Managing Type 2 Diabetes

Albert Almanza always has been a natural athlete. The Mexico native earned a spot on the University of Texas basketball team at Austin in 1957, and he played the sport on the U.S. Olympic team in both 1960 and 1964.

After college, he remained just as active. In fact, it was on a different playing field 20 years ago that he experienced his first real signs of a growing national illness. “I was playing tennis and I asked for a time-out to check my shoes … it felt like I had sand in them,” recalls Almanza, 66, now a retired insurance agent. “There was no sand, but the bottom of my feet were very red.”

On a hunch, his doctor ordered a blood test, which showed Almanza’s blood sugar levels were extremely high. He had Type 2 diabetes.

At the time, diabetes already was in a disturbing upward spiral. Now, the disease has reached epidemic proportions in America, with numbers nearing 17 million—more than double what they were 40 years ago. Of those who have it, 90 percent fall into the Type 2 category.

The three-prong basis for the epidemic bears a ferocious name. “It’s the Perfect Storm,” says Dr. Thomas C. Blevins, an endocrinologist who handles Almanza’s treatment at Texas Diabetes and Endocrinology in Austin and also leads seminars for the National Diabetes Education Initiative. “The three components of the storm include age—the population is aging; obesity, as the population gets more overweight; and ethnicity.”

Latinos and African-Americans are at greater risk for Type 2, with simple heredity to blame, Blevins says. And as these ethnic populations increase in America, so, too, do overall diabetes numbers. So while Almanza ate right and exercised, he couldn’t escape genetics.

Type 2 diabetes is caused by insulin resistance. The pancreas, which makes insulin, can’t keep up with the resistance and declines in function. Ultimately, glucose levels rises. The condition is partly environmental, in that it accompanies weight gain, and partly inherited.

“The people that need to be attentive way before they get symptomatic would include people who have family history of diabetes and people who are overweight,” Blevins says. “And a number of guidelines suggest that people over the age of 40 should be screened routinely.”

Almanza’s red feet were not a common symptom, Blevins says, but he also experienced excessive thirst, frequent urination, and tingling of the fingertips and toes—all classic signs. Other diabetes symptoms include unusual weight loss, extreme hunger, blurred vision, fatigue, and slowly healing wounds.

Poorly managed diabetes can lead to serious health problems, including eye damage, blindness, kidney damage, nerve damage, hypertension, heart attacks, and strokes, Blevins says.

If you exhibit diabetes risk factors, your best bet for avoiding the condition is controlling your weight and exercising. If you already have Type 2 diabetes, you still can lead a normal, healthy life.

“Diet is the mainstay of treatment, and some people can treat diabetes with diet alone ... at least for a time,” Blevins says.

Additional measures often are required.

“Make sure your blood sugar stays near normal and do whatever you have to do to keep it there,” Blevins says. “Could be with pills, could be with insulin ... could be insulin plus pills.”

Albert Almanza takes oral medication and gives himself insulin shots twice a day. It’s a small price to pay, he says, for good health.

“I have four grandkids,” he says. “I’d like to see them graduate high school.”

Next week: Leland Gammon chose to take control of his diabetes and run with it—literally.

Laura Sewell is a freelance writer based in Brentwood, Tenn.

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