FAIRMONT — Enjoying a baked potato at dinner may not be a big deal to most people, but for Kip Price, it is a well thought out and deliberate decision.
“I ate my first baked potato in a long time,” said Price, who lives in Fairmont. “I don’t have many potatoes at all any more.”
Seven years ago, Price was diagnosed with Type 2 diabetes.
To manage his blood sugar level, Price is vigilant. His meals contain plenty of vegetables and fiber, and he drinks quarts of water every day. He eats oatmeal with cinnamon for breakfast every day.
“It’s not easy, but I try to get that right mind set,” Price said.
Price is not alone.
West Virginia ranks dead last in the nation for diabetes-related deaths. According to the Centers for Disease Control and Prevention, the numbers of cases and deaths have increased every year for the past decade.
Statistics show that more than 16 percent of the adult population has been diagnosed with diabetes, and another 45,000 people have diabetes but don’t know it. Add to that nearly a half million people in West Virginia who are considered on the diabetes borderline, and the result is a health care crisis.
Genetics do play a part, but most cases come down to one culprit — sugar. The American diet is laden with sugar, both seen and unseen. Even foods that are labeled healthy or natural can be an epidemiologist’s worst nightmare. It’s when several factors collide that diabetes first makes an appearance.
“For any given individual, when diabetes occurs, it’s sort of an intersection between your genetic propensity — meaning your likelihood to develop diabetes — and then these other stressors that occur in your life that then either make diabetes occur or not,” said Emma Eggleston, director of the Center for Diabetic and Metabolic Health at West Virginia University’s Eastern Campus.
“Diabetes impacts every dimension of a person’s life. Because of that, it’s very complex — it impacts your sleep, it impacts your food, it impacts your job. It really impacts your sense of self and who you think you can be,” Eggleston said.
When Price began to experience physical problems — not necessarily related to his blood sugar — his doctor diagnosed him with diabetes.
“My sugar level was going up when I did my blood work,” Price said, “but instead of them first letting me try to combat it, to watch what I eat — instead of carbs — and walking, the doctor put me on this medication, metformin, and I didn’t agree with it one bit. I was doing all the other things [walking and watching sugar intake], then, with the medication [my blood sugar] dropped way too low. I had other side effects, too. I felt horrible.”
“A lot of people take [metformin],” Price said. “Some people it helps, and some people, like me, it doesn’t. My doctor wanted me to try another one, glipizide, with a lower dosage. He said take half. But it was the same thing. I didn’t need to take any of that junk.”
Since Price was diagnosed, some diabetes treatment has evolved.
“As it turns out, it is very individual,” Eggleston said. “It’s a very exciting time to learn about the prevention of diabetes because we are getting more and more research into parameters outside of just the prescription pad. At the end of the day, the most important thing about diabetes are the other preventive pieces. It’s not that the prescriptions are not important — they are — but they’re only a small piece of the pie.”
Eggleston described the four essential aspects of diabetes care — sleep, stress, food and exercise. “Everything we do is based on those four pillars,” she said.
“In terms of prevention, one way to think about diabetes and the whole spectrum of chronic disease that comes from diabetes is the core lifestyle pieces,” Eggleston said. “Because, really, lifestyle is the fundamental treatment for any type of diabetes.”
She said reading food labels can be a good starting point in self care of diabetes. Patients should be on the lookout for harmful ingredients.
“You want them to be whole, natural ingredients. And you want to really look for the first three ingredients — look for what are the sugars in it. You hear all the time you should eat whole wheat bread, not white bread. But when you look at a lot of the whole wheat bread, the first three ingredients are sugar, honey and high fructose corn syrup,” Eggleston said.
Exercise is another way to stay healthy in dealing with diabetes.
“We’ve known for a very long time that making sure that we all move as much as we can, and eat really healthy foods, get good sleep, and try to manage stress as much as we can,” Eggleston said. “These are really fundamental and we’ve known for a long time.”
And then, sleep and stress cannot be overlooked either, she said.
“In research, though, an area that is getting more focus is the impact of sleep, just what a big impact it has on the development of diabetes,” Eggleston said.
“The other thing is the impact of stress. Those two things are getting more and more research. Food and exercise we’ve known for a long time – those are the cornerstone.”
People who have a genetic propensity to diabetes have to be watchful.
“My mom has been on insulin for a number of years,” Price said. “With her, it’s twice a day.”
Price’s siblings now live with their mother, who is 85, to help her with regular insulin injections.
“You can’t beat your genetics. You have to manage it the best you can,” Price said. “It’s not easy, believe me. I’ve been managing it for several years.”
Price adheres pretty strictly to his doctor’s recommendations, especially when it comes to exercise.
“I lost weight by walking,” he said. “And I drink a lot of water. I was 195 [pounds], and I went down to below 170. Now I’m about 175.”
Several of Price’s friends are also concerned about diabetes. “These guys, they walk every day, from downtown Fairmont to down across the Watson Bridge and back. These guys are about my age, in their 60s,” Price said.
“There are some individuals who have a really strong family history,” Eggleston said. “They can do absolutely everything, and they may still develop diabetes. And they may have diabetes that needs treatment with medication.”
Rarely discussed in terms of diabetes care is the one-two punch of blame and guilt. “I think there’s a lot of self blame and societal blame that happens with diabetes because there is such a component of lifestyle. We can easily make people with diabetes feel that it’s their fault, or they should be doing more,” Eggleston said.
The anxiety caused by the onset of diabetes can add stress, which in turn causes the diabetes to worsen. Depression can set in, which makes adherence to a healthy lifestyle more difficult. “There’s such a deep link between diabetes and depression,” Eggleston said. “It goes both directions, so people who have depression are more likely to develop diabetes, and people who have diabetes are more likely to develop depression.”
“One of the most important things we as a society can do is support people as they try to make changes,” Eggleston said. “We need to remove that kind of blame, and then also, put things in place that make it easier for people to take care of themselves.”
From the financial standpoint, legislators have worked to reduce the cost of insulin and other diabetes drugs in West Virginia. And the insulin pump, which has been around for a long time, has become smaller, more sophisticated and more affordable for people.
For someone like Price, who is managing diabetes but always aware, any new tools are welcomed.
“My doctor is mostly concerned with my A1C [blood test that measures sugar levels],” Price said. “He wants it at 7 or below. If I overdo it with too many carbs, I can feel it. I don’t feel as healthy, I don’t feel as good. I get really tired. But so far, I’ve been able to keep it under 7.
“He said for me, for my age, right now I’m OK. But if it goes over 7, then we might have to start medication.”
“I’m optimistic,” Eggleston said. “In West Virginia we have a lot of really important conversations happening now — about our risks. And this is where we have to start because of all of the complex levels of diabetes care.”
When Price turned 66 in November, he didn’t throw a party.
“I celebrate every day,” he said. “I tell you, I’m trying — I take it one day at a time.”