Wednesday, July 30, 2014

Diabetes A bitter holiday side dish

By DOUG CARDER, Herald Senior Writer | 11/20/2012

People should watch what they eat year-round, but that’s especially true during the holidays, local health officials said.

“One, hearty Thanksgiving meal can contain up to 3,000 calories,” Brenda Pfizenmaier said. “The average daily diet is based on 2,000 calories. So people need to be careful not to put on those extra pounds during the holidays. They can do this by eating smaller portions, making healthy food choices and exercising every day.”

People should watch what they eat year-round, but that’s especially true during the holidays, local health officials said.

“One, hearty Thanksgiving meal can contain up to 3,000 calories,” Brenda Pfizenmaier said. “The average daily diet is based on 2,000 calories. So people need to be careful not to put on those extra pounds during the holidays. They can do this by eating smaller portions, making healthy food choices and exercising every day.”

Doing otherwise could bring health complications, including diabetes, Pfizenmaier, a clinical dietician and certified diabetes educator with Ransom Memorial Hospital, 1301 S. Main St., Ottawa, said. Pfizenmaier works with a number of patients who have been diagnosed with diabetes mellitus — or just diabetes, as it is more commonly known.

One diabetes patient improved her health by walking around a pool table each day.

Another diabetes patient lost 170 pounds. It started with the simple task of walking back and forth to her mailbox each day.

Those are two examples of why exercise is so important for people who have diabetes, Pfizenmaier said, a condition that can have adverse affects on a person’s vision, heart, kidneys and feet.

“I tell the patients to keep it simple,” Pfizenmaier, whose office is located in Gollier Rehabilitation and Wellness Center, 901 S. Main St., said. “Cut portion sizes, drink more water, and exercise. It’s amazing how just losing five to 10 pounds can make a big difference.”

With Type 1 diabetes, the pancreas is not making any insulin. Type 1 diabetes most often develops in children, but adults at any age can also get it, according to information from the American Diabetes Association. People with Type 1 usually must take insulin every day to get fuel into most cells. 

The pancreas might be making some but not enough insulin for people with Type 2 diabetes, which is on the rise in the U.S., national health research shows. Sometimes insulin or other medication is required to treat Type 2 diabetes, but proper diet and exercise also can help combat this form of the disease, local health officials said.

Behavioral Risk Factor Surveillance System (BRFS) data from 2009 indicated that 8.8 percent of Franklin County adults have received a diagnosis of diabetes — slightly above the state average of 8.5 percent, Midge Ransom, director of the Franklin County Health Department, 1418 S. Main St., Suite 1, Ottawa, said. 

The diabetes trend the past several years parallels the upward trends in modifiable risk factors, which include overweight/obesity, high blood pressure, physical inactivity, and an unhealthy diet, Ransom said. 

Using Franklin County residents’ weight and height information provided for the BRFS report, overweight adults were calculated at 32.8 percentage in the county, compared to a state average of 35.8 percent, Ransom said, with 28.5 percent of county residents considered obese. The percent of individuals reporting they met the recommended level of physical activity was 48.5 percent, about 3 percent above the 45.3 percent state average.

“It should be noted that this is all self-report, and therefore people tend to report themselves as weighing less, being taller and doing more activity that they actually do,” Ransom said.

The cost of diabetes to Kansas was more than $1 billion in 2002, Ransom said, citing a December 2011 Kansas Department of Health and Education report titled, “The Burden of Diabetes.”

Diabetes rates are higher among those with less education and lower income levels, Ransom said that research shows, with community health centers in Kansas seeing more than 8,000 patients with a primary diagnosis of diabetes mellitus in 2011. Among those diagnosed with diabetes, more than 78 percent reported eating less than the recommended five servings of fruits and vegetables per day, according to a KDHE report.

Some symptoms of diabetes include frequent urination, blurred vision, unusual thirst, unusual weight loss and extreme fatigue, Ransom said, adding that people who exhibit those systems should see a medical practitioner.

People also can exhibit pre-diabetes symptoms. Persons who might be more likely to have pre-diabetes include those over age 45 who are overweight, or people under age 45 who are overweight and have other risk factors for diabetes, according to the American Diabetes Association. 

The diabetes association said people are at increased risk for diabetes if they are:

• Overweight.

• Physically inactive.

• A parent, brother or sister with diabetes.

• African American, Native American, Asian American, Pacific Islander or Hispanic American.

• Have had a baby weighing more than 9 pounds or have had gestational diabetes.

• Have high blood pressure.

• Have a history of cholesterol problems. 

For more information, go to the American Diabetes Association’s website at www.diabetes.org

Pfizenmaier said some people who suffer from Type 2 Diabetes might not exhibit any symptoms.

Ransom concurred, adding that research shows: “Nationally, one-in-four adults are believed to be undiagnosed.” 

That’s why Pfizenmaier and Ransom both recommended people should have their fasting blood sugar checked annually.  

“If you don’t have a primary care practitioner, the health department can do a blood sugar/blood lipid rapid screen for you,” Ransom said.

People need to exercise daily, Ransom said.

“Even if you only tell yourself to walk around the block, do it,” she said. “Do more if you can. Exercise helps moderate blood sugar levels, burns calories and helps control weight — all impactful on diabetes. People who lose weight may reverse the need for diabetes medication.”

Ransom also encouraged people to increase fruit and vegetable intake and decrease fats in their diet.

A local community health assessment/improvement plan, which the Franklin County Health Department is helping spearhead, focuses on healthful eating as one of its top priorities, Ransom said.

“We are looking for community partners to help us address this issue,” Ransom said. “We want to make sure people in Franklin County have access to healthy, affordable food.”   

For more information about the community health improvement plan or partnership opportunities, call Ransom at the health department, (785) 229-3530. 

Cherry Coen, family consumer science teacher at Ottawa High School, said while she doesn’t have a specific lesson about diabetes, she does talk with students about health concerns such as high cholesterol and excessive sodium intake, as well as teach students the importance of reading nutritional labels and following the U.S. Department of Agriculture’s MyPlate dietary guidelines.

Making healthful food choices can help in the fight against diabetes, Coen said.

“I do have several students who are diabetic,” Coen said, “and I try to visit with them on a regular basis.”

Coen said she has downloaded a new online application for her iPad at school that contains nutritional information for all chain restaurants.

“I’ll be sharing this information with my students,” Coen said. “They are probably going to be eating out, and when they do, I want them to know there are healthy options they can choose. It may not be those french fries or that salad dressing, but there are some healthy choices they can make.

“I try to teach my students to be informed consumers,” she said.

Pfizenmaier recommended several websites to learn more about a healthful diet and exercise:

• www.Choosemyplate.gov, which helps people track the foods they eat and set calorie goals.

• www.myfitnesspal.com, which has a calorie counter.

• www.mapmywalk.com, which people can access with their smartphones to map their routes or track distances and calories burned while walking. “I have a couple of patients who use this and really like it,” she said.

“Just walking every day can bring down your blood sugar,” Pfizenmaier said.

Doug Carder is senior writer for The Herald. Email him at dcarder@ottawaherald.com

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