Published: October 11, 2008 11:35 pm         

Many Americans unaware they have pre-diabetes

There are 11 teaspoons of sugar in a 12-ounce can of soda, and fruit juice contains an almost equal amount of sugar.

Those types of portions can lead to a number of health problems, including diabetic and even cancer issues, according to Pam Baggett, clinical dietitian at St. Mary’s Regional Medical Center.

Due to the declining health of Americans, health care professionals are seeing more cases of “pre-diabetes” than ever before, said Patti Ruiz, diabetes educator at the hospital. Pre-diabetes is an area which measures blood sugar higher than the normal range of about 109 after fasting, but lower than the 126 level usually describing diabetes.

People with the upper-range numbers were formerly called “glucose intolerant.” Baggett said those people should make diet changes and exercise like any diabetic.

Ruiz has some interesting statistics to back up what she says. Sixty five percent of the population is overweight or obese. The risk factors are insulin resistance, glucose intolerance, Type II diabetes, coronary heart disease, stroke, heart failure and certain cancers, among other ailments.

Obesity is reported to be responsible for a high percentage of health care costs. Adults in the United States gain an average of 1.8 pounds to two pounds per year.

Fifty-seven million Americans are pre-diabetic and most are unaware of it. Health insurance and Medicare does not pay for diabetes education. But there are some simple steps to prevent diabetes and they are the same as those preventing obesity.

Exercising 20-minutes three times a week will lower blood sugar. That exercise can be as easy as a brisk walk. She also recommends watching intake of carbohydrates. Three pieces of bread has the same carbohydrate content as a piece of pie. There are 15 grams in a serving of carbohydrates. That can be found in cereal, bread, grains, corn, potatoes and peas. Beans are starchy vegetables.

“Fat affects the heart and the number one complication is diabetes,” she said.

Heart disease and stroke represent 65 percent of deaths in people with diabetes. Oklahoma is one of the highest ranked states in the rate of obesity. Ruiz said people live high stress lives with no exercise and eat large servings, which causes obesity and diabetes. Part of the problem also is genetics. But an individual predisposed to diabetes can take steps to avoid it by taking proper care of themselves, she said.

Smoking also increases the rate of complications from diabetes, she said.

“Smoking affects the vessels and aggravates all the problems when you smoke,” she said.

Ruiz tells her patients to watch what they eat and increase their metabolism to lose weight. She sees people every day who have no diabetes in the family, but when they reach age 60-80 they will be pre-diabetic or diabetic.

“They don’t chase around anymore, and they eat wrong,” she said.

Ruiz emphasizes watching the portions of meals and the number of carbohydrates eaten in a day. A safe level is nine to 11 servings of 15 grams, per day, but not all at the same time. She also urges people to eat all three meals and don’t skip. She has found that many people do not eat breakfast, even though is an important meal.

Ruiz said a lifestyle change that includes diet and exercise is necessary to live a health life. She also recommended avoiding large portions at meals, energy dense foods, indiscriminate snacking, intake of calorie beverages.

Virginia McCall, RN, is director of Heart Services and Critical Care at St. Mary’s. She is responsible for cardio rehabilitation.

“Cardiac event increases are secondary to lifestyle. There is also an increase in Type II diabetes that goes with cardiovascular disease,” she said.

Residents in cardiac rehabilitation see between 30 and 60 patients a day, those recovering from a “cardiac event,” heart attack or surgery. McCall said Americans are at the point where they are no longer compliant as a population in terms of healthy requirements. In her cardio rehabilitation unit she tries to improve the lifestyle of post-cardiac event patients.

To improve the quality of their lifestyle means seeing a dietitian and exercising. In stress management they teach patients to deal with stress and develop coping mechanisms they need. A social worker interacts with patients both one-on-one and in classrooms. Some patients are fearful after a cardiac event or they are concerned about aging and she works with them about that.

Oklahoma ranks among the highest states for heart trouble, she said. It is also at the top for high blood pressure and obesity.

“We also have a large population with congestive heart failure,” she said.

Her staff is also seeing an increase in cardiac disease and she is developing a heart failure support group for families.

“We are the aftermath of not taking care of yourself,” she said.

You are never too young or too old to start exercising and learning about nutrition.

“It’s easier to take care of yourself. A low-fat diet, no smoking, regular checkups; eat smart and exercise,” she said.

Dierdre Postier is a pediatric dietitian. She said Oklahoma is one of the fattest states, ranking in the top 10 states for obesity. Childhood obesity is an increasing problem in the state. Only 36 percent of parents of obese children see their child as obese, she said. Many of the parents are obese also. She teaches a young and fit program where parents bring their children, then stay and learn with the kids.

“There are so many conveniences. People don’t eat together, there is a lack of exercise. Go outside and play with your kids, go for a walk, show your kids you are willing to do things too,” she said.

Baggett sees every patient as a nutritional risk. She warned of the health problems that come with poor nutrition. Obesity is responsible for 5.5 percent to 7.5 percent of all health care costs and if the patients develops diabetes or heart disease that results in the remainder of the cost.

A big contributor is Americas change of lifestyle. Men do not make their living following a team of horses in the field, women do not do laundry the way they once did and not as many kids are going outside to play as they once did.

“We’re seeing more people unhealthy because of a lack of exercise. If we exercise we will be healthier,” she said.