Understanding Diabetes

Priya Mohanty, M.D., a member of the Olean Medical Group who specializes in diabetes, endocrinology and metabolism, gives a presentation Friday during a “Diabetes 2008” seminar at Bradford Area Public Library.
(Photo Courtesy of BRMC)

By George Nianiatus, senior writer
Communications Department

Diabetes is a metabolic disease, rife with potential life-threatening complications, that shows no signs of decreasing in the U.S. or elsewhere in the world.

This is why those with pre-diabetes, diabetes and at-risk individuals need to learn about the disease, be aware of possible telltale symptoms and undergo screenings. Also, it’s critical of those diagnosed with the disease to follow their physician’s treatment advice and get help from diabetes educators who can set them on the right course to make necessary lifestyle and dietary changes.

During a “Diabetes 2008” seminar, held Friday at the Bradford Area Public Library, more than 30 individuals learned about the disease, symptoms and treatment methods from Priya Mohanty, M.D., a member of the Olean Medical Group who specializes in diabetes, endocrinology and metabolism. She also has authored and co-authored a variety of publications about diabetes.

The seminar was sponsored by the McKean County Diabetes Task Force, of which Bradford Regional Medical Center (BRMC) is a member. The physician said, “Diabetes is a metabolic disease resulting from defects in insulin secretion, insulin action, or both.”

Diabetes is a disease in which the body does not produce or properly use insulin, a hormone needed to convert sugar, starches and other food into energy that’s needed for daily life. The cause of diabetes continues to be a mystery, although both genetic and environmental factors such as obesity and lack of exercise appear to play roles, Dr. Mohanty said.

In the U.S., nearly 21 million children and adults, or about 8 percent of the population, have diabetes according to statistics from the Centers for Disease Control and Prevention, she said. But the incidence of diabetes is likely to increase. “By the year 2030, estimates call for a 70 percent increase in diabetes,” the physician said.

It’s vital to understand the disease and the complications of diabetes that can be a major cause of death, Dr. Mohanty said. In order to determine whether or not a person has pre-diabetes or diabetes, healthcare providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes.

Here’s a look at the four major types of diabetes:
~~ Type 1 diabetes: Results from the body’s failure to produce insulin, the hormone that unlocks the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10 percent of people who are diagnosed with diabetes have type 1 diabetes;
~~Type 2 diabetes: Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most people who are diagnosed with diabetes have type 2 diabetes;
~~Gestational diabetes: Immediately after pregnancy, 5-10 percent of women with gestational diabetes are found to have diabetes, usually the type 2 form; and
~~ Pre-diabetes: This is a condition that results when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes.

Although the causes of diabetes are not known, the contributing factors are genetics, environmental causes, obesity, lack of exercise, pancreas disease and medications, Dr. Mohanty said.

Getting control of diabetes is crucial. Complications from unmanaged diabetes can include blindness, heart disease, loss of limbs and nervous system disorders, she said.

“Those treated have less chance of complications,” the physician said.

Additionally, managing the disease means regularly monitoring blood pressure as well.

The physician also talked about at-risk individuals who should be screened for diabetes. They include: those with a family history; signs of insulin resistance; gestational diabetes; age 40 and older; being overweight, with a 40-inch waist for men and 35-inch waist for women; high blood pressure; and a fasting glucose reading of more than 100 milligrams per deciliter (mg/DL).

Treating diabetes can include several measures, including insulin and other possible medications. Dr. Mohanty said. It also can require lifestyle modifications that include regular exercise each week, undergoing medical nutrition therapy and also eating a healthier diet that focuses more on fruits and vegetables and less on carbohydrates and fat.

“To control diabetes you need to have a team that includes a physician and diabetes educators so you can learn to self-manage the disease,” she said.

"We're committed to helping our patients manage their lives through education and improve their health through better management of their individual situations," said Stacia Nolder, RN, CDE, CPT, program coordinator of BRMC's Center for Diabetes. "The role of the patient today is much more expansive than in the past, and gives individuals greater control over their treatment options, leading to better overall health."

The seminar was sponsored by the McKean County Diabetes Task Force, along with BRMC, its members include BRMC’s Center for Diabetes & Nutritional Education, Beacon Light Behavioral Health Systems, Community Nurses Inc., McKean County Collaborative Board and the Pennsylvania Health Department.

Healthcare professionals, drug representatives and vendors had displays at the seminar. They included the Center for Diabetes, BRMC, Community Nurses Inc., Sanofi-Aventis, Eli Lilly and Novo Nordisk.

Also at the seminar, free flu shots and pneumonococcal vaccines were offered to diabetics and their family members.

The Center for Diabetes, located at 222 W. Washington St. in Bradford, provides diabetes self-management training, insulin pump education, medication training and medical nutrition therapy. The program is staffed with nurses and dietitians. For more information, call the Center for Diabetes at 814-362-8717. The program is accredited by the American Diabetes Association.