When it comes to disease awareness accessories, everyone knows the significance of the red ribbon for AIDS and the pink ribbon for breast cancer.

But what about gray ribbons or bracelets? Those are meant to call attention to diabetes care and prevention.

According to the American Diabetes Association, an estimated 23.6 million American adults and children have the disease. About 5 to 10 percent have Type 1 diabetes, which occurs when the body fails to produce insulin, the hormone that helps convert sugar, starches and other food into energy for cells. Type 2 diabetes is caused by an insulin deficiency combined with the body’s failure to properly utilize it. The sharp growth in Type 2 cases — which is connected to the rapid rise in obesity among Americans — alarms medical professionals and is straining healthcare resources.

Dr. Lina Mitchell, an endocrinologist at Mercy Health Partners Diabetes and Endocrinology Center in Liberty Township, says the strain is evident.

“When I started my practice, you could see a doctor right away after diagnosis. Now, because so many more people have diabetes and the number of endocrinologists hasn’t matched that growth, you could be on a waiting list for a month,” she observes.

If that’s not scary enough, the U.S. Centers for Disease Control estimates that close to one-third of Americans who have diabetes — about 5.7 million — should be seeking care but don’t even know they have it.

Diabetes is now one of the nation’s leading causes of death, and has quietly become the nation’s top cause of new blindness cases.

Diabetes is most often linked to kidney failure in the public’s mind, but the disease’s cardiovascular effects are the most deadly. Diabetics have heart disease death rates nearly four times higher than non-diabetics, according to the National Institutes of Health. Diabetes also leads to a much higher risk of strokes. Nerve damage caused by diabetes causes about 70,000 lower-limb amputations annually.

High blood glucose (sugar), which damages blood vessels, is a major signal of the chronic, incurable disease. Other symptoms, such as blurred vision or swelling in the legs, are less easily ignored but often under-estimated. Recognizing these signs getting tested for diabetes could not only save your life, experts say, but could vastly improve the years you have. Diabetes is a slowly progressing disease, but left undiagnosed and untreated, the effects are stark.

The keys to preventing diabetes — diet and exercise — are simple and well known. Yet the medical community continues to see growth in diabetes complications. “The key factor is denial,” Mitchell points out. “People see family members with the symptoms or recognize the symptoms in themselves and just put it off. We only see them when the problems are more severe.”

The non-specific nature of symptoms is also hindering prevention efforts. Frequent urination, excessive thirst and fatigue (all early warning signs) are too easily ignored, cautions Dr. Linda Hermiller, the medical director of the Northern Kentucky Center for Diabetes and Hormone Disorders.

“They’re easy to write off,” she says about those symptoms. “It’s ‘I’m just tired because I haven’t been sleeping well’ or ‘It’s hot out; that’s why I’m always thirsty’ and ‘I’m drinking so much; that’s why I always have to go.’ Anything but ‘I might have diabetes.’ The earlier we catch it, the better chance we have to prevent long-term damage.”

“We’ve got medications to help control the disease, but that’s only part of it,” Hermiller continues. “A large part of controlling diabetes is education: Learning the lifestyle changes you have to make. Diabetes is an inevitably progressing disease, but these things can slow that train down and help diabetics lead wholly normal lives.”

That care may involve different combinations of more than 20 types of injectable insulin or six classes of oral medications. New technology is improving monitoring and treatment, reports Dr. Barbara Ramlo-Halsted, director of the Diabetes Center at the University of Cincinnati.

Doctors are excited, she says, by drugs called incretin mimetics, which act like the natural hormones that lower blood sugar. Prescribed under the brand name Byetta, the drugs originated with an unlikely source: the venomous desert lizards known as Gila monsters.

“The lizard is able to subsist for a long period of time without food intake, which means it was controlling how its body broke down food and using that stored energy,” she explains. Byetta lowers blood glucose and slows the absorption of carbohydrates.

“It’s unique in the world of diabetes medications, because many of the medications we’ve had to date tend to promote weight gain. So, to actually be able to offer patients this drug that not only controls their blood sugar but promotes weight loss, which helps control the disease, is a double benefit,” she adds.

Research has produced a “smart” insulin pump and continuous glucose sensors that automatically deliver insulin 24 hours a day through a catheter. The pump’s controller is small enough to be worn on a wristband.

More important than such advances is getting more people to understand prevention and early detection, experts say. “Looking at the damage associated with long-term effects of diabetes, you have to realize it starts long before blood glucose levels rise to the established levels of diabetes,” Ramlo-Halsted says.

More research also is looking at natural dietary supplements, or “nutriceuticals,” that might help lower or control blood sugar.

Rod Hammons, a Cincinnatian who was trained as a chemist — and whose mother was diabetic — began investigating herbal supplements in 2005 when he became concerned about his own blood sugar. He experienced success in controlling it through diet, exercise and a dietary supplement he developed. His blend features natural herbs, vitamins and fatty acids, including some often cited in research, such as gymnema sylvestre, fenugreek seed and chromium. Hammons formed a company to manufacture and distribute the product, called Depsyl.

Hammons says his first goal is to educate people about diabetes. “Whether they take our product or not, they need to know what their blood sugar levels are. Ask your doctor. Too often, people wait until it’s too late.”

Experts always caution people to consult with a physician before beginning a new regimen, especially when taking prescribed medications. The National Center for Complimentary and Alternative Medicine offers guidelines and updates on the latest research at http://nccam.nih. gov/health/diabetes.
Pre-diabetes: What You Need to Know

About 57 million Americans have pre-diabetes, and many are unaware of it, according to the American Diabetes Association. Here is information to keep in mind.

Q: What is pre-diabetes and how is it different from diabetes?
Pre-diabetes is when a person’s blood glucose (sugar) levels are higher than normal but not high enough (yet) for a diagnosis of diabetes. It also means you may be at higher risk of other serious conditions, such as cardiovascular disease.

Q: How do I know if I have pre-diabetes?
Doctors can use either the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT) to detect pre-diabetes. Both require a person to fast overnight. In the FPG test, blood glucose is measured in the morning before eating. In the OGTT, the glucose is checked after fasting and again two hours after drinking a glucose-rich drink.

Q: How do these two tests define diabetes and pre-diabetes?
Normal fasting blood glucose (FPG) is below 100 mg/dl. Pre-diabetes is between 100 and 125 mg/dl, and a level over 125 is diabetic. With the OGTT, normal blood glucose is below 140 mg/dl two hours after the drink. A level of 140 to 199 mg/dl is pre-diabetic, and over 200 mg/dl is diabetic. According to the Diabetes Association’s experts, either test is appropriate.

Q: Why do I need to know if I have pre-diabetes?
Studies show that people with pre-diabetes can prevent or delay the development of Type 2 diabetes through changes to their lifestyle that include modest weight loss and regular exercise. For some people with pre-diabetes, intervening early can actually return elevated blood glucose levels to the normal range.

Q:Who should get tested for pre-diabetes?
you are overweight and age 45 or older, get checked during your next routine medical office visit. If your weight is normal and you’re over 45, ask your doctor if testing is appropriate. For overweight adults under 45, your doctor may recommend testing if you have other risk factors.

Q: Should children be screened for pre-diabetes?
The Diabetes Association does not yet recommend that, but that position may change. One study found that 25 percent of very obese children and 21 percent of very obese adolescents had pre-diabetes.

More information is available at www. diabetes.org

FOCUS AREA: Blood Sugar Management
EDUCATION: BA, Chemistry, Miami University; MBA, Xavier University.
PROFESSIONAL EXPERIENCE: CEO, DEPSYL LLC; Research and Development, Jergens and Krogers; owner, Hammons & Associates, Queen City Fasteners, National Aircraft Supply, Hammons Consulting.
INNOVATIVE TECHNIQUES: DEPSYL develops, formulates, distributes and markets a proprietary nutritional supplement sold through various marketing and distribution channels in the United States and internationally. DEPSYL developed the proprietary product of natural herbs, vitamins and fatty acids to maintain and support a healthy lifestyle. DEPSYL prides itself on a strong commitment to health, education, scientific integrity, quality and customer service. The company provides comprehensive solutions that include formulations based on scientific research, the highest manufacturing standards, supervision of regulatory compliance and marketing support.