Every time 18-year-old Minnesotan Chris Stokes gets behind the wheel to drive, he makes the usual safety checks: mirrors, seat belt, gas, blood sugar level.
Blood sugar? Yep. He needs to make sure his blood sugar, also called glucose, is at a safe level–not too high or too low. Either extreme could affect his reaction time, vision, and concentration, all of which need to be sharp for safe driving. Stokes has type 1 diabetes, a condition that limits the ability of glucose to move throughout the body and brain.
Jamie S., a 13-year-old from Alpharetta, Ga., also has to watch her glucose. But she has a different reason: type 2 diabetes. It leaves her feeling sluggish, and it’s caused her organs to swell.
Glucose is vital to the body’s energy system, much as gasoline is to a car. It’s the fuel needed to make the engine run. Without enough glucose, a person could collapse into a coma and possibly die. Too much of it overwhelms the body’s organs and can cause a coma as well.
A balancing act of medication, specific food eaten at specific times, and finger pricks to monitor blood sugar keeps diabetes in check for both teens. They are just two of the 24 million Americans with diabetes. Nick Jonas of Jonas Brothers is another. (More on him later.)
A Not-So-Sweet Problem
In medical terms, diabetes is called diabetes mellitus. A Latin word, mellitus means “honey sweet.” It refers to excess sugar flowing through the body.
An organ called the pancreas, which sits a little below the stomach, makes insulin. That hormone helps glucose get into cells, where it’s needed for energy. It is the way in which the body’s fueling process is interrupted that distinguishes the two types of diabetes and how they’re medically treated.
TYPE 1. In type 1 diabetes, the pancreas starts making less and less insulin. This type is called an autoimmune disorder because for unknown reasons, a person’s own immune system attacks the body’s insulin-making process. The condition is most often diagnosed in young people, which is why it used to be called juvenile diabetes. A person with type 1 diabetes needs daily doses of insulin, either through injections or a cell phone-sized pump. It’s a lifelong condition, but people with type 1 can lead active, healthy lives by following their doctors’ orders.
Stokes knows what happens when be ignores his diabetes. He has to eat on a regular basis or his glucose level drops dangerously low. “One time in high school, I was trying to make weight for a wrestling match and didn’t eat for one day,” recalls Stokes, who is now a student at Augsburg College in Minneapolis. “After the match, I just collapsed. It was a bad night.”
TYPE 2. In type 2 diabetes, the body makes enough insulin but doesn’t use it correctly. Glucose builds up in the bloodstream, causing excessive urination, fatigue, intense thirst, and blurred vision. (See symptoms of both types in “Diabetes: What Does It Feel Like?”) Type 2 can be caused by excess weight. Genetics also plays a role; having parents or other close relatives with the condition means you’re more likely to have it. Hispanics, Native Americans, and African Americans are at greater risk than other groups for developing type 2. But it can usually be prevented and controlled by maintaining a healthy weight, exercising daily, and eating a nutritious diet.
Rates of type 2 diabetes are rising. The increase, experts believe, mirrors the rise of U.S. obesity rates. Today, there are more than twice as many young children and almost three times as many teens who are overweight than there were in 1980. That, in turn, has led to younger people developing medical conditions usually seen in later life, such as high blood pressure, high cholesterol, and type 2 diabetes, which was once called adult-onset diabetes. “We never used to see type 2 in children,” says Sue Tocher, diabetes education coordinator and dietitian at Children’s Healthcare of Atlanta. A recent study of preteens’ and teens’ medication records showed that prescriptions for type 2 diabetes drugs doubled from 2002 to 2005.
A Silent, Slow Killer
As those children and teens grow up, the burden of diabetes will also grow. In this country, nearly one in 12 people have diabetes, and 57 million more may have insulin resistance or prediabetes, a condition that is often the first step in developing diabetes. That’s a serious problem. Diabetes already contributes to about 230,000 deaths in the United States annually.
The condition is often called a silent killer or a slow killer because organ damage can occur for years before being detected. Left untreated, diabetes can rob people of their vision, legs, and kidneys, and it often leads to heart attacks and strokes. When blood sugar levels drop too low, diabetics being treated with insulin are at risk for hypoglycemia, a serious medical condition that can lead to convulsions, coma, and death.
Healthy Habits Help
People with diabetes, if they take care of it, can lead long and healthy lives. But the possibility of losing a leg or going blind is often the last thing teens with the condition think about, says Dr. Lisa Gilliam, a specialist in endocrinological diseases and diabetes at Seattle Children’s Hospital and the University of Washington: “It’s really hard for kids. They don’t think these complications could happen later on in life.”
Type 2 diabetes can be controlled by becoming more active. Just walking .30 to 60 minutes a day can make a difference. Eating better helps, too, as Jamie’s experience shows. She has lost 10 pounds by drinking water instead of soft drinks and eating more lean meat and vegetables and fewer greasy foods. If she continues to lose weight, she may be able to stop taking her twice-a-day pills.
Like Jamie, Nick Jonas is figuring out how to cope with his condition, which be learned he had in 2005. In interviews, the pop star admitted to worrying about bis future and wondering, “Why me?” But Nick, 17, is past that now.
He’s not only living healthfully with the condition; he has become an advocate for people with diabetes. Jonas testified before Congress about the need for more diabetes research funding, helped design medical alert tags for people with diabetes, and started an awareness organization, Nick’s Simple Wins. “I now understand what it means to not only have diabetes,” he wrote on his Web site, “but to truly live with it and not be limited by it.”