Physician: Diabetes a ‘disease of choices’

Diabetes can lead to lots of serious, even life-threatening, complications. But it doesn’t have to.
Dr. Thomas Grace, a family medicine physician in practice at Blanchard Valley Diabetes Center who himself has diabetes, recalled finding some doctor’s appointments intimidating when he was growing up. His own philosophy as a doctor is “This is a judgment-free zone.”
He could try to scare patients — saying they will go blind or have a heart attack if they don’t get their diabetes under control. “Those things don’t have to happen,” though, so instead of using fear he simply explains how diabetes works. And he emphasizes that diabetics “can live a normal, healthy life.”
A quick lesson: The pancreas produces a hormone called insulin, which lets blood sugar into the cells of your body.
In Type 1 diabetes, insulin is not being produced, so people must take insulin through shots or a pump. Grace said Type 1 diabetes is an autoimmune disorder, in which the body has attacked the cells that make insulin.
In Type 2 diabetes, your cells are not using insulin effectively. There are different theories on how Type 2 diabetes is acquired, Grace said. He said it’s linked to obesity, and there are also genetic tendencies, so some families are more susceptible. More and more children are getting Type 2, related to childhood obesity, he said.
Grace said 30.3 million people in the United States have diabetes, or 9.4 percent of the population. In Hancock County, 11.5 percent have diabetes.
Nationally, 7.2 million people are undiagnosed, meaning about 1 in 4 people with diabetes don’t know they have it. And in the past 20 years, the number of adults diagnosed with diabetes has tripled, which Grace said is tied to the rise in people who are overweight.
Grace was himself diagnosed with Type 1 diabetes at age 3. Growing up, his endocrinologist was one of the heroes in his life — and it’s this that led Grace to go into medicine. Now 35, he has a passion for working with patients with diabetes and specializes in helping them learn to manage their disease.
Grace said everyone may have a different experience. Having diabetes himself helps him relate to the struggles of his patients, as “I’ve been through most of the trials and tribulations” that they have. He added patients are more likely to take care of themselves well if they have a good understanding of the process going on in their body.
Grace said our cells need sugar and oxygen for energy. Insulin is the bridge that lets sugar out of the bloodstream, into the cells. Without insulin, sugar is stuck in the bloodstream, which is dangerous in the long run. It can lead to damage to organs and can cause neuropathy, blindness, kidney problems, heart attacks and stroke. Since bacteria, too, use sugar for energy, Grace said people with uncontrolled diabetes are more prone to bacterial infections.
But the key is “uncontrolled.” Grace said patients may feel more motivated after they learn how to take care of themselves.
“Diabetes is really a disease of choices,” he said.
Choices include whether to take medications, what to eat and how active to be. Grace tells his patients that the choices were made for him when he was a child, and his parents did an excellent job, but it’s harder when you’re diagnosed as an adult and have been in the same routine for some time and are told to change.
He said people often get frustrated, and many people also experience depression, which makes it hard to manage their diabetes effectively. Patients see, though, that if they do make healthier choices, “They’re happier. They feel better.”
And he encourages his patients to be honest, so he can tailor their treatment around how they’re actually living, rather than having them hide that, for example, they are eating lots of sweets.
“You’re going to wake up with it every day for the rest of your life,” so knowing how to take care of yourself to ensure you live a good, healthy life is important, Grace said.
He starts by treating people with diet and exercise. But “exercise” doesn’t have to mean a strenuous workout at a gym.
“By ‘exercise’ I mean being active,” he said. “Being more active than you currently are.”
He said it can be a challenge, as “everyone’s busy,” but it requires adding just a little time in the day to take care of yourself.
In addition to diet and exercise, diabetes can be treated with medication. There are different medications used for Type 2 diabetes, some of which tell the pancreas to release a little more insulin, and some of which help the cells to use insulin better. There are also kidney medications that allow the body to eliminate extra sugar through urination. Other medications promote increased metabolism and weight loss.
Some patients with Type 2 diabetes do need to take injected insulin. “That is not a failure,” just how the disease has progressed, Grace said.
Jessica Halsey, community health educator with Hancock Public Health, said the community’s obesity and diabetes task force is creating action steps which came out of the community health assessment.
Halsey said many people who have diabetes don’t know it, so she encourages people to get regular checkups and make sure their blood sugar is tested. Especially if there is a family history of diabetes, “You always want to keep an eye on that.”
She said people can also live a healthier life by ensuring there are “multiple colors” on their plate. “Always choose those fresh fruits and vegetables,” she said
And make sure you and your children are getting activity, even if it’s just taking your dog out for a brief walk. She said the health department is working with the city to help increase awareness of bike paths, and is trying to create a community friendly toward walking and biking.
Ohio State University Extension offers a dining with diabetes class, with a new round of classes starting in early 2018.

Culled from Here

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