“If I knew then what I know now, I could have delayed the onset of or avoided diabetes,” says Steve Drinkwater.
In spring 2003, Steve was living a sedentary lifestyle in France when he got a wake-up call: a pre-diabetes diagnosis. Since that life-changing moment, he began volunteering for the Canadian Diabetes Association (CDA), hikes mountains, and enjoys kayaking and cycling.
Another CDA volunteer Petronella “Nel” Peach observed 27 years ago that she had some diabetic symptoms, headed to the doctor, and said, “I think I have diabetes,” but she was misdiagnosed. Later, Nel was diagnosed as diabetic. Today, she walks at least eight kilometres daily. Additionally, as a member of Team Diabetes, Nel participates in marathons in Canada and the U.S. She carried the 2010 Olympic torch in Salmon Arm on January 27.
Dr. Marshall Dahl, an endocrinologist and a clinical associate professor at UBC, also volunteers with CDA. His expertise will shed light on some of the diabetic risk factors.
“Type-2 diabetes is mostly genetic, so it’s common to find a family history of diabetes,” says Dr. Dahl. “Traditionally, about half the people who have diabetes don’t know it.”
Nel’s family history of Type-2 diabetes includes her father's sister, and her daughter (Nel's cousin) and Nel's brother. Yet, Nel has Type-1 diabetes.
The waist measurements of both genders are related to being overweight and indicate who is at the greatest health risk. Men’s waist: 102 cm (40 inches) or greater. Women’s waist: 88 cm (35 inches) or greater
“When I was diagnosed with Type-2 diabetes, my trousers size was 42; today it is 38,” says Steve.
Waist size is also connected to body mass index.
Body Mass Index (BMI)
BMI uses a person's weight and height to determine their degree of body fat. BMI applies equally to both genders and can be a Type-2 diabetes risk factor. In fact, a BMI of 25 or greater is a pre-diabetic risk factor for some people.
“Not all obese people develop diabetes; you must have the diabetes gene,” says Dr. Dahl. “Diabetes isn’t only about lifestyle, it really is a genetic thing.”
When Steve was diagnosed with diabetes, his BMI was 36; today it’s 30.”
The data also show that people with below normal or normal BMI have also been diagnosed with diabetes, most notably Asians.
BMI = (weight in kilograms) divided by (height in metres x height in metres)
For adults older than 20 years, the World Health Organization categorizes BMI as follows:
Normal: 18.5 - 24.9
Overweight/Pre-obese: 25.0 - 29.9
Obese: 30.0 - 39.9
Very obese/Morbidly obese: At least 40
“Blood pressure does not trigger diabetes. It just happens to the same person,” says Dr. Dahl. “People who get diabetes often have the genes for high blood pressure, high cholesterol and abdominal weight as well. If I have high blood pressure and high cholesterol, I should want to know my blood sugar reading because they often go together.” Nel says that for the past eight years, her blood pressure was maintained by the lowest dosage of medication, but recently her blood pressure was high.”
Fruity Smelling Breath
Fruity breath is an indicator of ketoacidosis acid in the urine, and diabetes. See a doctor if breath fragrance is a concern or if someone comments adversely about it. Twenty-seven years ago, Nel was diagnosed with ketones, which result when the body burns its own fat and is a common diabetic complication. If left untreated, it can lead to ketoacidosis, which can result in coma or even death.
Nel works hard to maintain good blood glucose levels because high levels once blurred her vision, which cleared up when the levels returned to normal. Vision blurs when high glucose levels cause the lens of the eye to swell. See an ophthalmologist at the first sign of blurred vision, because glaucoma, cataracts, and retinopathy are the three leading eye problems that afflict diabetics. Diabetes is the main reason for blindness in people aged 20 to 74 years old. Steve’s father, also a diabetic, lost his sight before he died.
Yeast infections are related to Candida (fungal) infections. For both genders, frequent bouts of these infections can lead to a diabetes diagnosis. “When I was diagnosed with Type-1 diabetes, I had a yeast infection,” says Nel. Some genital symptoms for yeast infections are common to both genders: itching, burning, irritation and painful urination. Because these infections could be related to other diseases, a medical examination is in order to find out the cause.
A voracious appetite is another risk factor. This is particularly true if there's been no increase in physical activity. Nel thought her “diet was under control,” but her ravenous appetite caused her to eat all the chocolates she received at Christmas in short order.
Increase Thirst and Frequent Urination
An insatiable thirst for sodas and other fluids alone or combined with frequent urination are pre-diabetic or diabetic risk factors.
“When I was in France, I was very thirsty and drank lots of Evian water,” says Steve. “It resulted in frequent urination, and I felt tired a lot, so much so that I thought I was just getting older. Later, during a routine examination, I was diagnosed with Type-2 diabetes.”
Dr. Dahl says, “Diabetics might start urinating frequently when the body tries to reduce high-blood-sugar level. This effort removes lots of water from the body through urination. As a result, they get very thirsty and that causes them to drink and urinate frequently.”
This risk factor can affect men in varying degrees. See a family doctor or urologist at the first sign of erectile dysfunction.
Life-Long Irregular Menstruation
Dr. Dahl says, “There is a female hormonal condition characterized by lifelong irregular periods called Polycystic Ovarian Syndrome (PCOS). It has a very strong association with Type-2 diabetes.”
Besides symptoms, diabetes has many complications. Poorly managed diabetes can cause blindness, kidney disease, amputation (due to poor circulation), heart disease and stroke. Symptoms can drastically affect lifestyle or shorten lives. People, who have a family history of diabetes, or other risk factors, should be screened for diabetes to find out their diabetic profile. Don't let “not knowing” open the door to this debilitating and chronic disease.
MARCH 2010 SENIOR LIVING MAGAZINE VANCOUVER ISLAND
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