MEN AND DIABETES...and Women Too!

Nkiru Oh

Disclaimer: this write-up is not meant to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. It is merely to raise awareness about Type 2 Diabetes!

I recently discovered one more reason why I should always love and be thankful for being a woman! After reading the BBC news article of 10/3/2011, titled "Men 'more prone to type 2 diabetes", am like, "thank God I am a woman!" Men must be wondering why I am jubilant. Let me clarify please. I ain't happy because men are more prone to developing diabetes. Am ecstatic because having extra subcutaneous fat on the behind and hips are beneficial, at least for once! Yippee!

According to researchers, men are 'biologically susceptible' to diabetes. How? Why? They store their fat in their liver and waist, two bad areas for fat storage! Women, on the other hand, are said to be endowed with more fat storage havens on their thighs and hips! Yes, thighs and hips as opposed to the liver and the waist! Due to this difference in fat distribution, the researchers opined that whereas men "need to gain far less weight than women to develop the condition...women need to accumulate more fat overall than men to develop the harmful fat deposits linked with diabetes." Mmmm...! And when I remember another finding that women who breastfeed for long have decreased risks of some cancers, I went wow, women are the bomb! Mothers with flat boobs can rejoice after all! Yea, their flat boobs have paid off, and exponentially too!

But before all the heavy-set ladies get carried away, let us remember that storing our excess fat in those two aforementioned areas have their health risks also! Besides diabetes, think about severe joint problems! Imagine being crippled by arthritis! How about being at higher risk for chronic conditions as hypertension and high cholesterol; coronary heart disease; stroke; gallbladder disease; some cancers, yes for example, colon, endometrial,etc; sleep apnea and other respiratory problems? You bet these are killer diseases if left unchecked! Gosh, what a jab! So what next? I have started to work on my excesses! Can't afford to not wear my block-heeled shoes! Diabetes scares the crap outta me too! You might as well start on yours. Seems nice if we share our ideas and compare notes later! What do you think?

The Glasgow University research team also found that men developed diabetes at a lower Body Mass Index (BMI) than women. According to the Center for Disease Control and Prevention (CDC), BMI is a number "calculated from a person's weight and height...[which] provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems." It is a tool for indicating weight status in adults in relation to height. BMI ranges are as follows (from CDC):

BMI	Weight Status
Below 18.5	Underweight
18.5—24.9	Normal
25.0—29.9	Overweight
30.0 and Above	Obese

Some classify BMI of 40.0 and above as Morbidly (deadly) Obese. Below are guides to calculating BMI (from CDC):

Measurement Units	Formula and Calculation
Kilograms and meters (or centimeters)	Formula: weight (kg) / [height (m)]2 With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared. Since height is commonly measured in centimeters, divide height in centimeters by 100 to obtain height in meters. Example: Weight = 68 kg, Height = 165 cm (1.65 m) Calculation: 68 ÷ (1.65)2 = 24.98 [ie. 68/1.65=41.212/1.65=24.977=24.98]
Pounds and inches	Formula: weight (lb) / [height (in)]2 x 703 Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversion factor of 703. Example: Weight = 150 lbs, Height = 5'5" (65") Calculation: [150 ÷ (65)2] x 703 = 24.96  [ie 150/65=2.307/65=0.0355x703=24.95=24.96]

Note that 1foot=12 inches; 1kg=2.2lbs

Also, note that BMI is not a diagnostic tool! It is only one factor related to risk for disease. To assess one's likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute recommends looking at two other predictors:

• One's waist circumference (because abdominal fat is a predictor of risk for obesity-related diseases). [40ins or less for men; 35ins or less for women. Note that waist circumference is measured around the navel and not below the waist...*wink*]
• Other risk factors one has for diseases and conditions associated with obesity (for example, high blood pressure or physical inactivity.

Consider the following too: as per CDC:

At the same BMI, women tend to have more body fat than men.

At the same BMI, older people, on average, tend to have more body fat than younger adults.
Highly trained athletes may have a high BMI because of increased muscularity rather than increased body fatness.

In effect, both men and women need to be aware of the issues at stake and how to reduce the risk of developing Type 2 diabetes. The disease is caused by too much sugar in the blood. This happens when the body stops making enough insulin or becomes unable to utilize the insulin produced to regulate sugar levels in its various organs! Anyone who is overweight should try to avoid gaining additional weight. And, being overweight with other risk factors (such as high LDL cholesterol, low HDL cholesterol, or high blood pressure), pose more risk! Weight loss is advised. Even a small weight loss (just 10% of one's current weight) may help lower the risk of disease. But please consult with your physician about the best weight loss regimen for you!

The Power of the Spoken Word!

Nkiru Oh

One night during the Winter of 2010, I encountered what was to become one of the sweetest, most satisfying workdays in my career as a health care professional. I was with some co-workers when Viveen (not real name) wobbled in and sank in the remaining empty chair at the corner. Before I could ask any question, she said resignedly, "V (my middle initial)...I am now a diabetic! I was diagnosed three days ago! My doctor checked me and my blood sugar was more than 500...yes, I am now a diabetic V!" Before I could say a word, she continued, tears running down her face, "he even gave me insulin shot...yea...said he had to...my sugar was too high." Again she repeated like a chorus to a music stanza, "I am now a diabetic...V....I am a diabetic!" When I looked at her face, I saw not only fear but hopelessness. I saw helplessness. I saw dejection and despair. I saw  resignation and emptiness. I saw a woman who believed she had received a death sentence and was waiting for the executioner in the gallows! I did not bargain for what was unfolding in front of me. The sight of the once energy-filled, vivacious Viveen, sitting on that chair like a piece of rag, stretched me beyond my training and experience! I quickly said a silent prayer, "Lord, pls tell me what to say!"

 While we were at it, as she sat there breathing heavily and sweating profusely despite the cold night, two of her friends cum colleagues came to give her what I chose to call the 'last sacrament'. One brought her two packs of unsalted crackers, the other a bottle of water, both gifts she absent-mindedly accepted and mumbled her thanks. The one that brought the crackers instructed her like a matron, "you know this is what you should be eating from now on. Now eat before your sugar gets messed up!" And both left. My heart sank into the pit of my stomach! Here were two people with no clue about diabetes, already 'teaching' and messing her up for real! Lord have mercy!

Viveen was about to open the crackers when I spoke. I honestly do not remember my exact words but based on what Viveen told me again yesterday, and probably for the hundredth time, the words literally brought her back to life! I remember bringing my chair closer, sitting about 2 feet from her, putting both hands on her shoulders, with her permission, and engaging her eyes as I spoke. I remember telling her that diabetes does not define her or any who has it; that it is a disease which if managed properly especially at the early stage, minimizes one's chances of developing complications years later! I remember asking her to discard those 'special gifts' together with the mindset with which she accepted them, to face diabetes and fight it as if there was no tomorrow! I asked her to discuss with her doctor so she would start walking immediately to lose some weight; and to work with her health care team to put the disease in check! Yes, exercise helps the body to utilize nutrients, and working with the doctor and the team is very crucial! I remember seeing Viveen sitting up, lightening up and wiping her tears as we spoke, and finally breathing a deep sigh of relief by the end of our talk! We then hugged and went back to our various units.

I did not know the full impact of our talk until about three weeks later. I saw the new Viveen, happier and energetic as ever. When she hugged me and told me all that happened in the past few weeks, I cried for joy! Viveen, after discussing with her physician, started to walk in the park. In three weeks, she already lost about twelve pounds, and she gladly showed me her new girth! Within a few months, her doctor reduced her medications to the barest dose. Need I say she is not on insulin! And her blood sugar has remained within the desired range!

I cried again last Saturday when we met at a party. Almost everyone there has heard about my encounter with Viveen that Winter night two years ago! What made me cry again for joy and wanna share this incident with the world was what one elderly woman said to me at that party. She put her hands on my shoulders and said, "My child, Viveen already told us what you did. Our words can kill. They can also heal. God uses people to help people. Please do not ever change!" I felt on top the world knowing that through one person, Viveen, I have ended up positively impacting many more lives! Yes, words can kill! Words can also save and heal! We can start impacting the world one person at a time! If after reading this piece someone realizes the need to say some kind words to others especially those that are hurting, and or becomes mindful of the power of the spoken words, my aim for sharing the story would have been achieved!