracking."

Archer took the list of meals Nicholas had recorded over a week when she was traveling and assessed a meal plan that she thought she could maintain with her hectic lifestyle.

"We try to individualize it without making major changes in types of foods," said Archer about the initial stages of planning meals for diabetics, adding the less they change the food the easier it is for patients to follow the plan.

"This is going to be the hardest part for me," said Nicholas about the meal plan.

Although overwhelming at first with the plastic food displays and trying to guess the amount of carbohydrates in each meal she ate, by the end Nicholas realized she would have to change little, if any, of her eating habits.

"Just think about what you like to eat so you can work it into your plan," said Tibbetts.

"People hear so much in class that by the time they are here they are OK," said Archer about the process of learning a healthier meal plan that includes a separate class dedicated to food. "They may feel overwhelmed when they leave class, but they're better once they get used to the pattern."

Because a majority of people who are susceptible to diabetes could reduce their risk by altering their eating and exercise habits, Tibbetts emphasized the importance of regular diabetes tests.

"We recommend that adults 45 and older that have a family history of diabetes and are obese get checked once every three years to see if they are high risk," she said. "We also encourage them to be active consumers and ask for their papers and make sure the family doctor is aware of their situation."

FORTY-ONE MILLION Americans are in the pre-diabetes classification, said Tibbetts.

If those pre-diagnosed make the necessary changes to their lives they can reduce their risk, but Tibbetts emphasized they are still more susceptible to develop the disease and recommend they be checked annually for the disease.

Through her 11 days of living as a diabetic, Nicholas plans to keep an on-line journal to document her process that can be accessed at www.diabetes.org. For more information about diabetes either visit the association's Web site, or call 1-800-Diabetes.