NOTHING SWEET ABOUT DIABETES

Jim Turner took a blood sample from Eleanor Brown of Cape Girardeau at the diabetes screening fair held at Southeast Missouri Hospital.

Susan Farrow, a nurse at the foot care clinic of Southeast Missouri Hospital, used a monofilament with Aline Bruns of Cape Girardeau to check nerve sensations in the feet at the hospital's diabetes screening fair last week.

Diabetes is not caused by eating sweets.

It is a disorder where the pancreas cannot produce insulin or the body cannot benefit from the production of insulin. It strikes the very young, known as Type 1, or it can develop in people later in life, known as Type 2, by a combination of genetic predisposition, inactivity and obesity.

Diabetes causes a person to be up to five times more likely to have a heart attack. It can also cause kidney failure and blindness, among other things. And the scary part, said Janet Stewart, a certified diabetes educator at Southeast Missouri Hospital, is that of the 16 million people in the United States who have diabetes -- half don't know it.

Stewart helped organize a diabetes screening fair recently at the hospital's Generations Family Resource Center. Screeners tested eyesight, foot problems, took blood tests and asked participants to fill out a questionnaire that asked about specific indicators of diabetes.

Diabetes, Stewart said, is essentially a build-up of blood sugar. Insulin is a hormone that converts blood sugar to a usable or storable form. If the pancreas is not producing insulin, those sugars remain in the blood stream making it as thick as syrup, she said.

The blood becomes tacky and coats the veins, arteries and capillaries. This causes red blood cells to accumulate on the sides of the vessels, restricting blood flow.

"So anywhere the blood flows there is body damage," Stewart said. The thickened blood also overworks the heart. "It's like putting the heaviest weight oil you can in a water pump. You're heart has to pump this heavy weight oil."

The questionnaire states people are at a higher risk if: they are older than 45, overweight, do not exercise regularly, have a family history of diabetes and women who have had a baby that weighed more than 9 pounds at birth.

Gwen Thoma, education services director at Southeast, said Type 2 diabetes occurs when the pancreas is making insulin but because of poor circulation the hormone does not disperse throughout the body. Subcutaneous fat can also prevent the insulin from reaching the proper receptors.

Thoma said this kind of diabetes can be reduced or corrected through weight loss, improved nutrition and exercise.

The warning signs of diabetes are: extreme thirst, occasional blurry vision, frequent urination, unusual tiredness or drowsiness, unexplained weight loss, frequent or recurring skin, gum or bladder infections and tingling or numbness in the hands or feet.

Julie Tarr, a trainer at Main Street Fitness, was taking blood samples during the diabetes fair. She said a normal range of blood sugar in the body is between 70 and 110 milligrams per decaliter of blood. Anything more than 200 milligrams is considered unhealthy only if it is sustained over a period of time. People who have a day where their blood sugar is higher than 200 are not necessarily diabetic.

Rick Weber of Kelso tested positive in March for diabetes with a blood sugar level of 893. He said doctors have warned him that his vision might begin to deteriorate but if he stays with his medication, exercise and diet it will come back. Weber was being tested at the fair for foot problems.

Susan Farrow, a nurse at the hospital's foot care clinic, said common foot problems arise through diabetes when the body's lack of circulation reduces feeling in the feet. She said diabetics have to constantly wear shoes because they can step on foreign matter that could become embedded in the foot without producing pain. She said diabetics have to visually and manually inspect the soles of their feet and remove anything that should not be there, to prevent infection.

Infections in the extremities of diabetics are harder to treat because the lack of circulation prevents the body's immune system from taking care of the problem.

Randy Dooley, a pharmacist at Southeast, said there are three forms of treatment doctors use for diabetes. Drugs like Rezulin increase the body's use of insulin. Another drug, called Precose, reduces the amount of glucose absorbed in the stomach and therefore dispersed into the blood stream. Dooley said the third method is transplantation of pancreatic tissue.

Dooley said the methods are used in combination to get the disorder under control.

"The difficult part of the treatment is getting the patients to understand where blood sugars come from, why your blood sugar is up. People tend to think that all they have to do is stay away from candy and concentrated sweets. They don't understand that sugar comes from things like bread and potatoes," he said.

Anita Smith, a registered dietitian and diabetes educator, said diabetics don't have to significantly modify their diets past that of non-diabetics. It is not necessary for diabetics to reduce their intake of carbohydrates, which convert to blood sugars. The biggest change is to reduce the intake of fat and help patients lose weight.