Across Virginia $5 billion is spent each year on diabetes-related hospital care, while 8.7 percent of Virginians have diabetes.
In Hampton Roads alone, it is estimated that 175,000 people are living with the disease, although many don’t know it.
Adults living with diabetes are twice as likely to die of heart disease as those without, and it’s the leading cause of kidney failure, low-limb amputations, and blindness in the United States.
The number of people with diabetes has doubled since the 1990s, said Dr. David Lieb, an associate professor of internal medicine and a physician at the Eastern Virginia Medical School’s Strelitz Diabetes Center.
While the increase is alarming, there have been beneficial advances made in recent decades.
“Being diagnosed with diabetes in 2018 is a lot different than being diagnosed in the 1990s, or even 10 years ago,” Lieb said.
Advances in technology, medications, community programs, and scientific studies on the topic have all helped to improve treatment, he said, adding that obesity, the most common risk factor for developing diabetes, wasn’t considered a disease until a few years ago.
Despite better treatment, diabetes is still a dangerous disease and one that should be taken seriously.
“Changes in behavior, especially diet and physical activity, can really affect how the disease is controlled,” Lieb said.
While diabetes is most often connected with obesity or overweight, genetics play a big part.
Often, someone with a parent or sibling who has diabetes is more at-risk for developing the disease.
As Lieb pointed out, not all people who are overweight develop diabetes, and it’s important to not make them feel worse than they already might.
“I tell people, you didn’t ask for this,” he said.
Today there is a lot of overlap in Type 1 and Type 2 diabetes. Type 1 used to be a disease that children were born with or developed early, and involved the inability to make insulin. Type 2 diabetes was more often associated with adults.
Now older people are developing Type 1 while more and more younger people are being diagnosed with Type 2.
In Virginia, 90-percent of those affected have Type 2, he said.
What’s first?
First and foremost, people need to be screened, Lieb said, especially if they have certain risk factors, such as a sedentary lifestyle, high blood pressure, high cholesterol, or if they’re actually experiencing symptoms.
Likewise, they should be screened if they’re in their 40s and they have a Body Mass Index of 25 or higher, which, he added, is about 60-percent of the U.S. population.
A fasting blood sugar test or an A1C hemoglobin test can read varying levels of sugar in the blood, from normal to intermediate to abnormal.
What are the symptoms?
The most common symptom is increased or excessive thirst
“People don’t realize they have diabetes or pre-diabetes, they drink a lot – often soda or another high-sugar drink – and they end up in a cycle,” Lieb said.
Other symptoms include frequent urination, weight loss, constant hunger, and extreme fatigue, as well as blurry vision, headaches, cuts and bruises that are slow to heal, and tingling or numbness in the hands or feet.
How can I reduce the risk?
While testing is recommended for anyone who is at-risk or showing symptoms, everyone should work harder to improve health behaviors.
Eating right and being more physically active can help lower blood sugar and the risk of developing diabetes or prediabetes.
First, Lieb said, everyone should drink more water and less sweet, sugary drinks.
He also recommends lots of vegetables.
“They’re low in carbs and very filling, so people aren’t as hungry later,” Lieb said.
He said EVMS educators often teach the “plating method,” which involves explaining that half of a regular sized plate should be veggies, while the other half should be half protein (chicken and fish are best) and half a starch, which breaks down into sugars in the body.
Lieb also recommended planning weekday meals ahead of time to help avoid impulsive fast food lunches and unhealthy snacks.
“Everything should be in moderation and you should have a proactive plan for what you’re going to eat when you’re hungry,” he said.
A couple of diets that may help address diabetes or the risk of developing it include the Dash Diet (developed by the National Institutes of Health) and the Mediterranean Diet, which involves lots of beans, nuts, and whole grains.
Proactive not reactive
Lieb said instead of simply reacting to the disease, people need to be proactive and get out in front of it.
“I think it’s important that we start teaching people at an early age the impact of health and how to stay healthy.”
He said local governments can ensure that they provide recreational opportunities for their residents; workplaces can allow workers time away from their desks for some physical activity; and restaurants can provide more information on their menus about nutrition and calories.
Minorities
Lieb said diabetes is more common in minority populations, especially African-Americans and Hispanics, which is likely why certain areas of Hampton Roads are above state averages. In Suffolk 17-percent of the population has diabetes, he said.
Poorer Americans often can’t afford to buy healthier food like vegetables, or they don’t have a grocery store nearby that sells produce, forcing them to buy unhealthy foods and empty calories.
“People are going to do what they need to do to feed their families,” Lieb said, adding it takes a community working together to address the diabetes epidemic and to determine who needs help and how they can be helped.
