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Beating Diabetes
Lifestyle changes and support help employees keep the prevalent chronic disease in check.

blank Hopkins' WIPES campaignNancyellen Brennan, right, makes sure Mary Finney is using her glucometer correctly. Says Finney, “Diabetes is not a handicap; it’s a lifestyle change. I feel so much better when I’m in control.”

Mary Finney didn’t need a doctor to tell her what diabetes looks like. At 63, her mother had died of complications from the disease that causes erratic disruptions in the way the body uses glucose, its main energy source. Finney, administrative coordinator for the Department of Dermatology, recalls her mom’s sudden sweating, dizziness and hours in dialysis after her kidneys shut down. “She hated it,” says Finney. “It sapped all her energy.” Meanwhile, Finney would think to herself, I don’t ever want to get to this point.

And yet, 10 years ago, Finney was surprised to learn that she too had diabetes. “I was feeling sluggish and running to the bathroom a lot,” she says, “but I was also eating right and exercising five days a week.” Indeed, a family history of diabetes can trump even vigilant self-care, says Nancyellen Brennan, nurse practitioner at the Johns Hopkins Comprehensive Diabetes Center. Considering that two of Finney’s brothers were also diagnosed with the disease, and one sister is borderline diabetic, Finney’s risk was high.

But whether the cause is genetic or otherwise, diabetes—particularly type 2—is the fastest growing chronic condition in the United States. It affects about 24 million Americans of all ages, but another 57 million are “prediabetic,” testing with higher-than-normal blood glucose levels. Unchecked, diabetes can cause heart disease, kidney failure, blindness and loss of limbs.

These trends are evident among Hopkins employees. Last year, nearly 1,000—or 5 percent—of employees across the institution who completed health risk assessment forms reported having diabetes.

Obesity, now at unprecedented levels, is a major factor in triggering the disease. According to the American Diabetes Association, nine out of 10 people diagnosed with diabetes are obese.

Located on the second floor of the outpatient center, the Diabetes Center treats patients in all stages of diabetes—from the newly diagnosed to those who have lived with the disease for most of their lives. Under the direction of endocrinologist Chris Saudek, a past president of the ADA, the center is part of Hopkins’ endocrinology program, which U. S. News and World Report has consistently ranked one of the top three in the country But, though Saudek and two other physicians see patients regularly, they rely heavily on the patient diabetes education program Saudek founded in 1984.

“It takes a lot of time to manage diabetics,” says Brennan, one of two nurse practitioners at the center, “because the treatment for the disease—exercise, food management and medication—is in their hands.” Typically, Brennan or her colleague, Susan Renda, spends a half-hour with patients per appointment. A dietitian, Michelle Bravo, is also on hand for meal planning and diabetes education. The center offers one-on-one consultations, a three-hour intensive nutrition class, a one-day diabetes survival skills class and a two-day comprehensive self-management class.

Though there’s no cure for diabetes, it can be controlled, says Brennan. “People can live long, productive lives. By integrating diet, oral medication or insulin, we work with patients to achieve the best possible outcome.”

If all this sounds intimidating, rest assured that the soft-spoken diabetes educator believes in baby steps. “So often in chronic care, patients are told to do multiple things and don’t know where to start,” says Brennan. “We want them to be successful, so we begin with something basic, like taking insulin. Then we move on to changing other habits.”

From the moment Finney wakes up, she thinks about her blood sugar. She begins the day by sticking herself so that a drop of blood falls on the strip that she will insert into her pocket-size glucometer, which tells her how much insulin she will need. When that number is high, she makes sure to eat immediately after injecting herself.

“It’s really no big deal,” she says. “Even my granddaughter, who lives with me, has learned how to inject me.” But many diabetics, says Brennan, see the need for insulin as a personal failure. “I tell patients to keep in mind that insulin use is inevitable in about 50 percent of cases because eventually the pancreas stops producing enough insulin.” 

Finney says she’s found the center’s help invaluable, especially around the holidays. “You have to substitute one thing for the other,” she says. “If you have one piece of bread, you can have a small piece of pie.” And if Finney is unsure about a food that may cause glucose levels to soar, she calls the center.

The main symptoms of diabetes are unexplained weight loss and frequent urination. (The word diabetes is derived from the Greek for siphon, passing through—referring to excessive amounts of urine.) Considering that it typically takes seven years before someone with diabetes is diagnosed, Brennan says early detection is pivotal. “I know there’s this whole denial thing, and it’s so scary,” she says, “but finding out early about your risk can help you avoid complications and add years to your life.”
                           

–JFM

For a free glucose-level check, stop by the East Baltimore location or Green Spring Station office. Additional info: 410-955-7139 or hopkinshospital.org/Diabetes/index.html


 

 

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