Diabetes Education

If you’re turned on your TV, read a newspaper or surfed the internet today, you’ve probably seen at least one story about diabetes. All those facts and figures and ominous warnings about heart and kidney disease can be overwhelming. And if no one in your family has ever had diabetes, you may think that it doesn’t involve you. But if you live in Mississippi, and especially if you live in the Delta, your life or the life of someone you care about, is going to be effected by this widespread disease.

Across America, 1 out of every 12 people will be diagnosed with diabetes at some time in their life. In Mississippi, those odds are closer to 1 out of 8 and maybe as high as 1 out of 5. One-third of Mississippians who have diabetes don’t even know it. And a huge percentage of those who do know it don’t receive proper care, which can lead to serious complications or even death. They run the risk of heart attack, stroke, kidney failure, blindness and amputations, all from a disease that can usually be controlled, if not cured.

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Situated in the very epicenter of Mississippi’s diabetes epidemic, Greenwood Leflore Hospital is committed to leading the way in diabetes diagnosis, treatment and education. Our primary care providers are alert to any symptoms which might suggest diabetes and are adept at ordering and interpreting the appropriate tests. Once diagnosed, they are skilled in providing not only medication but also counseling on weight control, exercise and prevention of complications. Should hospitalization be required, the doctors at GLH can handle anything from ketoacidosis to wound care and are networked with tertiary care centers should referral be necessary. Our Diabetes Education Center has been providing support and encouragement to patients for more than 20 years, with training sessions, speakers and group interaction.

Every one of us should know the risk factors, symptoms and treatment options for diabetes. It’s really not that complicated and anyone can make a commitment to being informed, both for their own health and for those that they care about. Let’s take all those numbers and scary names and break diabetes down into something we can handle.

What is diabetes and what are the types of diabetes?

Here’s the dictionary’s definition of diabetes: “A metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood.” That sounds intimidating, but here’s what it means: Your body uses GLUCOSE, a type of sugar, to power all of its cells. Glucose comes primarily from the foods you eat. The extra glucose in your blood is stored in the body with the help of a hormone called INSULIN. When your body doesn’t make enough insulin to handle the extra glucose or your cells stop responding to insulin, you have diabetes. That extra glucose stays in your bloodstream and causes damage to all sorts of body parts, like your blood vessels, heart, kidneys, eyes, brain and bones.

There are four primary types of diabetes:

  • Type I Diabetes: This is the most serious type of diabetes and the most difficult to control. It used to be known as Juvenile Diabetes, since it was the type most commonly diagnosed in children, but it is now more commonly called Insulin Dependent Diabetes Mellitus or IDDM. With this type of diabetes, the pancreas (a fish-shaped organ just below your stomach) quits making insulin and the body’s cells have no way of absorbing glucose from the blood. So they’re starving for energy and the blood is too full of glucose. This type of diabetes requires insulin injections to prevent serious complications.
  • Type II Diabetes: With Type II Diabetes (also known as Non-Insulin Dependent Diabetes Mellitus or NIDDM), the pancreas continues to make insulin, but either it’s not enough to handle all the glucose or the body’s cells stop responding to it. The glucose builds up in the bloodstream and damages the small vessels of the heart, eyes, brain and kidneys. Some patients with NIDDM require insulin injections but many can be treated with oral medications or controlled with weight loss and exercise.
  • Gestational Diabetes: During pregnancy, the mother’s body has to handle the nutritional needs of the baby as well as her own. Sometimes her pancreas cannot produce enough insulin to balance these needs and her blood sugar levels will rise. If untreated, this elevated blood sugar can cause damage to the developing infant and complications for the mother. If you are pregnant, your obstetrician will do periodic blood glucose levels to monitor any problems, even if you have no history of diabetes. Most women with gestational diabetes do well after their delivery and require no further treatment unless they become pregnant again.
  • Pre-diabetes: Regular physical check-ups will often reveal elevated blood glucose levels which do not reach the threshold for diagnosing active diabetes. Careful monitoring and lifestyle changes are vital to preventing the development of active diabetes.

What are the risk factors for diabetes?

Most of the risk factors for Type I (IDDM) diabetes are genetic and viral, meaning that there are not a lot of precautions to take to lower your risk of this disease. But Type II (NIDDM) diabetes, which is much more common, has several known risk factors which can be lowered with lifestyle or dietary changes. Let’s divide those risk factors into those you can’t control and those you can control:

Factors you can’t change: Factors you can change or control with medication or lifestyle changes:
Age over 45

Family history (a parent or sibling with diabetes)

Ethnic background (African Americans, Hispanics, American Indians and Pacific Islanders are more likely to develop Type II diabetes).

A history of Gestational diabetes.

Excess weight. With every pound you gain above a healthy level, your chance of developing NIDDM rises.

High blood pressure. If you are diagnosed with high blood pressure, frequent monitoring and adherence to your medication is vital.

Cholesterol levels. Just like with high blood pressure, it’s important to see your doctor and take your medicine to control your cholesterol and lipid levels.

Exercise. Just 30 minutes a day of activity can significantly decrease your risk of developing NIDDM.

What are the symptoms of diabetes?

Type I diabetes may present with symptoms of extreme constant thirst, frequent urination and weight loss. The body’s cells are being starved of glucose, leading to weight loss, while the blood vessels are overloaded with glucose. That extra sugar in the blood will cause thirst and then spill out through the kidney’s filters, leading to frequent need to urinate. If untreated, the elevated blood glucose can lead to a life-threatening condition called Diabetic Ketoacidosis, where the breakdown products of fat cells overwhelms the body’s filtering mechanisms, leading to dehydration and possibly coma. Sometimes, this is the initial event in diagnosing Type I diabetes, but it can also occur if a known Type I diabetic has not been keeping their blood sugar under control. Type II diabetes tends to sneak up on its victims. Just as in Type I diabetes, the extra glucose in the blood makes the patient thirsty and trotting to the bathroom frequently. Weight loss is unusual, but patients with Type II diabetes are often fatigued and may notice blurred vision, slow healing of cuts or sores, nausea, itching skin or frequent vaginal or urinary tract infections. Of course, all of those symptoms are seen with non-diabetic conditions, so a check-up is always in order to rule out diabetes.

How is diabetes treated?

Type I diabetes is almost always treated with insulin injections, either by a series of daily self-administered doses through a small needle and syringe, or with an insulin pump. Pumps monitor the blood’s glucose level and provide a steady stream of insulin with bolus dosages before meals. Type II diabetes may require insulin, but it is often treated with a combination of exercise, weight loss, dietary counseling and oral medications. The oral drugs work in a variety of ways to stimulate the body’s usage of glucose and prevent swings in sugar levels.

What are the potential complications of diabetes?

One of the major costs of American healthcare involves complications arising from diabetes. It is estimated that the disease and its long-term complications will cost more than 3 TRILLION DOLLARS from 2010 to 2020! Much of this expense and misery can be avoided by proper treatment and education for diabetics.

Here are some of the more common and serious side effects of poorly controlled diabetes:

  • Heart disease: Elevated blood glucose levels damage the cardiac muscle and the vessels that supply its oxygen. This can lead to heart failure or heart attacks.
  • Vascular disease: Diabetics tend to have damage to the large vessels which carry blood around the body and also to the tiny arteries and veins which serve the body’s tissues. When oxygen is cut off to the extremities, wounds will not heal and gangrene can set in. This can lead to amputations of the toes, feet, legs or fingers.
  • Brain and nervous system: In the same way, vessels in the brain can be damaged by poor glucose control, resulting in strokes or accelerated dementia. Strokes can leave patients with paralysis, speech difficulties or poor mental functioning. In the small nerves that supply the arms and legs, peripheral neuropathy can cause a loss of sensation or a persistent painful tingling.
  • Eyes: The tiny blood vessels which serve the eye’s retina can be damaged by long-term diabetes, with resulting blurred vision or even blindness. Diabetics are also more prone to develop cataracts and glaucoma.
  • Kidneys: Long-term filtering of heavy glucose levels can permanently damage the kidneys, causing end stage renal failure. This can require dialysis or kidney transplants.
  • Bones: As with every other system, the patient’s bones are damaged by uncontrolled glucose levels and become more brittle with time. This can aggravate the arthritic changes of aging.

How can Greenwood Leflore Hospital help me manage my diabetes?

All those complications are not inevitable, and diabetes patients can and do lead healthy, productive lives with proper monitoring and control of their blood glucose, along with prompt treatment of any problems. Greenwood Leflore’s wide network of primary care providers and specialists are equipped to help you with your diabetes challenges, whether they’re part of pre-diabetes, Type I, Type II or gestational diabetes.

Here are some of our treatment options:

  • Diagnosis: Greenwood Leflore Hospital supports a network of local health clinics and a walk-in clinic, all staffed by doctors and nurse practitioners who are well-trained in spotting the warning signs of diabetes and its complications. They will order the appropriate tests and help you plan a course of treatment, along with dietary counseling and exercise regimens. Should your case be unusually complicated, they will refer you to an endocrinologist, a specialist in diseases such as diabetes. In many cases, that specialist crafts a treatment plan that is then administered by your hometown provider.
  • Maintenance: Unfortunately, diabetes has no cure, although research is ongoing and hopeful. In the meantime, Greenwood Leflore Hospital and its clinics will be a ready source for monitoring and managing your glucose levels, always with the goal of minimizing future complications.
  • Education: The Diabetic Education Center at Greenwood Leflore Hospital is one of only two such facilities in the Delta and is accredited by the American Diabetes Association. The center offers training in the use of insulin and oral medications, as well as advice on dietary limitations, weight loss and exercise. Helpful films and lectures are offered and patients develop a network of support and friendship as they learn to deal with this chronic disease.

The Diabetes Education Center also offers comprehensive classes about living with and managing diabetes. The program is recognized by the American Diabetes Association, and the classes are certified. Physicians may refer patients that have been newly diagnosed or who just need to learn new techniques (10 hours per year), diets and exercise programs to help manage.

This PDF, provided by Medicare Learning Network, is complete with quick reference information on Preventative Services:

https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS_QuickReferenceChart_1.pdf

If you have diabetes, ask your physicians to refer you to the Diabetes Education Center to learn more about managing your diabetes. You and your doctor can decide if all or some of the courses we offer are right for you.

The Diabetes Education Center offers:

  • General Diabetic Training
  • Insulin Dependence Training
  • Dietary Education by the Dietitian
  • Monitor Training
  • Annual refresher courses to learn about the advancements and management techniques that were recently developed

Self-management education is a key step in improving health outcomes and quality of life for people with diabetes. Click here for more information on self-management:

http://www.medicare.gov/coverage/diabetes-self-mgmt-training.html

How can Greenwood Leflore Hospital manage my diabetic complications?

In spite of the best efforts of patients and practitioners, diabetes is a disease which can lead to complications. Most of these can be treated by Greenwood Leflore Hospital’s medical specialists and surgeons.

  • Heart disease: Dr. Abhash Thakur is a board-certified cardiologist who can diagnose and treat diabetes-related heart disease, optimizing cardiac function and preventing heart attacks and congestive heart failure.
  • Kidney disease: Dr. Randy White and Dr. Kent Plunkett are specialists in nephrology and diseases of the kidneys. Since diabetes has a direct effect on those organs, one frequent complication is renal failure leading to dialysis. Dr. White and Dr. Plunkett will work with your primary care provider to monitor the long-term effects of diabetes on the kidneys and try to prevent or delay failure. Should dialysis be necessary, they will guide the patient through the establishment of a convenient and effective regimen.
  • Eye disease: For those with diabetes, frequent and thorough eye exams are absolutely critical. Several opthomologists (eye specialists) in the Greenwood area can screen for and treat retinal disease, glaucoma and cataracts.
  • Neurologic disease: Uncontrolled diabetes can damage the nervous system, including the brain and the peripheral nerves which bring sensory input from the arms and legs. Dr. Ravi Pande is a specialist in neurology, or non-surgical, treatment of the nervous system and he can evaluate and treat peripheral neuropathy and strokes. Dr. Jimmy Miller and Dr. Craig Clark, both board-certified neurosurgeons, are skilled in treating diabetic complications which may require surgery, including accelerated deterioration of the neck and back and some cerebrovascular bleeding problems.
  • Foot disease: Diabetics are much more likely to have a loss of sensation and circulation in their feet and legs, which can lead to poor wound healing and even gangrene. Greenwood Leflore Hospital is fortunate to have two excellent podiatrists (foot specialists), Dr. Preston Boles and Dr. Joseph Assini, who are experienced in recognizing the warning signs of diabetic foot disease and prescribing medication, special footwear or surgery to treat these problems before they lead to amputation.
  • Bone disease: As a disease that affects every system in the body, diabetes can lead to accelerated bone deterioration and fragility in older patients. Dr. Asa Bennett and Dr. Donna DiPaolo combine their surgical skills to treat fractures and other orthopedic complications frequently seen in their diabetic patients.

As you can see, diabetes is a very complex and far-reaching challenge, with the potential to impact almost every aspect of a patient’s life. That’s the bad news. But the good news is that Greenwood Leflore Hospital’s team of professionals, state-of-the-art facilities and commitment to education can make a huge difference for you and your family. We will be there from the day you’re diagnosed, working with you to make sure that you have every tool you need to lead a long and complication-free life.