10-4 Magazine - For Today's Trucker

KEEPING LIFE SWEET
BY FAMILY NURSE PRACTITIONER NORMA STEPHENS HANNIGAN

It seems that every time you turn on the television there is another news broadcast about the obesity epidemic in the United States. The reason for so much concern about the issue these days is that study after study has shown that obesity leads to many illnesses: heart disease, osteoarthritis (the “wear and tear” kind of arthritis), and diabetes, to name a few. I would bet that anyone reading this article knows someone who has diabetes - it is that prevalent in our society. With all the modern health care available, how can that be? It’s simple, really. The most common form of Diabetes, Type 2, results from a combination of poor diet, inactivity and genetics. Sound familiar?

HOW DOES THE BODY USE FOOD? The pancreas, an organ located in the abdomen behind the stomach, normally produces insulin, a hormone that carries the sugar we get from food after it is digested into our body’s cells for the energy we need to keep us alive. That sugar is called glucose. It may help to think of it this way: insulin is like a pickup truck and the cell is like a garage. Glucose is the cargo carried by the truck into the garage/cell. If there is no insulin or not enough insulin, the glucose cannot get into the garage and the cell can’t use it for energy.

WHAT IS DIABETES? Diabetes comes in two varieties - Diabetes Type 1 and Type 2. With Diabetes Type 1, the body doesn’t produce insulin and the person must be treated with insulin injections. This is a disorder which comes on very quickly and is most often diagnosed in an emergency room. This is life-threatening because the body will rapidly begin to burn it’s fat stores to make sugar out of them. This produces ketones, and too many ketones floating around can disturb the balance of acid in your body, eventually leading to coma and death if not treated right away. In Diabetes Type 2, the kind that 90% of people with diabetes have, the pancreas still produces some insulin but not enough, and the cells are resistant to the insulin. It’s sort of like a combination of a pickup truck without enough gas and a garage door that gets stuck and will not open all the way. Some of the sugar can get into the cell, but some of it is left out in the bloodstream. Eventually, symptoms develop - fatigue, thirst, hunger and frequent urination (the word diabetes comes from the Greek word meaning flowing through), blurred vision, and impotence in men. These symptoms may develop quickly or slowly over time. Quite often, many people attribute the symptoms to other causes. “Of course I’m tired. I’m on the road all the time,” is a common response I’ve heard in the past. A person might be thirsty on a very hot day. It’s a recurring or more than usual pattern of these symptoms, though, that makes us think of the possibility of diabetes.

WHO GETS DIABETES? It is estimated that there are 16 million people in the United States with diabetes but only half of them know it. Being obese increases your risk of developing diabetes by 93%. Inactivity increases it by 24%. People whose fat is stored around the middle are more at risk, as are those who have a family history of diabetes. If you are of Latino, African American, Asian or Native American descent, you are at higher risk for developing diabetes as well. Some people may notice a dark discoloration around their necks or skin folds; this is a sign of insulin resistance, a pre-diabetic state.

HOW DOES DIABETES AFFECT YOU? We’ve already talked about some of the dramatic problems of high blood sugar that goes untreated, but what about the everyday consequences? Over time, high blood sugar damages the tiny blood vessels of the eyes and kidneys and may cause blindness and kidney failure. The kidneys help clean the blood of waste products. If a person’s kidneys stop working, the only way to purify the blood is by dialysis, a machine that takes over the blood cleaning job of the kidneys. The blood vessels and nerves of the feet and legs are particularly susceptible to damage as well, and poorly controlled diabetes may result in constant pain or amputation if the blood flow in the legs is not sufficient. Many people with diabetes also have high blood pressure and high cholesterol. The combination of these factors puts people with diabetes at a greater risk for heart disease. As you can see, diabetes can become many diseases, if not diagnosed and treated early.

HOW DO I PREVENT DIABETES? 1) Lose weight if you need to. Get some help from your health care provider if you’re having a hard time. 2) Start an exercise program. Even something as simple as parking farther away from your destination instead of right at the front door will add steps to your day. And every step counts!

I HAVE SOME OF THE SYMPTOMS - WHAT SHOULD I DO? See your health care provider. Some truck stops now have clinics attached to them. Simple blood tests can diagnose diabetes or pre-diabetes (a condition in which the blood sugar is slightly elevated but not enough to call it diabetes). If it turns out that your blood sugar is too high, there are many medicines that come in pill form for the treatment of diabetes. These medicines, in combination with a balanced weight loss diet (or maintenance diet for the person who is not overweight) and increased exercise can control your blood sugar. Someone with well-controlled diabetes can live a long, healthy life. Even if you have pre-diabetes, there are now treatments to prevent the condition from becoming diabetes.

And if you have no symptoms, being screened for diabetes during your annual physical is always a good idea. Unfortunately, DOT physicals do not include blood work, and many truckers count on them as a measure of good health. A urine test is done but that is not the ideal test for diagnosing diabetes. If you are found to have sugar in your urine, you will be required to have blood testing done to determine if you have diabetes. If you do, you will be required to show proof of treatment and control. The earlier you determine if you have diabetes, the earlier you can begin to control your blood sugar. Diabetes is not curable, but it is treatable. Life will be sweeter if you don’t have to deal with diabetes. If you already have it, you can stay healthier longer by making sure your blood sugar is controlled.