While shopping for groceries one summer evening in 2004, Jaia Kaikai passed out and fell to the linoleum floor.
Kaikai’s mother, a diabetic, rushed him home and checked his blood sugar level using her glucose meter – the meter read back an abnormally high level of sugar in Kaikai’s blood. A short drive to Children’s Hospital and a few tests later, Kaikai was diagnosed with type 1 diabetes.
“It changed my life perspective,” said Kaikai, now a freshman in accounting at Ohio State. “Before, I just knew my mom had diabetes – I knew if her blood sugar was high, she needed insulin and if it was low she needed some (fruit) juice,” Kaikai said. “That was about it. But ever since I got diagnosed, I became more educated.”
Education about daibetes will be crucial for Ohio as hundreds of new cases of the disease pop up each day in the state.
A recent study has shown that cases of diabetes in Ohio – and at least 22 other states – have almost doubled between 1994 and 2004. Of the 1 million Ohioans with the disease, almost 267,000 of them have not been diagnosed, according to a Jan. 16 Associated Press article. Although hundreds of research efforts and public awareness groups exist in the name of diabetes, Kaikai said most people know little about diabetes, let alone the difference between the two most prevalent forms: type 1 and type 2.
“A lot of people think if you’re overweight then you have a chance of getting diabetes, but a lot of it’s just bad luck,” Kaikai said.
Type 1 diabetes affects almost 10 percent of all diabetics and is a condition caused by a shortage or absence of insulin in the blood. Insulin is a hormone that brings energy-rich glucose sugar into the body’s cells from the blood.
Currently, researchers believe type 1 diabetes results from heredity factors along with severe stresses like viral infections. When insulin levels drop, glucose remains in the blood and the body responds by doing everything it can to remove the excess sugar. Frequent thirst and urge to urinate are two of the first warning signs because the kidneys use water to pull sugar out of blood and into urine.
Affecting more than 90 percent of diabetics, type 2 diabetes is also hereditary in nature but is caused by obesity or an inactive lifestyle. Type 2 differs from type 1 because insulin is adequately present in the body and ready to bring sugar into cells, but biochemical complications, still a mystery to scientists, prevent insulin from doing its job.
With both types, prolonged periods without treatment can lead to major health complications including memory loss, blindness, kidney failure, heart attack, stroke, amputation of limbs, and other serious health problems.
Because of these complications, researchers like Beth Dziengelewski, a dietitian and private coordinator for the division of endocrinology at OSU, fear an ensuing catastrophe.
“When you look at the epidemic of obesity in this country, which is not going away anytime soon, you can quickly see how the number of people with type 2 diabetes is skyrocketing,” Dziengelewski said. “It truly is going to become a health care crisis because there are not enough practitioners, educators, or programs out there to help these people.”
A researcher conducting a medical trial, Dziengelewski said she and her group at OSU are currently investigating how daily treatment of type 2 diabetes might reduce cardiovascular problems for 215 patients. This number is part of 10,000 total patients in a U.S. and Canadian study backed by the National Institutes of Health and several pharmaceutical companies.
“As part of treatment we talk about weight loss, but for most of our patients, this is really where they really get stuck,” Dziengelewski said. “For a lot of our patients losing weight is a motivation factor; many of them are not making a conscious effort to be physically active on a regular basis.”
Dr. Christopher Taylor, a dietitian and assistant professor in medical dietetics, said controlling obesity is a major component of controlling chronic diseases like type 2 diabetes.
“There’s been a few big clinical studies that have shown lifestyle changes, in diet and physical activity, were able to decrease the number of people who got type 2 diabetes by 60 percent,” Taylor said.
Taylor said the study was intended to test one drug’s ability to prevent type 2 diabetes cases in overweight people. Instead of finding the drug effective, researchers found the control group that followed a regimen of healthy eating and frequent exercise reduced the onset of type 2 diabetes more than twice as much as the drug alone.
“They said their findings were an accident, but now we know lifestyle change can indeed delay or prevent type 2 diabetes,” Taylor said.
Taylor said that although obesity comes partly from hereditary factors, eating habits formed early in life can lead to problems if they are not balanced and healthy. Fortunately college is a time where students not exposed to a diversity of foods early in life have the opportunity to branch out,Taylor said. But due to financial restraints and lack of time, Taylor said students can rely too much on fast food.
“It’s a matter of balancing convenience with taking the time to sit down and eat something healthy,” Taylor said. “We have to start taking some accountability for the foods we choose.”
Taylor said a major issue with type 2 diabetes is that it takes an average of eight years before a person experiences any signs or symptoms of the disease – often when it is too late to focus on preventative care.
To raise awareness and funding for diabetes research, Kaikai said he and a friend started the Breast Cancer and Diabetes Alliance at OSU. After each of them experienced illness in their families related to the diseases, Kaikai said it just made sense to start the group.
“Everyone knows somebody that has diabetes or breast cancer,” Kaikai said. “It’s a good thing for everyone to come together and speak about it.”
In addition to a swim-a-thon to raise money for the Central Ohio Diabetes Association, Kaikai said his group is brainstorming ideas to raise funds for the diabetes cause.
“We’re thinking about having a date auction and using it as a way to educate people about diabetes … and raise money for research,” Kaikai said.
Diagnosed as a type 1 diabetic since the age of 22 months, Stefanie Riediger, a junior in marketing, said some people do not cope well with a diabetes diagnosis even years after the fact.
“One of my cousins … doesn’t have the funding to take care of (her diabetes) and she also has emotional problems dealing with it,” Riediger said. Because her cousin is only 25 years old, Riediger said she is battling her diagnoisis instead of yielding to it.
“She hasn’t really accepted it, even though she has it,” Riediger said. “That’s causing many more complications, and she’s pretty much dying because she refuses to take care of herself.”
To combat increasing cases of diabetes and keep health insurance costs down, Dziengelewski said a proactive, preventative approach by the health insurance industry is critical.
“It’s a lot cheaper to pay $75 for an educator visit than it is to pay thousands of dollars for a major surgery because of a diabetes complication,” Dziengelewski said. “How (insurance companies) are looking at this is very backwards.”
Dziengelewski said daily treatment of diabetes alone can be too expensive for diabetics because insulin delivery systems and testing supplies can cost from $10 to $15 per day, up to hundreds of dollars per day.
As part of her study, Dziengelewski and her group provide free testing and insulin delivery supplies to their patients. Due to the tremendous cost of the diabetic supplies, Dziengelewski said she is worried what will happen when the 9-year study ends in 2009.
“I’m starting to get a lot of questions from my patients, which are ‘What am I going to do when the study is over?'” Dziengelewski said. “I hate to thin
k that we have to leave these people high-and-dry. Many of them are uninsured or their insurance company won’t pay for most of their supplies.”
Aside from concern for her patient’s futures, Dziengelewski said all Americans need to focus on prevention to have any hope of alleviating the type 2 diabetes epidemic.
“You can take all of these medications, but they’re not getting to the major source of the problem, which is an overweight society,” Dziengelewski said. “It’s quite a battle and your heart goes out to these people because diabetes is something they think about all the time – it can consume them.”
