Technology, diet, exercise help in coping with diabetes

By Gina DiGiovanna, Originally Posted on the Las Vegas Review Journal, January 13, 2013

Bruce Balch handles the tiny, sharp lancets with expertise in his insurance office.

He has been testing his blood about eight times daily for the past five years, since he was diagnosed with diabetes at age 45.

Balch dashes the notion that only overweight people get diabetes.

He was a nationally competitive triathlete at the time of his diagnosis. He still is.

He’s raced against Lance Armstrong, competed in Ironman events, earned the distinction of national champion in USA Triathlon’s 2012 Duathlon National Championship and qualified for a major event in China last year.

Balch took a break from triathlons after his diagnosis, but returned to competition precisely because of diabetes.

“It kind of ticked me off more than anything,” he said of the unexpected disease.

LACK OF AWARENESS

There are many misconceptions about diabetes. For instance, studies show that most people think diabetes is serious but not life-threatening.

“That couldn’t be further from the truth,” said Tracie Patten, market manager-Nevada for the American Diabetes Association.

Diabetes affects the body’s ability to change food into energy, causing blood sugar levels to spike. The disease impedes everything from thought processes to pumping blood.

“How do you keep this disease from taking over all your organs?” Patten asked. “Which is what it does. It’s the leading cause of heart attacks, stroke, kidney failure, blindness and amputation.”

She describes the disease as an “epidemic,” affecting 200,000 Nevadans. The association says 25.6 million Americans have diabetes. The disease is likely to affect another 79 million Americans in the next 10 years. And, it’s a greater killer in the United States than breast cancer and AIDS combined.

Moreover, in November, the association cited a study by the Centers for Disease Control and Prevention projecting that the number of youths with Type 2 diabetes in the United States will surge by 49 percent during the next 40 years, possibly even quadrupling. Those with Type 1 diabetes are projected to climb by 23 percent, possibly tripling.

Researchers have linked Type 1 (formerly associated with children, or “juvenile diabetes”) to autoimmune issues, while Type 2 relates to genetic tendencies as well as obesity, especially among Hispanic, African-American, Native American and Asian populations.

Type 1 diabetes ultimately requires a lifelong dependence on injected or pumped insulin. While diet and exercise can help a person living with Type 1, diet, exercise and medication are mainstays of control for Type 2 diabetes.

The local tide of Type 2 cases is rising, said Dr. Lubna Ahmad, a Las Vegas endocrinologist in practice for 14 years.

“We’re seeing more and more people developing diabetes at a younger age,” she said.

She’s also seen a wave of prediabetes, in which blood glucose levels are elevated but not yet high enough to indicate actual diabetes. And, she’s noticed a large population of people unaware that they even have Type 2 diabetes.

That unaware group, she said, is larger in Nevada than what she’s seen elsewhere. Disease awareness, dietary awareness, healthful lifestyles – much of it seems to vanish into Nevada’s thin air.

“What I saw in New York City is, people would walk,” she said.

Add to that lack of awareness a general confusion about diabetes, whether it’s the mistaken belief that Type 1 can turn into Type 2, what to eat or where exactly some adults fall between the two types.

“Eighty-five percent of those living with Type 1 diabetes are adults,” noted Marcela Arroyave, outreach manager for the Juvenile Diabetes Research Foundation’s Nevada chapter. She herself lives with Type 1, having been diagnosed when she was 14.

FALLING BETWEEN THE CRACKS

Balch’s doctor explained to him that his diabetes was more like a “1.5.”

Balch’s fall-between-the-cracks of Type 1 and Type 2, is called LADA, latent autoimmune diabetes in adults, said Dr. Fred Toffel, an endocrinologist practicing in Las Vegas since 1984, and the medical director of the Diabetes Treatment Center at Desert Springs Hospital.

“It presents like Type 2,” he said. “It’s not a rapid onset disease as we see in children with Type 1 diabetes. Often they’re given pills, and the pills may even work for a couple of months, maybe up to a year. Then the pills fail. You look at the person and they tend to look a little different than the typical person with Type 2 diabetes. They tend not to be as heavy.”

Toffel said they also tend not to have high blood sugar. But they do need insulin and are treated essentially within a year or two of diagnosis as a Type 1 patient.

“One point five” could also mean something else, Toffel added. “That’s why I don’t like using that term. It could be a patient who has true Type 1 diabetes but also has the genetics to get Type 2 diabetes, so they have metabolic syndrome, too. So here you have somebody with Type 1 diabetes who has all the cholesterol and blood pressure problems that people with Type 2 get, and are obese or overweight.”

For Balch, the onset of diabetes was as cryptic as his diagnosis.

“I was out riding and all of a sudden I realized that the street signs were fuzzy,” he recalled. He chalked it up to age and got glasses. Then came fatigue, along with losing weight and the “classic peeing, drinking.”

“I’m like, I’m 45,” he said. “I’d been going hard. And when I mean training, I’m training with all my biker buddies, hard-core stuff, going 200-plus miles a week and really pushing it.”

When taking a break didn’t work, frustration drove him to other solutions, even changing his bike. Several months later, he suspected allergies, and had a corticosteroid shot – not the best move, he said, if you have diabetes.

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