
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, November 22, 1994                   TAG: 9411220085
SECTION: EXTRA                    PAGE: 1   EDITION: METRO 
SOURCE: BOB CONDOR CHICAGO TRIBUNE
DATELINE:                                 LENGTH: Medium

EDUCATION IS THE FIRST STEP IN FIGHTING DIABETES

There's a special day, week or month for nearly every health problem. All of them are admirable exercises in drawing public attention to various diseases and disorders.

For example, Nov. 17 marked the American Cancer Society's Great American SmokeOut. It targets millions of smokers to quit their tobacco habits for the day, hoping a certain percentage of them will stay off the smokes for a longer period - maybe even until next year's SmokeOut.

On the other hand, every day in November is part of Diabetes Awareness Month. It's a health promotion with a distinct twist: Of the more than 13 million Americans who have diabetes, about half don't even know they have it.

Awareness takes on additional meaning. Without medical attention, diabetes can lead to blindness, kidney disease, heart disease, strokes, nerve damage and gangrene.

``Diabetes can smolder in some adults for years,'' said Dr. Gerald Charnogursky, director of MacNeal Hospital's Joslin Center for Diabetes, a Harvard Medical School-affiliated program in Bridgeview, Ill. ``It comes on gradually but can present itself suddenly. Many older patients are diagnosed with serious complications.''

There are two types of diabetes. Type I means a person's pancreas cannot produce insulin, a hormone vital to moving the carbohydrates, amino acids, fats and other food fuels from the blood into the cells of our bodies. People with this diagnosis, usually children and younger adults, will become acutely ill. This makes for a more clear-cut diagnosis and treatment.

Type I patients can lead normal lives with regular insulin injections. There is a growing body of research endorsing the value of prescribed diets and exercise, but long-term complications from the disease still need to be monitored.

While 10 percent of diabetes cases are Type I, the rest are classified as Type II. This condition is most frequently diagnosed in adults older than 40, and studies show women are more at risk than men. People with Type II diabetes still produce insulin in the pancreas, but their bodies have become resistant to their own insulin. The pancreas cannot compensate for the resistance, and blood sugar levels go beyond the top end of the normal range (140 millimeters per decileter).

Just how the body becomes resistant to insulin is still a mystery, but it is documented that being overweight and inactive can accelerate the process. Genetics may also play a role: A family history of the disease can increase your chances; Hispanic and black populations are particularly at risk.

Charnogursky said anyone who has a 140 reading twice within a prescribed fasting period (overnight, six hours during the day) or a single reading of 200 can be classified as Type II. You don't need to experience acute symptoms or even early warning signs such as fatigue, dizziness, excessive thirst, frequent urination, unexplained weight loss/steady weight gain, blurred vision and slow healing of cuts and bruises.

Though some physicians might call such a patient as a borderline diabetic, Charnogursky prefers to call it ``Type II without symptoms.''

``This person has diabetes and should seek treatment accordingly,'' he said.

That doesn't necessarily translate to insulin injections. Even conservative physicians have been convinced by the many scientific studies showing that people with blood sugar readings in the 140 to 200 range can significantly reduce their risk with a regular exercise program and careful diet.

There is new research challenging just what is a proper diet, which has traditionally been considered one high in carbohydrates and low in saturated fats. For instance, a multi-institution study conducted by the University of Texas Southwestern Medical Center in Dallas suggested earlier this year that some diabetic patients will respond most favorably to foods with monounsaturated fats, such as olive oil and peanut oil.

In May, the American Diabetes Association amended its own guidelines to encourage physicians and patients to customize a diet to each individual's needs.

by CNB