Press Releases 

Hitting the Target: Read John's Diabetes Story
Date: 11/12/2015
Diabetes symptoms can be hard to recognize, and dangerous if left unchecked

As the primary caregiver for his aging mother, and in the midst of planning his father’s funeral, John had a lot on his mind. Like many in a caregiver role, John’s own health was the last thing he wanted to think about. His body had other plans. 

Warnings from Within
The Hamilton resident was having symptoms he could not ignore: general tiredness, nausea, poor vision, frequent urination and weight loss. 

“I knew it was something really bad,” he says. “I just wanted to wait until after the funeral to deal with it.” 

On the day of his father’s wake, John felt particularly bad. He took his blood pressure before leaving the house. It was 70/40. Something was terribly wrong, and he couldn’t hide it. 

“People thought I was drinking or on something,” he recalls. “I saw a friend I hadn’t seen in years, and I don’t even remember our conversation.”

Thankfully, John’s cousin with diabetes recognized his symptoms right away, and took his blood sugar on the spot. It was 525 (a healthy blood glucose level is less than 140 mg/dL two hours after eating). 

His cousin told his to get to the hospital right away. “I believe that saved my life,” he says.

John was diagnosed with type II, or adult-onset diabetes. He spent three days in the intensive care unit with ketoacidosis, which occurs when a lack of insulin prevents cells from getting the sugar they need for energy. The body begins to break down fat and muscle for energy, which causes a chemical imbalance that can be fatal. 

“Adult-onset diabetes often takes a slower, more insidious path where insulin resistance occurs, rather than a lack of insulin,” explains John’s primary care physician, Shankar Santhanam, MD, board certified in family medicine.

As a result, the condition builds and symptoms appear slowly. For someone who doesn’t know to look for them, sugars can reach dangerous levels.

“Typical presentation of diabetes involves the 'hyperglycemic' or high sugar states, which is what John experienced,” explains Dr. Santhanam. 

This includes: 
Increased thirst or hunger
Frequent urination (as the body seeks to eliminate the high sugar in the urine)
Feeling unusually tired 
Changes in vision, such as blurring
Difficulty healing from injury or fighting infections as the body's processes become less effective

Once John was stable, he was relieved to know his diagnosis was something he could manage. “When I looked at all the symptoms for diabetes, I had everything going on. I just didn’t know what it was,” says John.

Living With a New Normal
Dr. Santhanam referred John to the Diabetes Self-Management Program at RWJ Hamilton. 

“Diabetes is not all about medications,” says Dr. Santhanam. “It’s about your maintaining a healthy status of your body. The better you do, the less intervention you need from a doctor.”

Gerry Jaekel, RN, BSN, CDE, is one of the educators who works with patients who have diabetes in the outpatient program, which involves regular one-hour meetings with a certified diabetes educator. This service is covered by most insurance, and requires a prescription. 

“It’s important for people who are living with diabetes to focus on what they need to know on an everyday level,” explains Jaekel. 

“Some people think they have to completely alter their life, or ‘quit pasta completely.’ That’s not what it’s about.” 
According to Jaekel, it’s about finding ways to improve choices through education. 

“Anyone can change, but if it’s not realistic, it won’t stick. When we first meet with a patient, we individualize the program to their needs. Every patient has different goals,” she says.

While the program is individualized, there are some common elements a patient can expect from the Diabetes Self-Management Program, such as:
The diabetes educator’s communication with the treating physician
A consultation with a nutritionist to discuss diet
Access to the latest information and research
Ongoing support 

“The outpatient program has been so helpful to me,” explains John. “My A1C levels have gone from 12.5% to 5.4%, which is a huge change.”

For John, the diagnosis has truly been life-changing, but not in the way you would think. 

“It has been a real eye opener related to my health. I used to just flop on the couch and watch TV most of the day,” John says. “Now, I’m walking 2.5 miles a day. I’ve lost 60 pounds. I feel healthier than ever.”

Are You at Risk for Type II?
Risk factors for type II diabetes include the following:

Family history of diabetes Poor diet
Overweight or obesity 
Sedentary lifestyle
Ethnicity: Hispanic, Asian, Native American and African ancestry
A history polycystic ovarian syndrome or gestational diabetes in females