Diabetes is one of the more prominent diseases within the United States. According to the American Diabetes Association, 1.4 million new cases of Americans are diagnosed every year.
Being a newly diagnosed patient can be frightening and, often, overwhelming. Lifestyle changes are difficult, especially since many Americans are uneducated on the diabetes frontier. Diabetes is a complicated condition that can be difficult to bear if not treated appropriately. Dr. Mark Watkins, a pediatric endocrinologist, practices at the Endocrine & Diabetes Care Center in the ProMedica Mary Ellen Falzone Diabetes Center in Toledo. He completed his residency in internal medicine and pediatrics at the University of Toledo in 2004 and, from there, completed a three-year fellowship in pediatric endocrinology at the University of Michigan in 2007.
HealthScene Ohio: What is the most commonly misunderstood concept about diabetes?
Dr. Mark Watkins: There is a lot of confusion regarding the difference between type 1 and type 2 diabetes. Type 1 diabetes is an auto-immune disease in which the person’s own immune system destroys the beta cells that produce insulin. Type 2 diabetes is when the body becomes resistant to insulin, resulting in high blood sugars. In general, people with type 1 diabetes are completely dependent on insulin for survival while people with type 2 diabetes often take insulin to help lower their blood sugars, but they are dependent on insulin for survival.
HSO: Is it difficult for a diabetic person to prepare food for himself or herself?
MW: For type 1 diabetes, the overall diet doesn’t change very much. However, the proper insulin dose needs to be calculated to account for the carbohydrates in the meal. For type 2 diabetes, diet changes significantly because obesity is frequently present.
HSO: What would you tell a pregnant woman who develops gestational diabetes about maintaining her and the baby’s health?
MW: In pregnant women with type 1 diabetes, if uncontrolled during pregnancy, it can be very harmful to the baby. Babies can be born very large, congenital heart disease may be present and dangerously low blood sugars may develop, just to name a few of the possible complications. It’s very important to see a maternal-fetal medicine specialist.
HSO: How can one avoid becoming diabetic? If I am diabetic, are my kids at risk of following in a similar path?
MW: There isn’t a way to prevent type 1 diabetes and, often, there is no family history, either.
For type 1, they are at risk if one of the parents has type 1 diabetes. For example, if a father has type 1 diabetes, there is a 4 percent chance that multiple children will be affected, and if the mother has diabetes, there is an 8 percent chance. There are studies being conducted to help prevent the development of type 1. One of the studies aims to prevent antibodies from destroying beta cells.
For type 2 diabetes, there are risk factors, some of which are modifiable and non-modifiable. Modifiable risk factors are those you can control, such as diet and exercise. Non-modifiable risk factors are things you cannot control, such as if both parents have diabetes. Also, some ethnic groups that are at risk are American Indians, African Americans and Hispanics.
HSO: How can families of the diabetic help their loved ones?
MW: With type 1 diabetes, families can help by learning as much as they can. Everybody who is assisting in the care of the child should learn and be educated.
HSO: How important is exercise?
MW: Exercise can increase muscle mass, which improves insulin sensitivity and, in turn, lowers blood sugar and allows insulin to work better. Better controlled blood sugars prevent diseases such as blindness, kidney disease, and nerve damage.
HSO: What if diabetics can’t afford medication?
MW: This is a major problem with type 1 and type 2 diabetes. Fortunately, most children are on a parent’s insurance, but I’ve had a case with a patient who chose between insulin and college. Insulin is several hundred dollars per month. When patients aren’t able to get everything they need, they will have very poor control of their disease. However, many patients can be helped through government assistance. There are also some drug companies that have patient assistance programs where they get either discounted or free medications.
HSO: Is there a support group people can join?
MW: Yes, we have an organization called Diabetes Youth Services. It provides education to parents, support and education to school nurses. Also, there is a diabetes camp for all age groups, along with our teen support group. The organization services are in southeast Michigan and northeast Ohio.
Ray Bruster is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. Mark Watkins is a board-certified pediatric endocrinologist with ProMedica Physicians. Watkins earned a doctorate of osteopathic medicine at the University of Health Sciences College of Osteopathic Medicine. He completed a residency in internal medicine and pediatrics at the University of Toledo College of Medicine and a fellowship in pediatric endocrinology at University of Michigan CS Mott Children’s Hospital. Watkins is a member of the American Academy of Pediatrics and the American College of Physicians.
To find more information about support in your area, visit the American Diabetes Association’s website at www.diabetes.org.
