More than 29 million people in this country have diabetes according to the Centers for Disease Control and Prevention and one out of every four of those people don’t even know they have the disease. Here in Florida the numbers are even worse. Back in 2011 the Orlando Sentinel reported that one in ten Floridians had diabetes and now, in 2015, the Sunshine State has the dubious distinction of having the eighth highest rate of diabetes in the entire country. That does not sit well with Dr. Mary Quillinan.
A doctor of osteopathy and the former internal medicine department chair and director of the diabetes program at Lakeland Regional Medical Center before moving to Vero Beach and the Indian River Medical Center, Quillinan does point out that some of Florida’s diabetes problems are not of its own makings.
“The graying and aging of America is a factor here,” she explains, “the older you get, the more likely you are to develop diabetes,” and as more and more retirees move to the Florida, bringing their diabetes with them, the state’s numbers are skewed. Quillinan, however, has her sights firmly fixed on some other, more fixable, factors.
But before delving into those factors, it should be pointed out that there are two main classifications of diabetes: Type 1 and Type 2.
Type 1 diabetes used to be called “juvenile diabetes” or “insulin-dependent” diabetes and is, for all intents and purposes, a disease some people are simply born with. In Type 1 diabetes, a person’s pancreas produces little or no insulin. (Insulin is a hormone that allows sugar or “glucose” to enter human cells and produce energy, particularly in the brain.) People with Type 1 diabetes must take insulin injections throughout their lives. They also must ensure proper blood-glucose levels by giving themselves regular blood tests. There is no cure for Type 1 diabetes, but, fortunately, it accounts for only 10 percent of all the diabetes cases in the U.S.
The far more common Type 2 diabetes accounts for almost 90 percent of diabetes cases in this country and that clearly riles Quillinan because, she says, it can be controlled and even prevented. People, Quillinan states, can usually limit their Type 2 symptoms or even avoid the disease altogether by losing weight, following a healthy diet and getting plenty of exercise.
In Type 2 diabetes, the pancreas does produce insulin but for reasons no one can completely explain, the body’s cells develop a resistance to it and stop converting glucose into energy. Instead of being absorbed by the cells that need it, glucose/sugar builds up in the bloodstream.
Overweight and obese people are statistically much more likely to develop Type 2 diabetes than are people with normal body weight and that’s one of the factors that draws Quillinan’s ire.
“When I was in medical school,” explains Quillinan, “I was told I’d see diabetics in their golden years: their sixties, seventies and eighties. But now I’m seeing diabetics in their twenties.”
The biggest factor in the spread of Type 2 diabetes to younger people, Quillinan continues, “is this obesity epidemic. “We are seeing people with diabetes younger and younger.”
That is not good news since Type 2 diabetes is typically a progressive disease: it continues to get worse as the patient ages. Adding to the problem, another 86 million American adults have prediabetes. That means their blood sugar levels are higher than normal but not high enough to be classified as Type 2. Without weight loss and physical activity, as many as 30 percent of them, (another 25 million people), will likely develop the disease.
It is all too easy to increase the chances of developing Type 2 diabetes. In the journal “Diabetologia” researchers from the Imperial College of London reported that drinking just one can of a non-diet soft drink a day can increase the chances of developing Type 2 diabetes by as much as 22 percent. Those researchers believe the impact of sugary soft drinks on diabetes may be more than just adding all those calories to a person’s diet and eventually, their body weight.
Again, Quillinan returns to the exercise factor. “Really when we talk about prevention, exercise is the biggest thing. Even if you exercise and don’t lose a single pound, it helps to prevent diabetes,” she states. “You can run,” she continues, “or ride a bicycle. You can do Zumba. It doesn’t really matter.”
Ann Albright, director of the CDC’s Division of Diabetes put the situation into one of dollars and cents.
“Diabetes is costly in both human and economic terms,” says Albright. According to the Washington Post, “Medical expenses tend to be twice as high, on average, for people with diabetes than for those without the disease. Collectively, [diabetes] costs the U.S. health system an estimated $250 billion a year, including major amounts of lost work and productivity. That includes billions spent on inpatient care, doctor’s visits, medication and supplies such as glucose monitoring strips. The American Diabetes Association (ADA) estimates that treating patients with the disease accounts for more than $1 of every $5 spent on health care in the United States.”
Those figures are only going to balloon as those 20-year-old diabetics Dr. Quillinan reports seeing begin to seek treatment.
And they’d better seek treatment.
Left unattended, diabetes has some nasty impacts on lives including heart attacks, strokes, loss of limbs and even blindness. Bad circulation in the legs from diabetes, says Quillinan, can lead to sores and gangrene and result in the amputation of feet and legs.
As to vision problems, Quillinan minces no words. “Basically,” she explains, “diabetes causes two problems with the eyes. It can cause blurring of vision and even retinopathy, or retinal detachment. That is irreversible and people do go blind.”
Perhaps most surprisingly, Quillinan is also an advocate of weight loss surgery. Many doctors disagree but Quillinan says, “I think weight loss surgery is a good thing for the right person. For some people it really is lifesaving. I have definitely seen patients who I sent to surgery and I am 100 percent sure it saved their lives.”
She quickly adds, however, that candidates for weight loss surgery, “have to be willing to make changes in their lives. The surgery is a tool, not a panacea. If they say well, I am going to eating whatever I want and I am not going to exercise,” then surgery is not going to help.
Unfortunately, the symptoms for Type 2 diabetes can go undetected for years. Those symptoms might include increased thirst; frequent urination; extreme hunger; the presence of ketones in the urine (a byproduct of the breakdown of muscle and fat that happens when the body’s insulin isn’t doing its job); fatigue; irritability; blurred vision; slow-healing sores and frequent infections.
Simple blood tests are the best way to catch diabetes early so check with your doctor. The sooner diabetes is diagnosed and treated, the better the outcome.
Dr. Quillinan’s office is at 801 Wellness Way in Sebastian, Florida. The phone is 772-581-5581.
