January 10, 2006

The silent diabetes epidemic

An estimated 800,000 adult New Yorkers - more than one in every eight - now have diabetes, and city health officials describe the problem as a bona fide epidemic. Diabetes is the only major disease in the city that is growing, both in the number of new cases and the number of people it kills. And it is growing quickly, even as other scourges like heart disease and cancers are stable or in decline.

Already, diabetes has swept through families, entire neighborhoods in the Bronx and broad slices of Brooklyn, where it is such a fact of life that people describe it casually, almost comfortably, as "getting the sugar" or having "the sweet blood."

But as alarmed as health officials are about the present, they worry more about what is to come.

Within a generation or so, doctors fear, a huge wave of new cases could overwhelm the public health system and engulf growing numbers of the young, creating a city where hospitals are swamped by the disease's handiwork, schools scramble for resources as they accommodate diabetic children, and the work force abounds with the blind and the halt.

The prospect is frightening, but it has gone largely unnoticed outside public health circles. As epidemics go, diabetes has been a quiet one, provoking little of the fear or the prevention efforts inspired by AIDS or lung cancer.

In its most common form, diabetes, which allows excess sugar to build up in the blood and exact ferocious damage throughout the body, retains an outdated reputation as a relatively benign sickness of the old. Those who get it do not usually suffer any symptoms for years, and many have a hard time believing that they are truly ill.

Yet a close look at its surge in New York offers a disturbing glimpse of where the city, and the rest of the world, may be headed if diabetes remains unchecked.

From the readers forums:
andradepaulanyc - 10:54 AM ET January 9, 2006 (#18 of 39)

What is to have a family member with diabetes...

I live in Brazil, and I believe we are also having a not so big but still dangerous version of this kind of diabetes crisis here too.
At least in Sao Paulo, the country's major city, many people have had the same life conditions as in New York: little exercise, high fat and sugar diets.
Three generations of my family have diabetes. My great-grandmother, grandmother and her brother had, and also my mother has it.
I never took it seriously until nowadays. I have learned in the past five years what desperation is.
My mother had 3 diabetes pregnancies 20-23 years ago. The first baby she lost a week before the caesarian. Then came me and my brother, both born with 8 months, and required her to spend the last 2 months of pregnancy at the hospital. Diabetes came once for all about 15 years ago.
5 years ago my mother was going through laser surgery for her eyes. Now she is blind in one eye and has low vision in the other.
She was a very active and independent person, but got into depression since then (sometimes it comes just a little, sometimes really bad), because now she depends on someone else to help her on everything, and she can't stand it.
Three years ago she started doing "peritoneal" dialysis at home, because her kidneys weren't functioning anymore and she doesn't have strong veins to do it through her blood at the hospital. Frequent travels that she loved so much became scarce. Dialysis in the beginning was manually, four times a day, each one lasting more than an hour. Then the Brazilian government provided a machine that makes dialysis during the night, while she sleeps. As she can't do it herself because she can't see anymore, my father prepares it every single day for her. He too had to stop doing many things he liked, not enjoying his so deserved retirement as it should be after working almost 30 years for Ford in Brazil.
Two years ago, during complete exams in order to get into the kidney transplant list, it was found a heart artery almost closed. My mother went through heart surgery, substituting the bad artery by one from her leg. Then the leg's wound got an infection, although my father was restless taking her to the hospital to clean it correctly. By then I was leaving New York City and coming back to Brazil.
She wasn't feeling anything on her legs by then, not even cold, warm, or pain. She even broke one toe, and we just knew because it started swelling.
More wounds on her legs and feet came. Started almost dumbly, like pulling a simple dry skin on her heel, or a scratch on the shank. A humid skin between the two smallest toes came out once. It infected, and then she had her toe amputated. Now she is fighting to heal it, but itwhat became a big wound. My father preferred to hire a professional nurse to clean it twice a day. It's still opened and there is a risk to loose the whole foot. It's a slow battle, day by day.
She has been on bed for many months, because is hard to walk. A few months ago my father decided to buy her a wheelchair, so sometimes she eats at the table or watch TV with us in the living room, but that's becoming rarer each day. That's make her tired.
As this article says, my mother really seems much older. Although she is 54 years old and my father is 8 years older than she, it seems the opposite.
Both of them, instead of a peaceful and happy retirement, are aging more tired and unhappy each day as I have never seen before. There is little I can do to help, since they live 300km away from me.
I'm concerned about my life too, and especially about my brother's. He's obese, and doesn't like to exercise. My problem is dieting. I try hard to eat correctly but every so often I crave to eat what I shouldn't. But at least I'm not sedentary, and keep doing glucose tests every month. My chances of developing Diabetes are pretty high, and I really wouldn't like to be my family's forth generation with the disease.
Diabetes is really a hard battle for any family.


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