Cover Story
With lifestyle changes and help from diabetes educators at Baylor Plano, Donald Dickhens, 73, was able to delay the onset of type 2 diabetes.
A Plan for Prevention
Five ways to stay a step ahead of diabetes.
Type 2 diabetes isn’t entirely preventable, but there are ways you can keep this common disease at bay. Just ask Donald Dickhens, who was able to stave off the condition until he was 73 years old with help from Baylor Regional Medical Center at Plano. “My doctor told me about two years ago I was borderline [for type 2 diabetes],” he says. “I made sensible life changes—things that I should have done before.”Small steps in the right direction can make big differences in your health. Here are some places to start:
Eat better. “Eating better” doesn’t mean eating only salads—it means making changes that help you head in the right direction. “There isn’t anything you can’t have,” explains P.J. Pugh, R.N., a certified diabetes educator and coordinator of the Diabetes Education Center at Baylor Regional Medical Center at Grapevine. “We identify what people are eating to see where they can eat less.”
She negotiates with people to help them find places to cut back. For example, someone who drinks four regular sodas daily can start by switching to three, replacing one with diet soda or water. Or, swap a three-day-a-week fast-food habit for just two days.
For Dickhens, cutting back on alcohol, rarely eating candy, and choosing fish and grilled chicken in place of fried food moved him in a healthier direction.
Eat less. Pugh sees people who make mostly healthy choices, but are eating too much food. “Many of us need to look at our portion sizes,” she says. Her advice is to start by serving yourself half the amount of food you would normally take.
Restaurants often serve up large portions, so try splitting a meal or ask for a takeout container when your meal is served and pack half of it right away.
Exercise. Once you have your doctor’s approval, find an activity you like—maybe walking, swimming or dancing. “If you enjoy the activity, you’re more likely to do it,” Pugh says. But start
Even five to 10 minutes of exercise two to three days a week can help form a habit, and you can build on that success.
slowly. Many people are overwhelmed at the idea of exercising, but you don’t need to start with an hour of exercise a day. Even five to 10 minutes two to three days a week can help form a habit, and you can build on that success.
Include some strength training, since muscle mass is more metabolically active than fat. “You don’t have to go to a gym. Try stretch bands or cords or an exercise ball—some even come with a video,” Pugh says. Plus, strength training can bring quick results that give people the positive feedback they need.
She says a lot of people ask her what time of day is best for exercise. Her reply? “Whenever you’ll exercise. Identify the time of day you have the most control over. That is going to help you stick with your plan.”
Lose weight. If you follow the eating and exercise ideas, weight loss should follow. And you don’t have to get back to your high-school weight. “We’re not talking about a hundred pounds. Even five to 10 can make a big difference,” Pugh says. Why? People at risk for type 2 diabetes still make plenty of insulin. Their bodies just aren’t responding to it properly. “When you lose some of the weight, you gain back some of the insulin sensitivity,” she explains. Dickhens dropped 24 pounds—so far—with his lifestyle changes.
Get checked. Routine blood work should include a glucose check, so your doctor can tell you if your glucose level is elevated. “That’s a head’s up—a red flag that your body is starting to struggle,” Pugh says.
By Stephanie Thurrott
Talk with your doctor to find out if you’re at risk for diabetes. For a referral to a physician on the medical staff at Baylor who specializes in endocrinology, call 1-800-4BAYLOR or use our on-line physician directory.
On The Horizon
Baylor researchers are looking for better ways to keep diabetes under control. Priscilla Hollander, M.D., Ph.D., an endocrinologist on the medical staff at Baylor University Medical Center at Dallas, says her team is currently studying:- A new type of short-acting insulin for people with type 1 and advanced type 2 diabetes
- Different short-acting inhaled insulins
- A program to see how to best use long-acting insulins that are already FDA-approved
- Ways to stimulate the pancreas to produce more insulin
- Medications to suppress appetite and combat obesity in people both with and without diabetes
- Combinations of drugs that may work to counteract obesity
Researchers in the Pancreatic Islet Cell Transplant Program at Baylor University Medical Center at Dallas and Baylor All Saints Medical Center at Fort Worth are working with an experimental technique to help people with type 1 diabetes make insulin.
“We’re extracting islet cells from the pancreas of an organ donor and infusing them into the liver,” explains Marlon Levy, M.D., surgical director for transplantation on the medical staff at Baylor All Saints Medical Center at Fort Worth. “There, they can start producing insulin to control diabetes.”
Healing the Wounds of Diabetes
As you develop your exercise, diet and screening program to manage your type 2 diabetes, remember to pay special attention to those two things you walk on every day: your feet. Because it can impair circulation and sensation, diabetes can turn a small nick on the bottom of your foot into a hard-to- heal, chronic wound—without your even knowing it.
Help is available. With a medical staff that includes vascular surgeons, infectious disease and internal medicine specialists, a physiatrist and more, the Baylor Wound and Hyperbaric Medicine Center at Baylor Medical Center at Garland offers advanced diagnosis and treatment for diabetes patients dealing with chronic wounds. Debridement, IV antibiotics, negative pressure therapy, hyperbaric oxygen treatment and vascular surgery to restore blood flow are just a few of the approaches.
For limb- or life-threatening wounds, hyperbaric medicine is also an option. “We strive to save all the limbs that we can,” says Sandy Cook, R.N., clinical nurse manager for the Baylor Wound and Hyperbaric Medicine Center. Their success shows; the center’s amputation rate is only 2.8 percent, well below the national average of 7 to 12 percent.
The physicians on the medical staff at the center always seek to identify and address the underlying factors contributing to a patient’s chronic wound, and the patient is seen weekly until wound healing is well under way. That level of care makes a significant difference.
“In 2007, we healed 90.2 percent of all the wounds we saw, and 93.4 percent of those were healed within the national benchmark of 16 weeks,” says Jim Ashbaugh, program director of the Baylor Wound and Hyperbaric Medicine Center.
Even so, it’s easier to prevent a wound in the first place. So take good care of your feet by always wearing comfortable, well-fitting shoes and by inspecting your feet daily for cuts, blisters, redness or swelling.
By Deborah Paddison
Call (972) 696-1234 to schedule an appointment at the Baylor Wound and Hyperbaric Medicine Center at Baylor Garland.