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November is Diabetes Awareness Month

Kossuth County Advance - 11/16/2017

In a world full of fast food, large portions and escalators, making healthy decisions throughout the day is becoming increasingly more difficult, but nonetheless important. Not only is it important to stay feeling well and healthy but also to prevent or manage diseases like diabetes.

Throughout the United States, the Center for Disease Control has determined that more than one out of every three individuals have prediabetes with one out of every 10 people having some form of diabetes.

In honor of National Diabetes Awareness Month, Sheila Ingalls, R.N., C.D.E. and Mindy Simpson, R.N., B.S.N., diabetic educators at Kossuth Regional Health Center, weigh in on this issue.

Seeing over 100 patients a year, the duo works together with KRHC's dietician, Deb Studer and the physicians to educate those diagnosed with diabetes on living well and managing the disease.

Individuals recently diagnosed undergo a four-session course called Diabetes Self-Management Training.

Focused on a patient centered model, Ingalls said they allow patients to pick from several options to implement in their life. Additionally, Ingalls and Simpson welcome calls from any of their patients who have questions or need a motivational pep talk even a year after the patients' initial consultation.

If individuals are struggling to maintain their blood sugar levels, the diabetic educators can equip them with a continuous glucose monitor to better understand what is going on in their bodies throughout the day.

Over the course of five days the monitor tracks blood sugar levels in order to give a more complete picture of when the individual has high and low blood sugar levels. Individuals diagnosed with diabetes must be referred to Ingalls and Simpson in order to receive their services.

"The risk of when people's blood sugars are high for a period of time, that is when complications can occur," explained Simpson.

Complications from diabetes can take place anywhere that blood flows. "Basically when your blood sugar is high, it is like glass in your body," she explained.

If diabetes goes untreated or is unmanaged, Simpson said, "You can go blind, you can have neuropathy which is numbness and tingling of the nerves, you can have a higher risk for a heart attack."

"The sad thing is that it (diabetes) can be undiagnosed for years because it doesn't necessarily have symptoms right away, but as the blood sugar goes up, fatigue is usually the number one (symptom)," remarked Ingalls about the symptoms of diabetes.

"Feeling really thirsty, getting up during the night and going to the bathroom a lot, blurry vision, maybe wounds that won't heal. Those are probably the most popular," added Simpson.

Although there are a number of symptoms an individual with diabetes can have, the onset and symptoms are somewhat differentiated depending upon the type of diabetes. These can include, Gestational, Type 1, Type 2 and Prediabetes.

Gestational diabetes occurs when a woman is pregnant and it is discovered during a routine blood test at 24 - 28 weeks of pregnancy when blood sugar levels comes back higher than normal, explained Ingalls.

Being diagnosed with Gestational diabetes increases the woman's risk of developing diabetes later on in life.

"If they don't continue to stay active and make sure their blood sugars are in the same range and maintain a healthy weight and eat healthy, that increases the risk," Ingalls explained.

Where various hormones the placenta puts off during pregnancy can contribute to gestational diabetes, Type 1 diabetes is the result of an autoimmune disease where the body attacks itself, mentioned Simpson.

Individuals diagnosed with Type 1 diabetes, either cannot produce insulin or cannot produce enough to fit the body's needs.

As a result, individuals with Type 1 are typically diagnosed between the ages of infant to 13 years old with the symptoms of weight loss, frequent urination, fatigue, constant hunger and thirst. "All of these symptoms are very sudden," remarked Simpson.

Individuals at a higher risk of developing Type 2 diabetes include those of a certain age, being over-weight, inactivity, poor eating habits and ethnicity.

"Risk factors that we used to say was over 40, but that is not true anymore because we are now seeing grade school age diagnosed," revealed Ingalls.

"It is a growing epidemic."

Because Type 2 diabetes includes a high number of risk factors, reducing or eliminating some of those factors through lifestyle changes is typically the first treatment option, depending on the practitioner and severity of the disease.

"When they come for the diabetes education, we try to help them look at if there is something that they can change in their current lifestyle," remarked In-galls. This can include changes in their diet and exercise levels.

The next step is oral, non-insulin medication to help manage Type 2 diabetes. "They are just trying to give the medication according to what organ isn't doing the job," explained Ingalls. "If that doesn't work and they have done the lifestyle changes or maybe they choose not to do them, then they go to the insulin."

Despite all of these treatment options for Type 2 diabetes, each case is different and depending upon the severity of the symptoms and blood sugar levels, the individual might be placed on insulin as step one.

A diagnosis of diabetes not only affects the individual, but their family. "I definitely think it affects the family. They are probably going to start making healthier decisions or try to avoid bringing pop in the house and try to be more active," remarked Simpson.

"It seems like the ones that are more successful are the ones where the whole family is involved so they are all working together," added Ingalls.

Whether or not an individual is diagnosed with diabetes, there are steps that can be taken to maintain a healthy lifestyle including, what a person eats and their activity levels.

"A lot of people don't eat breakfast and that is bad because the carbohydrates, the sugar, the glucose, it is all kind of the same, that is actually what your body is supposed to be using for energy," explained Ingalls. "What usually happens if people skip breakfast, the next meal they will over eat."

Beyond eating breakfast, smaller portion sizes are also recommended. Ingalls suggest individual to split a meal if they are dining out.

In order to control blood sugar levels, diabetics are recommended to watch how many carbs they eat at each meal.

Getting through the holidays, family celebrations and graduations as a diabetic doesn't have to be a burden as Ingalls and Simpson offer some helpful tips for eating during the festivities.

Ingalls recommends avoiding grazing throughout the day, placing what foods the individual would like to eat on a small plate to maintain portion control.

"If there is a big spread, kind of look and see what those selections are. That way you can look and see what is all there to eat and then decide before you start," explained Simpson.

Beyond food, exercise plays an important role in overall health.

"They usually say that you should try to get at least 30 minutes of physical activity at least five days a week," said Ingalls. These 30 minutes of exercise can be broken down into smaller increments throughout the day.

Additionally, losing just five to seven percent of their body weight can move individuals out of prediabetes, mentioned Ingalls.

Moving forward, Ingalls and Simpson would like to start a type of diabetic sharing group for those with diabetes to get together and talk about their challenges, successes and motivations. "I would like to hear from people that would be interested in having a diabetes sharing group," remarked Ingalls.

If anyone is interested, they can contact the diabetic education department at KRHC by calling 515-295-4607.

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