It’s in the blood, sugar

Diabetes is at epidemic levels in Nevada. If you think constant testing is bad, it’s not just about finger pricks.

Take a look at the Nevada diabetes chart from the Center for Disease Control and Prevention (below). It’s fairly easy to understand: In 2009 in Nevada, there were 26,000 people ages 18-24 with diabetes; 73,000 were 45-64-year-olds; 32,000 were 65-74-year-olds; and 29,000 were 75 years and older. One noticeable detail is that the general trend of the lines is up. More people in Nevada have diabetes than at any time in our recorded history.

There’s another point of interest: How is it the percentages drop so much after age 64? Or to state it another way, if the older a person gets, the more likely he or she is to develop the disease, why aren’t percentages of people over age 64 with diabetes even higher?

It’s because those missing people are dead. Uncontrolled diabetes kills people.

Mylan Hawkins, executive director of the Nevada Diabetes Association,, said while Nevada is about average in the country with an 8 percent rate, the state has some reasons peculiar to it that make diabetes a particular problem here.

“Part of it has to do with an aging population, and the other part of it has to do with lifestyle,” she said. “Of course, it really is a pandemic all over the world. It’s a huge problem throughout the United States.”

Hawkins said the lifestyle factors include fast food diets, the state’s poverty level, a lack of health insurance, a lack of knowledge and education, and a culture of cheap, unhealthful food.

“Basically, looking at Nevada, because we are a small state with limited income to handle health care problems, we have a huge problem with this one disease,” she said. “It’s major. It’s major.”

What is diabetes?

Simply put, diabetes is caused by a pancreas that doesn’t work correctly. The pancreas produces the hormone insulin. Insulin removes glucose from the blood. In diabetics, there’s too much blood sugar. Excess sugar is poison to many types of cells in the body.

There are three main types of diabetes: Type 1, you produce no insulin at all; Type 2, you don’t produce enough insulin, or your insulin is working improperly; Gestational diabetes is when you develop diabetes when pregnant. Many researchers have also claimed a link between diabetes and diseases like Alzheimer’s, describing certain dementias as a fourth form of diabetes.

According to the Medical News Today, “If diabetes is not adequately controlled, the patient has a significantly higher risk of developing complications, such as hypoglycemia, ketoacidosis, and nonketotic hypersosmolar coma. Longer term complications could be cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.”

Ever notice how there seems to be a lot of fat people in wheelchairs with missing feet? There’s even a socio-economic aspect to it. Just check out anywhere homeless people gather—if they’re not veterans, and they’re missing feet, they’re probably diabetic.

But those who haven’t begun treatment or who can’t afford it have all kinds of fun symptoms, according to the same website: Frequent urination, unusual thirst, intense hunger, weight gain, unusual weight loss, increased fatigue, irritability, blurred vision, cuts and bruises that don’t heal properly, more frequent skin and/or yeast infections, itchy skin, frequent gum disease/infection, sexual dysfunction among men, and numbness or tingling in feet and hands.

And then there are the other diseases caused by diabetes: blindness, kidney disease, heart and blood vessel disease, nerve disease.

That’s why men get put in a particular circle of diabetes hell. If the extremities’ blood vessels and nerve cells fail, that most delicate of the extremities, the penis, fails. No amount of Viagra or friendly persuasion will ever bring it back. And though diabetes can be controlled with medications, particularly insulin, many of its ravages can never be repaired. That means some men will live in that sexless hell for a very long time. Decades. Until they die.

Cause for alarm

Now, not to pick on Type 1 diabetics, but they’ve got a disease that doesn’t lose its symptoms without medicinal treatment. They have to exercise and eat right and take drugs, but it’s probable they’ve had the disease since childhood and will have it for the rest of their lives.

What risk factors increase the likelihood of developing Type 2 diabetes?

Being overweight or obese; having a parent, brother, or sister with diabetes; being African-American, American Indian, Asian-American, Pacific Islander, or Latino; having had gestational diabetes or birth of at least one baby weighing more than 9 pounds; having high blood pressure measuring 140/90 or higher; having HDL cholesterol 35 or lower or triglyceride level is 250 or higher; being physically inactive—exercising fewer than three times a week.

None of this is controversial. It’s all what the medical establishment says. Forget all those other detailed factors—fat, lazy and stressed-out people are more likely to develop diabetes and a limp penis. For Type 2 diabetics, “moderate diet and exercise of about 30 minutes or more, 5 or more days per week, or of 150 or more minutes per week, resulting in a 5 percent to 7 percent weight loss can delay and possibly prevent type 2 diabetes,” according to the CDC. Many—if not most—Type 2 diabetics who can get fit can get entirely off pharmaceuticals.

Here’s the controversial part: Diabetes and obesity are caused by carbohydrates. Most diabetic diets prescribe fewer processed grains and sugars (and less fat, although that appears to be a misguided idea about consuming fewer overall calories and bringing down the weight).

The CDC again makes it simple, with the idea that when whole grains are substituted, fewer processed grains will be consumed.

What should someone with blood-sugar issues eat more of?

Eat more fiber by eating more whole-grain foods. Whole grains can be found in:

• Breakfast cereals made with 100 percent whole grains.

• Oatmeal.

• Whole grain rice.

• Whole-wheat bread, bagels, pita bread, and tortillas.

Eat a variety of fruits and vegetables every day. Choose fresh, frozen, canned, or dried fruit and 100 percent fruit juices most of the time. Some experts say to avoid all fruits. Eat plenty of veggies like these:

• Dark green veggies (e.g., broccoli, spinach, Brussels sprouts).

• Orange veggies (e.g., carrots, sweet potatoes, pumpkin, winter squash).

• Beans and peas (e.g., black beans, garbanzo beans, kidney beans, pinto beans, split peas, lentils).

What should someone with blood-sugar issues eat less of?

Foods that are high in sugar, such as:

• Fruit-flavored drinks.

• Sodas.

• Tea or coffee sweetened with sugar.

• Salt.

Blood simple

Pricking your finger may be as simple as fingering your prick—once a day is fine. But for people who are new to the disease or are simply threatened by pre-diabetes or insulin resistance, more may be necessary. For the first month—or long enough to recognize patterns—five to eight tests daily may be necessary. One local tested before each meal, at 2 a.m. and immediately upon waking. During this analysis period, diabetics can expect to have sore fingertips.

The procedure goes like this for fasting blood sugar with most blood sugar meters: Insert the correct type of test strip into the correct meter. Swab the finger with rubbing alcohol. Press the spring-leaded lancet (pin) into the chosen finger, and push the button. Cry a little bit. Squeeze the fingertip until a drop of blood forms, which is lightly touched to the test strip. (And by the way, the same test strips, say Accu-Chek Comfort Curve Test Strips, can cost from $19.99 on to $140-plus at other online retailers—that’s for 50 strips.) After a few seconds, a number will appear on the meter’s screen. If it’s less than 100 in the morning, rejoice, you’re not showing unusually high glucose, although at least one study has shown damage from glucose begins in the high range of normal. If the number is less than 120, you’re high, but not dangerously so. Between 120-125, insulin resistant. Above 125, bad, diabetes bad, and it gets worse from there. There are other measures that suggest 100-125 is the insulin resistant zone. Log the numbers in a notebook that also includes what you ate, when you ate it, and how much you exercised.

Particularly if the test is for fasting blood sugar, which is tested first thing in the morning, the results can determine how your entire day will go.

There is one thing guaranteed to decrease glucose numbers, and that’s insulin. While new methods of delivering the hormone are being developed all the time—for example, the insulin pump is quickly developing a fan base—most people find the most effective method is a syringe. Shots are a daily, and sometimes more, reality for those who haven’t watched their weight and their carbohydrates and didn’t correctly pick their parents. They, especially, get to be their own science project, trying to factor in things like sleep, foods eaten and exercise.

That’s what a young adulthood filled with doughnuts, football from the couch, good beer and sugary soft drinks will get you: Poked but unlaid. You still get screwed.