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Winning the battle against diabetes

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Eight years ago, Kent Porter of Lantana left his optometrist’s office, and went on to become an A1C Champion.  A1C is not a sports league for athletes with good vision, but a part of red blood cell hemoglobin that transports glucose or blood sugar throughout the body.

Kent’s vision had changed so he decided to get new glasses.

“I had a WOW moment after the optometrist asked if I had sugar problems,” he said.

A normal healthy person’s blood cells contain about 4-6 percent hemoglobin A1C, a protein.  People with higher percentages are at higher risk of developing or having diabetes and the eerie complications we hear about.

At a consistent 14 percent A1C may indicate increased risk for heart attacks; at 21 percent or more it can indicate increased risk for vision, kidney, nervous system, and heart ailments.

The top source of end-stage kidney disease that requires dialysis or transplant is diabetes.  A majority of diabetics die of heart disease.  The single biggest cause of blindness is diabetes. The annual cost to care for all this is over $700 billion.  Think of the vacations we miss!

Kent took his “sugar problem” and A1C percentage by the proverbial horns, and got serious about avoiding foods that negatively affect glucose or blood sugar, taking his medication as prescribed, and exercising.

No, he doesn’t salsa dance until the wee hours every Saturday night.  Nor does he jog around in Nikes and short shorts just after sunrise every morning, but with commitment and common sense cooperation with his health care team he came out on top of a difficult health situation.

As a diabetic who has succeeded in maintaining an American Diabetes Association recommended A1C level below 7 percent, he is an “A1C Champion” who works with the VPR Patient Outreach Program to provide free diabetes educational presentations.  The objective is to help others achieve good blood sugar control and reduce diabetes complication risks.

Kent received his B.S. in Pharmacy, and M.S. in Hospital Pharmacy Management from the University of Utah.  He followed those with the PharmD (Doctor of Pharmacy) from the University of Southern California in Los Angeles where he completed a Clinical Pharmacy residency at the LA County/USC Medical Center.  As a faculty member at the University of Michigan at Ann Arbor he started that school’s Clinical Pharmacy Program.

He was a member of the active National Guard or U.S. Army Reserve for 31 years.  At age 17 he started as a Cannoneer in artillery then became a Demolition Specialist with a Special Forces A-Team.  He attended Officer Candidate School and served as an A-Team executive officer and commander.  To add to the excitement he became paratrooper, and finally served as an Active Guard/Reserve officer in the U.S. Army Reserve 328th General Hospital near Salt Lake City.  A member of the Order of Military Medical Merit, he retired in 1989 at the U.S.A.R. Personnel Center in St. Louis then moved with his family to the DFW area to begin work as a civilian pharmacist at the V.A. hospital in Dallas.

“I did not have your stereotypical retail pharmacy career,” he said with a laugh.

Three years after military retirement, 13 years before his diabetes diagnosis, Kent took the post of Medical Science Liaison with an international pharmaceutical company.  He spent the last 10 years of his career working with a new insulin that became popular with diabetes professionals and patients.

The day he walked out of his fateful eye exam Kent already knew a lot about his suspected disorder.

“This problem was not a huge surprise because my mother had adult onset (Type 2) diabetes,” he said. “We tend to stereotype diabetes as an affliction of obesity, but a close relative with diabetes is bigger risk factor.  The interesting thing is my mother died from heart failure.”

Cardiovascular changes precede the onset of Type 2 by 10 or more years. If you have a family history of diabetes and signs of cardiovascular changes, don’t wait for symptoms to develop because diabetes does not have to be lethal.  Early diagnosis lowers the complications risk, just like with high blood pressure.

“Don’t wait for Elvis to leave the building,” Kent said.

Elvis’s departure is his metaphor for the loss of or damage to insulin-producing cells in the pancreas and the invisible progression of complications.  Early detection usually means those cells’ death can be slowed or even stopped with multi-faceted management of this metabolic disorder.

“Fortunately we discovered my problem before Elvis took off,” he said.  “There is no cure for diabetes.  It is a progressive disorder that normally worsens, sometimes quickly, sometimes slowly over years.”

How a diabetic reacts to the news of his or her situation is of vital importance.  Most doctors do not live with their diabetic patients so guess where the day-to-day disease management buck stops?  If you guessed Numero Uno, you’re right.

Here’s what happens when we consume snacks and meals.

Among other things, our stomachs and intestines break up the carbohydrates we eat into a sugar called glucose which gets in our blood, and hitches a ride to our cells–piggyback–on chemical compounds, the A1C proteins.

Meanwhile special cells in our pancreas create and release into our blood a hormone called insulin.  Think of insulin as tiny keys that jingle along and unlock doors in cell walls to let in the glucose which the cells eat to stay healthy and accomplish their jobs.  Sugar junkies?

If the insulin-producing cells in the pancreas malfunction or die, sticky glucose accumulates in the circulatory system where, among other things, it can wreak havoc by clumping on blood vessel walls.

A person with higher-than-normal glucose or blood sugar has hyperglycemia, and at high enough levels, diabetes.  A diabetic may be thirstier or hungrier or more tired than normal.  He or she may experience blurry vision, numb or tingly toes and feet, or lose weight inexplicably, or urinate too often–or here’s the kicker–he or she may have no symptoms at all.

This last nightmare is the situation which gives diabetes its horror film nickname The Silent Killer, just like high blood pressure and bad cholesterol which can also occur without symptoms.

Type 1 or childhood onset diabetes is an autoimmune disorder where the immune system goes haywire and begins to attack normal cells.  Researchers at Stanford University have developed a Type 1 diabetes vaccine product that has had some success turning off specific portions of the immune system that attack insulin-producing cells in the pancreas.  This qualifies as treatment fine tuning.

The researchers changed a piece of DNA to increase the amount of insulin’s chemical forerunner created in the pancreas.  The DNA change caused the immune system to shut down the rogue cells attacking the insulin-making cells.  It triggered the body going after the killer cells.

The researchers warn, however, that the new product does not appear to cure Type 1 diabetes; it appears to reduce the number of daily insulin injections.  For Type 1 patients who require multiple insulin shots each day this is wonderful news.

Type 2 diabetes is not an autoimmune response gone awry so vaccine treatment is not in the foreseeable future, but whole new classes of diabetes drugs have come into existence since 2000.  This timing is remarkable since insulin was discovered in 1922, and oral insulin was not developed until the 1960s.

After his initial diagnosis Kent decided he was figuratively allergic to sharp needles and diabetes-related health problems that might get in the way of the good life which he defines as spontaneous visits with the four children and 12 grandchildren he and his wife Brigitt
e lovingly call “our dirty dozen.”

He took control of his ailment with the help of many resources.

“A diabetic’s best friends are accurate information and positive action,” he said.

He retired when he was ready to do so, well past the age of 64.  He travels for pleasure: think a recent cruise to the Baltics and St. Petersburg, Russia.  He works as a volunteer who makes A1C presentations, is busy at church, and of course spends that cherished time with his family.

He and his wife, who are both fluent and literate in German, will be flying to Germany next month where they will serve as missionaries for a year and a half before they decide on their lives’ next adventure.

Before the invention of synthetic insulin none of this would have been possible because a diabetes diagnosis was a death sentence.  Kent is 72, but with a full head of thick white hair does not look a day over 16.  Okay, that last comment is a slight exaggeration, but if you see him on the street you won’t stereotype him as a diabetic headed for trouble.

The A1C Champions’ programs do not endorse or mention specific products.  Their sole purpose is to help diabetics and people close to them learn to manage the problem so they can enjoy life.

If you or someone you love has diabetes, you may get more information at Info@VPRPOP.com or call the Champions business office toll-free at 855-212-4267.  You may also use the American Diabetes Association (ADA) website: www.diabetes.com.

“Sources of information abound,” Kent said, “but verify what you suspect with your healthcare provider before you roll the dice and act.”

 

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