One of the first things Dr. McNeal Brockington wants people to know about diabetes is that it is often preventable. Once patients are diagnosed with it, the quality of life is largely up to them.
Its full name is diabetes mellitus and there are two main types. Diabetes occurs when blood sugar runs too high because the pancreas does not produce enough of a hormone called insulin.
Juvenile diabetes, also known as type I, occurs mainly in children and young adults. Type I diabetics almost always are insulin zTC dependent, requiring injections of insulin daily to live. Type II diabetics produce more -- but not enough -- insulin and may be referrd to as non-insulin dependents. Type II occurs in adults usually over 40.
A native of Baltimore, Dr. Brockington is an internist with the Parkwest Medical Center's satellite office on Reisterstown Road. Although he is an internist -- one who specializes in adult medicine -- his diabetic patients are both type I and II.
An article in a health quarterly magazine says, "More than 11 million Americans have diabetes. Approximately one million have type I diabetes and almost 10 million Americans have type II . . . " Ethnic groups have "a higher rate of diabetes than the general population." Dr. Brockington agrees with the figures, noting that most of his diabetic black patients have type II.
Clara J. McLaughlin, author of the "Black Parents' Handbook," wrote that many women who may have the trait may not see diabetes manifested until pregnancy or childbirth. These "gestational diabetics," says Ms. McLaughlin, may return to "normal" after giving birth. She says that delivery has often been by Caesarean section and that a woman monitored naturally fares better than a pregnant diabetic without doctor's supervision.
Early symptoms of diabetes include chronic thirst, frequent urination, caused by too much glucose (sugar), and blurred vision. Other symptoms include excessive sweating, dizzy spells and tingling or numbness, particularly in the feet. Dr. Basil Morgan, an ophthalmologist (an eye physician and surgeon) says that diabetes left untreated may also cause bleeding behind the eyes, leading to blindness.
Dr. Morgan, an assistant professor of ophthalmology at Johns Hopkins Hospital, says that diabetes is one of the three leading causes of blindness and causes high incidences of cataracts and glaucoma. "These things are preventable and treatable if caught early," he says.
Dr. Brockington says that "There is some suggestion that diabetes may be provoked by a viral disease or infection." He says that there are some "features of the environment that are unhealthy. The dietary environment that you've been brought up in can be a contributing factor."
Dr. Morgan says adult diabetes is more often than not "lifestyle induced." Risk factors that could be controlled are often ignored. In the black community, Dr. Morgan says, ". . . we tend to eat food rich in starch and high in sugar (causing) a sugar overload." He says the community in general suffers from obesity, lack of exercise and sedentary lifestyles, all of which have a connection to diseases such as diabetes.
Dr. Carlton Frederick's "New & Complete Nutrition Handbook" points the finger at obesity and poor nutrition in connection with diabetes. He links tooth decay -- brought on by too much processed sugar and carbohydrates -- as one of the first signs of an impending disease.
Dr. Frederick said that the problems faced in the U.S. linked with the "processed food industry" had been "virtually unknown to native Africans. . ." who maintained traditional diets. This held true, he said, until they were also exposed to high-sugar foods. "When we export our diet, we export our sickness," Dr. Frederick. "If we outlawed the use of more than 12 pounds of sugar per person, per year, we'd reduce tooth decay without fluoridating our reservoirs, cut down on the incidence of diabetes, and prevent many cases of hypoglycemia (low blood sugar)."
After establishing the causes connected to diabetes -- poor nutrition, lack of exercise, sedentary lifestyle -- what are the logical preventive measures? For type II, Dr. Morgan stresses regular exercise -- swimming, jogging or aerobics; watching caloric intake, and with everything, "moderation is the key word," he says. Dr. Brockington also stresses exercise, as well as eating nutritional food, weight loss and maintaining a normal weight.
"What it really boils down to," says Dr. Brockington, "is diet and exercise. Getting back to the basics -- hard work, hard exercise or hard play, eating balanced foods . . . fresh fruit and vegetables and meals.
Those methods used to prevent diabetes -- exercise, maintaining weight normalcy and eating nutritionally balanced foods -- are also used in treatment, along with insulin or oral medications. "A healthy diet and regular exercise are all that's needed to bring elevated blood sugar levels under control." Dr. Brockington says.