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Health > More Health StoriesSummer 2009 IS Magazine8/5/09 IS Online

Reality Check

Controlling diabetes takes willpower and determination.

By Craig DeSilva

Kathy Westlake doesn’t give up easily. When she falls off her paddle board, she gets right back on.

“I’m more like the splish-splash queen,” laughs Westlake, a 55-year-old social worker. She’s not a surfer, but she knows the exercise will keep her active and help control her diabetes.

“I’m trying and not giving up,” says Westlake, who took up the sport after being diagnosed with type 2 diabetes. “You’ve got to believe in yourself. And even if you stumble, you gotta keep going. Because if you stop and give up hope, it’s game over.”

That’s the same strong-willed attitude Westlake takes with managing her diabetes. “At first, I was shocked, angry and in denial,” she admits about being diagnosed with the disease. “But I was not totally surprised because I’ve always been a little chubby. Then I realized it was something I needed to deal with.”

Lifestyle Changes

Adopt a healthier lifestyle.

Dealing with diabetes meant adopting a healthier lifestyle to lose weight and control her blood sugar. In addition to stand-up paddle boarding, Westlake swims at the beach and walks about 30 minutes a day.

Westlake also changed her diet. She now chooses whole-wheat bread over white and low-fat milk over whole milk. And she mixes brown and white (“hapa”) rice. Instead of eating an entire dessert, she’ll just take a bite or opt for fruit instead. The changes, she admits, haven’t come easily. “It’s hard because Hawai‘i is such a food-oriented state,” she says. “Everywhere you go, there’s food – malassadas when you go to a person’s house or doughnuts at work.”

The changes have paid off. She has lost nearly 10 pounds and continues to set goals. “The hardest part of diabetes is that it’s an everyday thing. It’s not like a sprained ankle that will eventually heal. Diabetes is a chronic disease that will never go away. You’re testing your blood sugar and planning your meals all the time,” she says.

Health Complications

Westlake chooses not to gamble with her life. She realizes that if left untreated, diabetes can lead to serious and sometimes deadly consequences. People with diabetes are more likely than others to develop heart disease or have a stroke. They are also more likely to die from the flu or pneumonia. Diabetes can lead to blindness and is the number-one cause of kidney failure. The disease can also cause nerve damage and poor circulation in the feet, which can lead to amputation. It can take up to 10 years before symptoms develop and other organs are affected.

“This is a progressive, degenerative disease,” says John Melish, M.D., an endocrinologist at The Queen’s Medical Center. “It limits life an average of 10 years. Once complications are present, they don’t reverse easily.” Melish has first-hand knowledge of diabetes; he was diagnosed with the disease 20 years ago.

Health Epidemic

Nearly 24 million people in the U.S. – or about 8 percent of the population – have diabetes. That’s an increase of more than 3 million from three years ago, according to the Centers for Disease Control and Prevention (CDC). Another 57 million people are estimated to have pre-diabetes, a condition that puts people at increased risk for diabetes. As much as 25 percent of people with diabetes don’t even know they have it. In Hawai‘i, there are about 102,000 people living with the disease. That’s 8 percent of the state population, up from 5 percent a decade ago.

What’s causing the increase in diabetes? Genetics are partly to blame. But the main culprit is preventable: Unhealthy lifestyle behaviors. “It’s a combination of obesity and lack of activity,” says Melish. “Weight gain is responsible. So if we develop good habits early in life, fewer of us will develop diabetes.”

As obesity rates increase nationwide, so does diabetes. About 57 percent of Hawai‘i adults are either overweight or obese, according to the Hawai‘i Department of Health. People are eating more fat- and sugar-laden fast-foods and spending more time in front of their computer or TV and less time outdoors. What’s alarming is that more young people are developing type 2 diabetes, a trend that was unheard of just decades ago. Hawai‘i has one of the highest childhood obesity rates in the country.

Personal Responsibility

Making healthier choices.

Studies show that maintaining a healthy weight through healthy eating and exercise can prevent or delay the onset of diabetes. “Even small amounts of weight loss or regular exercise without even losing weight can still have positive effects on controlling blood sugar,” says Judy Thompson, a dietitian who specializes in diabetes education at The Queen’s Medical Center.

In addition to diet and exercise, people with diabetes must monitor their blood sugar level and receive regular cholesterol and blood pressure screenings. Some have to inject insulin to survive. “Ninety-five percent of diabetes requires self-care,” says Marie Robello, R.N., a diabetes educator at Queen’s Health Education and Wellness department.

“Patients have to do certain self-management skills every day to successfully manage their diabetes,” says Robello, who became more physically active after being diagnosed with the disease.

Still, up to 26,000 people in Hawai‘i are at risk for diabetes but may not know they have it. “That’s why we’re encouraging people who are at risk to get tested regularly,” says Robello.

Despite increased awareness of the disease, a majority of people with diabetes are not doing enough to control their condition. Some believe it can simply be controlled with medication – not diet and exercise. This has a ripple effect since unhealthy behaviors can be passed on from one generation to the next.

A government projection says one in three children born in the U.S. five years ago is likely to develop diabetes sometime during their lifetime. “Unfortunately, diabetes is not a disease where you can just take medication and everything will be OK. Prevention through a healthy lifestyle is the key,” says Robello.

Road Ahead

Treatment for diabetes has a high price tag. It’s estimated that the disease costs $116 billion a year nationally in medical costs and $58 billion in loss of work productivity. This doesn’t include the time family and friends spend on caregiving. But those with uncontrolled diabetes pay the highest price through a lower quality of life.

“It’s likely to get worse before it gets better,” says Melish. “We’ve only started to make a dent with the concept of prevention and lifestyle change. It took years for people to accept that even [second-hand] cigarette smoke is not good for your health. But the diabetes problem is being recognized more, which is great.”

 
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