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Public Health Mayday

April 28, 2015

In 1910, an international distress signal was developed from International Morse code letters SOS to signal a universal call of distress.

Today in the Inland Empire, health professionals might wish to symbolically issue an alarm about a growing threat in our community, the insidious disease of diabetes, which is increasing in our population at an alarming rate.  While the overall incidence of the disease is surging nationwide, our regional rates of diabetes are skyrocketing, ahead of national averages.

As an internist at Riverside Medical Clinic, I bear testament not only to escalating incidence, but also the deleterious effects of this insipid disease that so greatly affects the quality of life and health for patients and their families.

Lifestyle culprits

Diabetes is the result of inappropriately high blood sugar levels and the body’s inability to produce or properly utilize insulin, a hormone needed to convert sugar, starches and other food into energy needed for daily life.  While there are many unknown causes of diabetes, there is irrefutable evidence that environmental factors such as obesity and lack of exercise play part in development of the disease.

Modern life today is hectic and stressful for just about everyone.  This rapid pace results in significant impacts on health maintenance and disease prevention.  Working long hours or enduring long daily commutes can lead to poor nutrition and lack of exercise, which have been causal factors for a rising rate of obesity among adults and children.  Particularly for those who have a genetic predisposition to developing diabetes, lifestyle choices can accelerate or deter the development of diabetes.  Some people who are borderline diabetic can reverse the progression through lifestyle choices and get their glucose levels back to a manageable range without having further medical intervention.

Rising rates of obesity in children are producing astounding spikes in diabetes in children of younger and younger ages.  When I was in medical school, it was astounding to find a young person of 22 developing Type II diabetes; today, we do not find it unusual to diagnose children as young as eight or 10 years old.

Warning signs

Often, this debilitating disease presents no overt symptoms or symptoms that are easily attributed to harmless causes.  It must be diagnosed through a blood test which captures blood glucose levels.  Some of the diabetes symptoms include:

Frequent urination 

Excessive thirst 

Extreme hunger 

Unusual weight loss 

Increased fatigue 

Blurry vision 

Most Americans are diagnosed with insulin-resistant diabetes, also known as type 2 diabetes.  This condition results when the body is unable to properly use insulin and is accompanied by a relative insulin deficiency as well.

How diabetes is diagnosed

A simple blood test known as a Fasting Plasma Glucose Test (FPG) can evaluate how well your body is regulating blood sugar.  We recommend an annual screening, depending on family history and other risk factors.  It is important to note that some ethnic groups have higher incidences of the disease, including African Americans, Latinos, Asians and Native Americans.

Diabetes management

With borderline or marginally high blood glucose levels, diabetes can first be treated with education, including information about disease characteristics and causal factors, nutritional counseling, weight management, exercise and support groups.  It is often possible, in early stages, to return blood sugar levels to normal through lifestyle changes alone such as weight loss, exercise and reduction of body mass index to below 23 percent.

In the case of medication to control sugar levels, there are several options to review with a physician, including oral medications and insulin augmentation through dosing meters or injections.

With any treatment option, lifelong, regular monitoring must become part of the diabetic’s health regimen.

Dangerous complications

It becomes imperative to control blood sugar levels, because left unchecked, extended exposure to high sugar can lead to devastating complications from disease progression, including coronary heart disease, amputation, blindness and kidney failure.  At Riverside Medical Clinic, we believe putting each patient in the driver’s seat of their personal health program is key to success and that education and awareness about how and why they should take control is the important first step on that journey.  We seek to control the disease at its manageable stage in order to prevent the development of debilitating, lifestyle impeding and life-threatening effects.

Take control

Patients who take control over their diabetes can take heart.  I have had several encouraging and inspiring patients who took back their destinies through proactive measures to regain their health. Among them is one woman who weighed more than 400 pounds and who required extremely high doses of insulin on a continual basis but who was still unable to get her blood sugar under regular control.  One day, she said, she woke up to realize that she was going to die very prematurely if she did not take action.  Over several years, she lost 200 pounds, turned her health habits completely around and eventually returned her blood sugar levels to normal.  Her diabetes, blood pressure, high cholesterol and cardiac risk were all returned to normal ranges.

All families, not just those with elevated risk, should strive to eat more healthfully and get more exercise.  The fast-food nation, accompanied by video gaming and lack of exercise is wreaking havoc on our health, producing heartache and suffering, not to mention high costs, both monetary and emotional, to individuals, to our provider system and to the families and friends who love and care for diabetic patients.

It’s time to reverse the disturbing statistic that for the first time in more than a century, life expectancy spans are decreasing.  The heightened prevalence of this devastating disease is a major contributing cause to this alarming statistic. Taking an ounce of prevention today can be so much more rewarding than a pound of cure tomorrow.

Dr. Sarah Chae is an internist at Riverside Medical Clinic’s Canyon Springs location on Day Street.  She earned her undergraduate degree in biology from Yale University and is a graduate of Standford University of Medicine.  She conducted her residency and internship at the UCLA Center for Health Sciences.  Dr. Chae can be reached directly at her office at (951) 697-5420.

Riverside Medical Clinic is the largest private provider of ambulatory care in the Inland Empire.  If you’d like to find a general physician or a specialist, call the clinic’s physician referral line at (951) 782-3602  or go to  HYPERLINK “” ; for an online physician directory by location and specialty.

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