Many diabetics unaware of their illness

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BANGOR – Maybe you’re experiencing excessive thirst or frequent urination; fatigue; unexplained weight loss; sores that don’t heal; tingling in the legs or feet; or even blurry vision. If so, you could be one of the 23,000 Mainers who haven’t found out they have diabetes.

Officials urge people to check out any of the above symptoms with their health care provider, and they emphasize that excellent medical care is available for those with diabetes. Awareness is key.

“There are 70,000 Mainers with diabetes, but one-third don’t know they have it – and won’t know until complications arise,” said Christine Noble, area director of the American Diabetes Association.

Noble, who hopes lots of Mainers will turn out for this weekend’s America’s Walk for Diabetes this weekend, would like to see diabetes screenings included as a part of annual physicals, especially for those who are over 45.

Diabetes is a disease of the endocrine glands. In type I diabetics, the pancreas does not produce insulin, which metabolizes sugar. Type II diabetics don’t produce enough insulin, or their bodies don’t make good use of the insulin they have.

Nationwide, said Heather Leclair, clinical supervisor of the Diabetes, Endocrine & Nutrition Center at Eastern Maine Medical Center, diabetes is “a leading cause of lower limb amputation, of blindness in adults, of heart disease and end-stage kidney disease.”

Certainly there are good tools for managing diabetes, from diet and exercise to medications, insulin and stress reduction. But people need to know they have it.

Noble made her pitch for greater awareness recently at a meeting of the Bangor Area Breakfast Rotary Club, where she said it’s too bad that public screenings for the disease aren’t available in this state.

“I’d like to see regular screenings, just like they have skin cancer screenings,” or testing for blood pressure or cholesterol, Noble said. “It would be just a great service if we can offer it to people.” Many who might be intimidated at the thought of going to a hospital, she said, would consider getting their blood sugar tested on the spur of the moment if it were easily available.

A blood test would show the person’s blood glucose level at that time, and could indicate whether further medical attention was needed promptly. But local health officials have differing views on the state statute preventing community testing.

“It’s crazy,” Leclair said of the ban. “They’re doing cholesterol screenings, why can’t they do blood glucose screenings? It’s so easy. We have a glucose analyzer. [Not allowing community testing] is not in the best public interest.” She is convinced that community testing would identify extra people earlier in the disease.

On the other hand, Carole Webber has seen the downside of public testing for diabetes. She remembers when the statute disallowing the practice went into effect in 1984.

Webber, now director of education and of the Diabetes and Nutrition Center for St. Joseph Healthcare, was working at James Taylor Osteopathic Hospital and doing glucose testing at public health fairs then.

Realizing that a high blood-glucose reading could indicate diabetes – a chronic disease that currently has no cure, people would often be “in a tizzy,” Webber explained, especially if they didn’t have a family doctor to see right away, or if they had to wait because the testing had been done on a weekend.

She agrees with the statute prohibiting community testing for blood glucose.

But Webber and Leclair are of one mind on the importance of diabetes education, because they’ve seen its positive results in an area where the rate of diabetes is higher than the rest of the state.

Yet hospitalizations and deaths from diabetes are lower than might be expected, Leclair said, according to a study funded last year by Eastern Maine Healthcare.

Fore more than 20 years, Webber said, those working in the field have seen the results of education and helping patients. St. Joseph, EMMC and then-James Taylor Osteopathic Hospital each sent staffers to the first training session conducted by Maine’s Diabetes Control Project.

In the first year, said Webber, who attended the training, the effort showed that patient education and assistance “would reduce the number of hospitalizations, improve ulcers on feet, reduce the numbers of amputations.

“Insurance companies said, ‘whoa, we’d better pay for this,'” she added, pointing out that that decision was recognition of how education could save money, as well as lives.

St. Joseph’s center at 900 Broadway has approximately 3,000 patient visits a year. Services include nutritional therapy, insulin pump therapy, one-on-one sessions with patients for whom group education may not be appropriate, and a free monthly support group for anyone with diabetes, and for families. Dr. Roy Corbin will speak on foot care at 1 p.m. Oct. 3 in Building 2 at 900 Broadway.

The center also is starting services for those with diabetes in pregnancy, and has created a “quiet room” with plants and music for use by patients who need to relieve stress when coming for appointments.

“We also have the ability to download patients’ glucose meters,” Webber said, a service that allows those with diabetes to see a graph with the pattern of their blood sugars over time.

Both St. Joseph and EMMC offer the ADEF program – Ambulatory Diabetes Education and Follow-up, which includes group teaching sessions and follow-up with nurses and/or dietitians over the course of a year.

EMMC has its center at the EMH Mall on Union Street, Leclair explained, where it receives more than 15,000 patient visits a year. The center serves 520 adult diabetic patients, has 400 patients on insulin pumps, and follows 250 children and families. More than 200 patients with diabetes in pregnancy also come to the center each year.

The facility also coordinates EMMC’s surgical weight-loss program, and, in a different approach, offers COPE, a weekly group therapy program for compulsive overeaters. The group is led by a licensed professional clinical counselor on staff who does one-on-one therapy with some of the center’s patients.

Good information is available online, Leclair pointed out, at sites such as the American Diabetes Association’s www.diabetes.org.

Diabetes is on the increase along with the incidence of being overweight, Leclair and Webber acknowledged. But, they emphasized, there’s more help available than ever before.

America’s Walk for Diabetes will be held at six locations throughout the state. Each race begins at 9:30 a.m.

. Bangor, Sunday, Sept. 29, YMCA Fitness Center, Taft Street.

. Presque Isle, Saturday, Sept. 28, Zipple School.

. Augusta, Sunday, Sept. 29, Buker Middle School.

. Brunswick, Saturday, Oct. 5, Fair-haven Assembly of God.

. Lewiston, Sunday, Sept. 29, Lewiston Armory.

. Portland, Saturday, Oct. 5, Back Cove, Baxter Boulevard.

For information, call (888) 342-2383, or check the ADA Web site at www.diabetes.org.