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by Ginny Rich, APRN, BC, ADM, CDE
Visiting China as part of a Diabetes Education delegation with the People to People Ambassador program was meaningful in many ways, but especially because of my personal connection to diabetes. Nineteen years ago, at age 5, the oldest of our three children was diagnosed with Type 1 diabetes and admitted to Children's Hospital Boston.
We were overwhelmed by the news and feared for our son's day-to-day safety and long-term health. I had worked in the critical care and cardiology research fields and understood all too well what a diabetes diagnosis could mean in terms of long-term eye, kidney and circulatory problems. Like most parents, we were heartsick with the news, but were determined to provide our child with a healthy and satisfying life. We learned everything we could about how to live well with diabetes, and through hard work, access to excellent medical care and good fortune, our son, Chris, also a member of the delegation, is doing well and has not let diabetes stand in his way.
A second personal connection came about four years ago when my mother was diagnosed with Type 2 diabetes. She, like many others with Type 2, had diabetes for many years without knowing it, and as a result had diabetic complications at the time of diagnosis. The care she requires today is extremely expensive, whereas the cost of prevention would have been much less—and the "quality of life" cost can't be quantified.
Although there have been great strides in diabetes treatment in recent years, the incidence worldwide is increasing and the toll it's taking on individuals and society is significant. The opportunity to visit seven clinical sites in three cities in China helped us to understand the rising global impact of diabetes and the importance of taking steps to focus attention on this world-wide health threat: 200 million people worldwide are living with diabetes and the number is increasing by an incredible six million every year.
In China, we saw paralleled increases in obesity, sedentary behavior and Type 2 diabetes seen in America. This has been accompanied by a lower consumption of traditional plant-based foods and is more pronounced in the urban areas. Indeed, American fast food restaurants were abundant in all three cities we visited: Beijing, Xian and Shanghai. As part of an American diabetes delegation, it was ironic and sad to see unhealthful fast foods equated with the American lifestyle.
As a nurse practitioner and diabetes educator at Children's, I am encouraged by the advances and technological innovations for those with Type 1 diabetes. At the same time, I am dismayed by the alarming rise in Type 2 in the pediatric population, which is associated with increases in obesity and sedentary behavior. Unlike Type 1, which is an auto-immune condition in which the body mistakes insulin-producing cells as invaders and destroys them, thereby making one dependent on injected insulin, we have the ability to prevent or possibly reverse Type 2. It's certainly not an easy task, but ask someone with Type 1 diabetes if they'd welcome an opportunity to prevent or reverse their condition and you'll see what I mean.
So what are we to do? As individuals, it's important to have regular check-ups, know your family history (more so for Type 2 than 1) and recognize the symptoms of diabetes. These include excessive thirst and urination, weight loss and fatigue. Annual blood sugar tests are important if you're over 45 or are under 45 and overweight or have a family history of diabetes. Regular check ups and discussion about risk factors with your physician are essential to prevention and/or early detection. We also have to re-educate ourselves about healthful portion sizes, food choices and activity levels. Healthy environments need to be adopted and supported by schools, businesses and governments, and this is something we can all endorse and advocate for. Diabetes is a pandemic that threatens to overwhelm health care resources and disable people of working age, but it can be turned around. It's imperative that efforts be made to prevent diabetes, better manage it and reverse it, when possible.
Traveling to China with other American Association of Diabetes Educators was rewarding culturally and professionally. We learned a lot about the similarities and differences in diabetes care between our countries, but most significantly, it opened our eyes to the global incidence and cost of diabetes, which is staggering. A report by the American Diabetes Association listed the cost of diabetes in the United States (health care and lost productivity) at $174 billion in 2007, up from $132 billion in 2006. That's more than the $150 billion in damages caused by hurricane Katrina! The good news is that routine diabetes care actually costs very little in the grand scheme of things. Most of the enormous cost comes from uncontrolled diabetes. I have witnessed this in my own family. This summer, the world will come together as China hosts the summer Olympics in Beijing. We must also come together to address the alarming rise in diabetes. We have the ability to effectively prevent and better manage this disease and this is an opportunity we cannot afford to ignore.
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