Vail Daily health feature: Diabetes affects millions of Americans who don’t know they have it
August 18, 2014
Signs of diabetes
• Excessive thirst and increased urination.
• Weight loss
• Blurred vision
• Slow healing sores or frequent infections
• Tingling hands and feet
• Red, swollen, tender gums
It's hard to imagine having a disease you don't know about. Right now, millions of Americans are living with diabetes and are completely unaware of it.
In June the Centers for Disease Control and Prevention reported that one in four Americans don't know they have diabetes. According to the CDC, diabetes affects more than 29 million people in the U.S. On top of this, 86 million adults in the U.S. have pre-diabetes, which means they have high blood sugar levels, but they're not yet high enough to be classified as type 2 diabetes.
Too little testing, too late
Edwards resident Arlene Cordova knew she had a family history of diabetes, but she had never been tested for the disease until six years ago, at age 53. After getting her blood tested during a wellness clinic at her job, Cordova discovered she had Type 2 diabetes.
"I thought because I was in my 50s and I hadn't gotten (diabetes), why worry about it?" Cordova said. "I just thought I was immune to the whole thing and wouldn't get it, but unfortunately I did."
Cordova's story is more the rule than the exception. Dr. Monique Manganelli, endocrinologist at Vail Valley Medical Center, said diabetes is increasing in prevalence every year.
"A lot of people aren't tested," Manganelli said. "They're not aware of what they should be looking for. … If it's progressed, it can become very clear. You'll have excess thirst, excess urination, you feel very tired, you may be losing weight. Those things usually take awhile, so it doesn't happen overnight."
Cordova had been experiencing many of the common symptoms, but didn't connect them to a potential diabetes diagnosis.
"I couldn't consume enough water," Cordova said. "I felt tired all the time, very sluggish, constantly (needing to) go to the bathroom and a dry, cottony mouth. I just wasn't really aware. My mother had it, but I didn't know a lot about diabetes because I never really had to deal with it."
Taking action towards prevention
Type 1 diabetes, where the pancreas does not produce enough insulin, typically occurs in children and young adults. Type 2 diabetes is far more common, affecting 90 to 95 percent of those with diabetes. With Type 2 diabetes, your body may not produce enough insulin or become resistant to it. We don't know the direct cause of the disease, but we do know that genetics, weight, eating habits and exercise can all play role in developing both pre-diabetes and diabetes.
"There's a big genetic component but also a big lifestyle component," Manganelli said. "A lot of people think, 'If I eat a lot of sugar, I'm going to become a diabetic.' If you do have diabetes, we don't want you to be consuming a lot of sugar, but most of it has to do with other environmental and genetic factors."
Because there is no cure for diabetes, prevention and stopping the disease during the pre-diabetes stage is critical.
"About one in three adults have pre-diabetes," Manganelli said. "Those individuals might have up to a 30 percent chance of eventually developing diabetes. (This) is a very good place to get in and really work with (pre-diabetic people) and turn things around so they'll never develop it."
For those with pre-diabetes, small changes could make a significant difference.
"The next step is to start the lifestyle changes," Manganelli said. "Just reducing one's weight by 5 to 7 percent will oftentimes reverse the metabolic abnormality. (Another step is) nutrition counseling, having someone take a closer look at what they're eating, (see) if they're hypertensive and get that under control. (Also) get people much more active."
Manganelli said she can't force people to eat healthier or exercise more, even if they are at risk.
"I can't make them (change); I can only encourage them," Manganelli said. "When most of my patients find out, they're alarmed. … But they know they don't want to have complications (in the future), so they really try to make those changes. Lifestyle changes are hard and you need to have someone encouraging you. You need the support of your family, friends, the medical community and support groups."
Living with a lifelong diagnosis
Cordova said diabetes can seem like a scary disease, which leads to people being in denial and not getting tested rather than dealing with it.
"Some don't go (to a doctor) until it's too late," Cordova said. "I wish I would have found out a little earlier. I wish I would have paid more attention to how I was feeling and not put it on the back burner, thinking 'Oh, it's stress. I'm just overtired'."
Manganelli said even though people in the Vail Valley are more proactive about their health than in other areas, no one is entirely exempt from developing diabetes. She recommends those older than 45 get tested for the disease annually, and those younger than 45 to get tested if they have risk factors. Complications from diabetes can include heart disease, stroke, blindness and kidney failure.
"People with severe complications, it's been decades of very bad control and not wanting to face the reality of the disease," Manganelli said.
Despite the alarming statistics, Manganelli still has hope that diabetes can decline.
"I'm very optimistic as far as what we're going to be able to do in the future," Manganelli said. "If people just take control and take that first step (in getting tested), we can really make a difference in people's lives. … I have seen several patients who've turned around dramatically and have improved their overall control (of the disease)."
Cordova said we live in a "junk food society" and the only way to wake people up to the realities of diabetes is more awareness.
"There's a lot of information out there about heart disease, high blood pressure and stroke," Cordova said. "All of that goes hand in hand with diabetes."
Manganelli reminds us that even if someone gets tested and is diagnosed with diabetes, it's not a "death sentence," she said.
"You can have a very long, healthy life with this diagnosis, assuming that you try to take control of it," Manganelli said.
For Cordova, living with diabetes everyday can be difficult, but that doesn't prevent her from making plans far in advance.
"I wish I didn't have this disease, but I do," Cordova said. "I just have to work through it and take care of myself. I hope to be around for a very long time for my children and my grandchildren."