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Diabetes seminar focuses on awareness

There are 16 million diabetics in the United States today and many don’t know about it.

That number is expected to rise to 40 million by 2052.

To help address the need for more education, Rose Marie Rincon, 14-year diabetic and sponsor of the Williams Diabetes Support Group, has organized a diabetes committee.

This Saturday, representatives from local businesses and organizations will gather at the Best Western Inn, 2600 W. Route 66, at 8:30 a.m. to participate in a Diabetes Today seminar to learn how to increasing diabetes awareness in town.

“This is our community and we would like to make a difference by getting the word out about diabetes,” said Rincon. “Our speaker will be Carmen Ramirez from the Arizona Department of Health Services.”

Ramirez is the Community Program Coordinator for the Diabetes Control Program, Bureau of Community and Family Health Services and she was also a prior speaker for the monthly support group.

“What we will do will be to gather ideas that will target the different employers and business in our community to bring greater awareness of the problem of diabetes in our community,” Rincon said.

During the six hour seminar, Grace Fass, school nurse, will represent the Williams School District; Ervin H. White, trainmaster — Grand Canyon Railway; Jan Neal, information receptionist — Williams Ranger District; Denise Smith — KC Hilites; Kris Vasquez, occupational therapist — Rehab Therapy Services; Yolanda Corona, account clerk II — City of Williams; Cindy Christman, director — Williams Health Care Center; the Rev. Michael Bain — St. Joseph Catholic Church; Josie Lann, loan processor —The Stockmen’s Bank; Gabe Ayala, owner — Gabe’s Plumbing, and Kenny Brooks, supervisor — Arizona Department of Transportation.

The diabetes committee is scheduled to hold three one hour meetings each year.

Nerve damage

It’s easy to name the chief factor responsible for nerve damage in diabetics, said Dr. James Wurgler to the March meeting of the Williams Diabetic Support Group.

“High blood glucose levels,” he said are responsible for diabetic neuropathy.

Nerve degeneration is caused by diabetic neuropathy, which in turn is caused by hyperglycemia or high blood sugar levels.

It is estimated that 60 percent of diabetics, both Type I and Type II, who have had the disease for a long time have some degree of neuropathy, according to the Diabetes Self-Management web page. The web page states the most common form of nerve damage is peripheral diabetic polyneuropathy, which affects the feet, legs, arms and hands.

Wurgler, who has been a doctor for more than 40 years, said problems with these extremities could lead to serious issues especially since “diabetics tend to have a decrease in circulation.”

“You may not be able to feel it’s hot,” he said to the support group about soaking feet in warmed water or placing feet on a heater. “The problem is you could burn your foot significantly and not have a clue.”

When blood glucose levels are maintained at a high level, damage occurs to the tips of the nerves.

“Think of a nerve as an electrical cord,” said Dr. Eva Feldman, a neurologist at the University of Michigan and Director of the Juvenile Diabetes Research Foundation (JDRF) Center for Complications of Diabetes. “The nerve fiber itself is the wire inside the cord, and it is surrounded by insulation. In diabetic neuropathy, the nerve fiber itself becomes damaged at its farthest points, and the insulation also becomes damaged. Also, the cell

body that supplies the nerve becomes dysfunctional and dies.”

In other words, the longest nerves, like those that extend to the toes, are affected first.

Susan Mullins, Ash Fork resident who was diagnosed with diabetes one and a half years ago, said keeping blood sugars low is the key to avoiding problems.

“The doctors cannot help you ó you have to help yourself,” she said. “If you keep it (blood glucose levels) at 300, you are a prime candidate for neuropathy.”

Another important self-care issue dealing with neuropathy is not smoking.

“Smoking is a no-no for diabetics,” Mullins said. “Anyone who combines a 300 (blood sugar level) and smoking can make an appointment with the doctor now.”

Not keeping sugar levels low can lead to a number of complications; the most severe of which is amputation.

“The good news is that there is an approved product to treat the cause of neuropathy, and you (diabetics) already have it: insulin,” the DSM web site states. “Controlling blood sugar can not only delay the onset of neuropathy but can also reportedly improve symptoms for those already affected.”

The Diabetes Complications and Control Trial, a major study published in 1993, demonstrated conclusively that there was at least a 60 percent decrease in neuropathy when blood sugar levels were kept close to the normal range.

Early detection and intervention is important. The problem is the early signs and symptoms of diabetic neuropathy are often overlooked.

“Neuropathy is dangerous because it is subtle, and that makes awareness paramount,” the DSM web site states. “The feet that are most likely to ulcerate and possibly be amputated are not the painful feet but the numb feet.”

Wurgler suggested diabetics watch their diets and have feet checked at least annually. He also suggested diabetics increase the amount of fish they consume.

“Sardines are a great source of omega-3,” he said.

Fish oil contains omega-3 fatty acids, which lower cholesterol levels. Some studies have shown that people who eat some fish regularly have lower rates of heart disease than people who consume none. Wurgler said the other benefits of omega-3 are still being discovered.

The diabetes support group meets 6:30 p.m. the first Thursday of each month in the lobby of the Williams Health Care Center. April 5 Linda Paul, nurse at Flagstaff Medical Center and Northern Arizona Healthcare, will speak about the insulin pump and stress management.


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