Diabetes expert discusses treatment
CRANBERRY TWP — Diabetes is on the rise, but those diagnosed with the disease are lucky to live in an age where help — and in some cases, a cure — is available.
Joyce Rudolph, the diabetes management coordinator for the Butler Health System, said while Type I patients are diagnosed at a fairly young age after suffering from classic symptoms like extreme thirst, poor healing and frequent urination, Type II diabetes patients can take steps to control or even reverse the disease.
She explained that in diabetes, the pancreas either produces too little insulin or fails to use the insulin produced correctly, or both.
Insulin, Rudolph said, allows the sugar in the blood to move from the blood system to the organs, muscles and tissues to provide energy.
Left untreated, the sugar produced through carbohydrates and sweets in the diet remains in the blood instead of producing energy.
She said while Type I is a “noisy” disease with clear and undesirable symptoms that will send a patient to the doctor, Type II diabetes may cause slight blurred vision or fatigue.
“Most people make an appointment with the eye doctor,” Rudolph said. “Nobody thinks 'Hey, I might have diabetes.'”
She said while most Type I patients have traditionally been diagnosed as children when the pancreas stops producing insulin, more and more adults are being diagnosed every year.
She said strict meal balancing and insulin injections or pumps are required for Type I diabetes sufferers.
In Type II, most cases are caused by poor diet, weight gain and a lack of exercise.
Rudolph said if diagnosed early, disciplined patients can turn the condition around through diet changes, exercise and weight loss.
If that plan fails, doctors usually add a medication like Metformin to help control blood sugar.
“That is the first line of defense that the American Diabetes Association recommends,” Rudolph said. “Metformin has been around for a long time, and is very successful (in managing Type II diabetes).”
She said the drug helps the body properly use the insulin manufactured by the pancreas and slows the liver's release of extra sugar, known as glucose.Should Metformin not work, Rudolph said there are a number of other medications the ADA recommends doctors prescribe that are also successful.She said the goal in Type II diabetes is to preserve as much of the pancreas' function as possible to prevent complications from diabetes.She said the most severe complications include kidney or eye damage, circulatory damage that could cause the loss of toes or even death.Rudolph has known of patients who go to the emergency room with symptoms and were found to have blood glucose counts in the thousands.According to several online diabetes websites, the normal glucose count is 70 to 100, an early diabetes count is between 101 and 125, and diabetes is diagnosed if the blood glucose count is 126 or more.“If it's past 500 or 600, they will usually end up in the emergency room (because of their symptoms,)” Rudolph said.At the Butler Health System's Diabetes and Health Management/Education Center on Oneida Valley Road, Rudolph and her co-workers counsel and educate newly diagnosed diabetics and support those who have been diagnosed.“We do a lot of encouraging,” she said.She said most doctors who are affiliated with the Butler Health System send newly diagnosed diabetes patients to the Oneida Valley Road facility to learn about their disease and the lifestyle changes required to manage it.New patients sit down with Rudolph or another professional for one hour to receive a simple definition of diabetes, share what the patient knows about the disease, and learn about carbohydrates and their effect on the body.“There is a lot of misconception that occurs,” Rudolph said. “People don't understand the disease.”Services available at the center include:• Individual appointments with the diabetes nurse educator or dietitian for nutrition counseling• Glucose monitoring• Sick day guidelines• Pre-insulin pump training• Carbohydrate counting• Diabetes Self-Management classes for new patients• Medical nutrition therapy by a registered dietitianAccording to www.diabetes.org, 25.8 million Americans, or 8.3 percent of the population, had diabetes as of January 2011.The site said 18.8 million have been diagnosed, and 7 million were undiagnosed. Some 79 million Americans, the site said, were prediabetic. About 1.9 million Americans older than 20 were newly diagnosed in 2010, the site said.
