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April 24, 2007 > 'Minding' Diabetes

'Minding' Diabetes

"Diabetes is a serious chronic disease, but it is not a death sentence," says Theresa Garnero, R.N., M.S.N., director of Washington Hospital's Diabetes Services Program. "Uncontrolled diabetes is the problem."
Despite this "good" news, the experience of being diagnosed with diabetes and having to change your lifestyle to control the disease can be overwhelming. Just ask any of the 66,000 Alameda County residents who have been diagnosed with diabetes. (It's estimated that another 33,000 people in this county have diabetes but don't know it.)
Diabetes education is a critical factor in enabling people to get the skills they need to manage their disease for a lifetime. That's why Washington Hospital established a specialized educational program just for this purpose. A key component of the program is "Diabetes Matters," a free monthly diabetes education class and group discussion featuring expert speakers. The lectures are open to everyone, and no registration is required. (See box for more information.)
What is diabetes?
Insulin is necessary for the body to be able to use sugar (glucose), the basic fuel for the cells in the body. In type 2 diabetes, the most common form of the disease, the body either doesn't produce enough insulin or the cells ignore the insulin, according to the American Diabetes Association. When glucose builds up in the blood instead of going into cells, it can cause two problems. First, your cells may be starved for energy. Then, elevated glucose levels in the blood can hurt your eyes, kidneys, nerves or heart.
Common symptoms of type 2 diabetes are:

* Frequent urination
* Excessive thirst
* Extreme hunger
* Unusual weight loss
* Increased fatigue
* Irritability
* Blurry vision

Some people experience no symptoms at all. Although most of the symptoms that do occur are physical in nature, there's also no denying the importance of the mind in controlling diabetes.
Changes for life
"People who take a diabetes class do pretty well for about six months or a year, then they often start to slip," explains Mary Kelly, M.F.T., a certified diabetes educator who has type 1 diabetes herself. Usually diagnosed in children and young adults, in type 1 diabetes the body does not produce insulin.
Since 1986, Kelly has been working with various diabetes programs and support groups in the community, including the American Diabetes Association. She is the featured speaker at Washington's upcoming Diabetes Matters lecture on Thursday, May 3, "The Mind-Diabetes Connection."
At the class, Kelly will talk about the importance of people with diabetes being ready for change. Typically, there are five stages people go through before they can adopt a change in behavior for the long term. She'll explain these stages in more detail.
"Sometimes, people have to go through the changes four or five times before they are set," observes Kelly. "One thing that is common to all the stages is a need for social support, which is critical to making a change and maintaining it."
Figuring it out
Most people want to take care of their diabetes, Kelly says, but it's a matter of helping them figure out how to make the behavior change they need. For some people, their lifestyle is such that they just have to make a few "tweaks." For many others, it involves significant shifts in the way they eat and their activity level, as well as the way they structure their time. They need to identify any roadblocks to behavior change and then figure out how to get around the roadblocks, step by step.
"The process is different for everyone, and very rarely do people go from zero to 100 just like that," says Kelly. "I tell them they have the rest of their life to become the perfect diabetic."
The role of stress
Science has shown that the hormones our bodies produce when we are under stress can block insulin, and this can signal the body to release even more glucose. A study done at Duke University comparing two groups of people with diabetes - one with diabetes education and one with diabetes education and stress management - found that the group with stress management support had significantly lower average blood glucose levels.
"Stress is a wild card with diabetes," she adds. "One day, you can just let stress pass you by; but on another day you will react."
At the May 3 class, Kelly will talk about the importance of people with diabetes learning to manage stress more effectively.
In addition to being open to the public, Diabetes Matters classes offer health care professionals who attend one free continuing education unit (CEU). To see past Diabetes Matters lectures, go to, click on "Services & Programs" and select the "Diabetes Services" tab, or check out the DVD or VHS tape at Washington Hospital's Community Health Resource Library.
"Diabetes Matters - The Mind-Diabetes Connection"

Thursday, May 3
Lecture: 7 p.m. to 8 p.m.
Group discussion: 8 p.m. to 9 p.m.

Conrad E. Anderson, M.D. Auditorium
Washington West
2500 Mowry Avenue

Free. No registration required.
For more information, call (510) 608-1327 or visit






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