November is National Diabetes Awareness Month. To help us better understand what this means, Hamden Library staff member Ariana Davis takes the reins, guiding us through the ins and outs of what diabetes is and how it affects the lives of tens of millions of Americans. She also interviews Dr. Helen Anaedo, a board-certified endocrinologist with Hartford HealthCare, to help dispel some of the myths and misconceptions about this chronic condition.
Michael Pierry 0:07
Thank you so much for tuning into this month's episode of The Hamden Library Podcast. I'm Michael Pierry. I'm usually joined by associate director and co host, Alyssa Bussard, but this month we will temporarily hand the hosting reins to one of Hamden Public Library's newest hires: Ariana Davis.
Ariana Davis 0:25
Thank you so much, Michael, for that introduction. I'm so grateful for this opportunity. I've been enjoying working as a library page and participating in creative projects such as the work behind this podcast. I can't believe that it's been almost two years that I've been serving in this capacity. It's truly been an honor, and really, being behind the scenes of the library, so to speak, has helped me to appreciate the amazing work that librarians and library workers do for the community each and every day.
Michael Pierry 1:00
Yes, and your segment will be focusing on one of America's hidden epidemics. To our audience, can you guess what that might be? Before we get started, here's what's coming up this month at the library.
On December 6, the Miller Library will have not one but two children's grab and go bags available in the children's room. The first is a snow person and the second is make a snow globe. You don't need to sign up to get one of these but they are only available while supplies last. So don't wait if you think you'll be wanting one or both of those grab and go bags.
On December 9 at 7pm. The library will host the last of its community conversations on Zoom. If you haven't heard about these, it's a great opportunity for you to talk about the community and about the library. And to make your voice heard. You can register for the community conversation via our website Hamden. library.org If you haven't had a chance yet to participate in one of these conversations, I hope you can do so because everybody's voice is important.
Children ages five and up can decorate a gingerbread house in Thornton Wilder Hall. You do have to register for this program, which takes place on Monday, November 13.
At 3:30pm LEGO Club is back at the Brundage Community Branch library at your own physically distant station. Come and build with the library's LEGOs on Wednesday, December 15, from six to 7:15pm. For ages four to 12 registration is required.
Then on Monday, the 20th Miller Library will have another doubleheader of children's grab and go bags this time it's reindeer and seasonal greeting cards. Finally, on Wednesday the 22nd from 6:30 to 7pm. There will be another pajama storytime at Brundage Community library. Wear your pajamas if you wish and bring your favorite stuffed animal. I believe that message is meant for the kids not for the adults. Registration required. Recommended for ages three to six, and reminder that all adults and children ages two and up are still required to wear a mask while visiting the library, regardless of vaccination status. And that's what's going on at the library.
Now before we get back to Ariana, here's Mike Wheatley with another movie recommendation and a special note about the portrayal of diabetes and film.
Mike Wheatley 3:17
What do "Panic Room" (2002), "Steel Magnolias" (1989), "Reversal of Fortune" (1990), "Nothing in Common" (1986) "ConAir" (1997) have in common? Diabetes, and the problem of Hollywood films choosing drama over correct medical information.
To quote Diabetes Health in a recent article, "Hollywood's depiction of people with diabetes often have grown out of the need for a dramatic element". They use the example of "Panic Room" where Jodie Foster and her daughter with diabetes played by Kristen Stewart, are trapped in a safe room in a house being robbed. "The young character Sarah experiences an episode of low blood glucose -- hypoglycemia -- while trapped in the panic room with her mother. 'Without that element, obviously they could have stayed in there for days if they wanted to,' associate producer John Dorsey explains." To quote an informative Health Line Media's online newsletters example:
"In the movie, the teen gets a shot for the low blood sugar, which people with diabetes may recognize as rescue glucagon. But of course, most people with no knowledge of this condition could easily assume it was insulin. Unfortunately, several film reviewers incorrectly referred to this life saving shot as an insulin injection. This obviously imparts the dangerous misperception that a person having low blood glucose level needs more insulin instead of sugar.
"Of course, the teenager recovers immediately after the injection rather than the several minutes it typically takes after using emergency glucagon. At one point, the writer even makes Sarah turn blue -- which doesn't happen with hypos. At another point in the film, the teen gets anxious and the mom cautions her to not get worked up as it can lead to diabetes problems.
'There's no law saying we have to be right in every movie scene', the film's technical medical adviser Donna Cline said. 'Frankly, we deliver what the public wants.'
"Cline claims she researched the appearance and behavior associated with low blood glucose and other aspects of diabetes. She even consulted textbooks, and sought help from experts in diabetes care, finding in one manual on cardiopulmonary resuscitation (CPR) that stated 'great emotional stress' could lead to hypos. That's what led to the mom's scripted comment about her daughter getting worked up.
"Even more interesting is the producer of "Panic Room" has a daughter with Type 1 diabetes, and still the script was far from technically accurate in many spots. Although one could argue that it got the urgency of diabetes emergencies across."
The point needs to be made that with the prevalence of medical shows on TV and movies, and the use of illness as plot points, we assume that there are many times a difference between what the public wants and factual useful information, indeed.
My film recommendation this month, although not directly related to diabetes, is a fact-based story of a white surgeon and a black lab technician who together developed one of the first cardiac surgery techniques. In 1944, at Johns Hopkins, they operated on a blue baby born with a heart defect. The film is "Something the Lord Made" from 2004. Mos Def as Vivien Thomas and Alan Rickman as Dr. Alfred Blaylock. Having his savings wiped out by the Great Depression, Thomas's hopes to become a doctor are dashed and he takes a job at Vanderbilt in Nashville as a janitor. Blaylock recognizes his skills and takes him on as a lab assistant. When Blaylock is called to Johns Hopkins in Baltimore, he demands that Thomas come with him to be his assistant. There Thomas's skills shine. I love this film because it not only shows the brilliance of the two lead actors and the characters they portray, but the pervasive evil of the racism they encounter. With a great supporting cast and high production values, this movie tells the true story of real life pioneers.
Ariana Davis 8:13
Thank you so much, Michael, for that recommendation. One of the many things that I appreciate about the library is the platform that it provides, not only to inform but also to inspire. In that same line of thought, we are focusing this month of November on National Diabetes Awareness Month, and this is a time that's dedicated to increasing public recognition, encouraging education, and dispelling misinformation about diabetes. According to the American Diabetes Association, National Diabetes Month was established in 1975, but didn't begin to receive more recognition until the early 1980s. World Diabetes Day was established by the International Diabetes Federation and the World Health Organization in 1991, and became an official United Nations Day in 2006. The date of November 14 was particularly chosen to honor Dr. Frederick Banting, who, along with Dr. Charles Best, co-discovered insulin back in 1921.
Perhaps you, the listener, could reason there are many diseases that exist in our world. Why does diabetes deserve its own month for awareness? Well, consider these statistics found in the CDC's latest National Diabetes Statistics Report:
34.2 million people have diabetes. That's 10.5% of the US population. This number includes those who are diagnosed (26.9 million people), as well as those who are undiagnosed (7.3 million people). A little over 21% of diabetics are undiagnosed.
In the United States, 88 million adults--that's more than one in three--have prediabetes, a precursor to Type 2 diabetes, 34.5% of the adult US population.
The American Diabetes Association released new research in 2018, estimating the total costs of diagnosed diabetes to have risen to $327 billion in 2017 from $245 billion in 2012, when the cost was last examined. This figure represents a 26% increase over a five year period.
I'm sure you would agree that these statistics truly speak for themselves. Diabetes is a serious health epidemic that has an enormous impact not only on individuals and families, but also on our society and economy.
Even as more Americans are diagnosed with diabetes each year, there still seems to be a lot of confusion and misinformation about the disease. Perhaps during this podcast episode, you will learn something new, or your understanding of what it is like to live with this chronic disease will deepen.
Firstly, I would like to share some important definitions. Diabetes is a chronic disease that occurs when the pancreas is no longer able to make enough insulin, or any at all, or when the body cannot make good use of the insulin it produces.
Why is insulin so important? Well, insulin is the key to unlocking the cells in our body, allowing glucose, or sugar, to move from our bloodstream into our cells to be used as energy. Without this hormone, glucose builds up in the bloodstream, which can lead to long term as well as life threatening complications. There are mainly three types of diabetes: type 1, type 2, and gestational. Also, it would be remiss of me not to mention prediabetes, a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as Type 2 diabetes.
Type 1 diabetes, formerly known as juvenile diabetes, is an autoimmune condition and accounts for about 5% of all diagnosed cases of diabetes. The immune system mistakenly attacks the body, destroying cells in the pancreas that produce insulin, so to properly regulate blood sugar type 1 diabetics are dependent on insulin therapy, which can be provided by means of regular injections, or the use of an insulin pump. All type 1 diabetics must be on guard to prevent diabetic ketoacidosis, or DKA, a serious complication that can lead to coma and even death if left untreated.
Type 2 diabetes is a condition where the body cannot properly use its own insulin, or as the disease progresses may not make enough insulin. It occurs most often in middle aged and older people; however, it can develop at any age, and the number of children and young people being diagnosed with type 2 diabetes is on the rise. Family history, ethnic background, environment, weight, diet and physical activity all play important roles in increasing or decreasing one's chances of developing this disease. Treatment options for type 2 diabetes can include taking prescription oral medications like Metformin, insulin therapy, or a combination of different therapies, if other treatments have been unsuccessful in keeping blood sugars within a healthy range.
Gestational diabetes is a condition in which a woman who formerly did not have diabetes develops high blood sugar levels during pregnancy. It is important to note that all pregnant women have a measure of insulin resistance during the late stage of their pregnancy, but women who begin their pregnancy with an increased need for insulin are more likely to develop gestational diabetes. While many symptoms of type 1 and type 2 diabetes are similar -- such as excessive thirst or hunger, frequent urination, blurred vision, irritability, and fatigue and exhaustion -- most pregnant women with gestational diabetes don't present noticeable symptoms. If left untreated, this condition increases a mother's risk of having a stillbirth or giving birth to a baby that is premature, very large and/or has low blood sugar. Gestational diabetes usually goes away after a baby is born, but according to the CDC, about 50% of women with gestational diabetes go on to develop type 2 diabetes. Additionally, her child is at a higher risk of being overweight and developing type 2 diabetes later in life.
Diabetes increases the risk for medical complications and the development of other health problems such as heart disease, stroke, kidney disease, diabetic neuropathy, eye issues, foot problems and dental disease. Keeping blood sugar in a healthy range and lowering A1C, a number that represents average blood sugar levels over a three month period, can help prevent many diabetes related complications. Diabetes has no known cure, but can be properly treated and well managed, allowing many diabetics to lead long, healthy and active lives. Research has shown that type 2 diabetes can be prevented or delayed, and prediabetes can be reversed by improving one's overall health through various lifestyle changes. Both diabetics and prediabetics will benefit from losing excess weight or maintaining a healthy weight by eating a balanced diet and practicing a regular exercise regimen, managing stress and emotional triggers, improving the quality of their sleep and following the advice of a medical professional team.
Now, those are the medical terms. How can it feel to live with such a diagnosis? Well, diabetes can be daunting. Feeling overwhelmed is not unfounded, especially after being newly diagnosed with diabetes. There is so much information circulating about different diets, approaches and so called solutions. Where does one begin?
Hamden Public Library has over 1500 available and materials on diabetes. Of course, these resources should supplement the advice and recommendations of a medical professional who can provide personal and specific guidance.
Diabetes can be stressful. managing diabetes is a complex balance of food intake, physical activity, and medicinal and or carefully calculated insulin administration. To keep blood sugar's within a healthy range. Each day brings its own unique struggles, and dealing with this uncertainty can be very challenging. The demands of daily life can, over time, take a physical, mental and emotional toll on a diabetic.
Diabetes can be isolating. A diabetes diagnosis affects more than just the person him or herself, but it can be a very lonely disease. A person with diabetes can feel unsupported and misunderstood if their family members do not understand what is involved in daily management, and do not encourage healthy behaviors. Working together to make lifestyle changes can improve the health of the entire family and help diabetics to better accept and cope with their diagnosis in the long term.
Caring for diabetics of different types, ethnicities, backgrounds and conditions, is the expertise of Dr. Helen Anaedo, an internal medicine physician at Hartford Healthcare. Please listen in to our interview.
Thank you so much, Dr. Anaedo, for taking the time out of your schedule to meet with me. The first question that I'd like to ask you, is what motivated you to pursue a career in medicine with a subspecialty in endocrinology?
Dr. Helen Anaedo 18:29
Thank you so much for having me. I got into medicine because I grew up watching my mother -- who is a nurse -- make a difference in the lives of many people. So I wanted to do the same and I thought, you know, a career as a physician was a great way to contribute by quarter to health care. During my training, I developed a passion for physiology and biochemistry, which translated to my choice of endocrinology. This avails me the opportunity for continuous intellectual stimulation. It also has promising advancements in management of patients and long term results-oriented patient care. So I think that's my driving force to subspecialize in endocrinology.
Ariana Davis 19:19
Why are you particularly passionate about diabetes?
Dr. Helen Anaedo 19:24
Know diabetes cuts across all ages, race and sex. It can also involve all the systems in the body and my feel for diabetes as continues to grow from my daily experience with patients. It is a chronic disease that can be controlled, and its complications can be prevented. So it is very rewarding for me to be part of the care team that can assist patients to achieve excellent diabetes control using available resources.
Ariana Davis 19:58
Thank you so much for this important work that you're doing in diabetes care, endocrinology care. My next question is, have you noticed any misconceptions or myths about diabetes? And are there any particular ones that you find to be the most concerning?
Dr. Helen Anaedo 20:17
Yeah. Thank you for this great question. I think people who have diabetes, or people without -- you know -- that have loved ones that have diabetes, some have -- we've seen a lot of misconceptions about this. Sometimes they say, "if you have diabetes, you must go on insulin, or lose a limb or go blind".
But the fact is, if you have diabetes type 1, yes, you may need insulin, due to the deficiency from the pancreas, you know, it's not producing enough insulin. So you will, you may need insulin. Most of the time they do. But people with type 2 have insulin resistance. Their body produces insulin. So it is, there are many oral pills now that we can use for diabetes management without necessarily going on insulin, and no, you do not need to lose a limb or go blind because you have diabetes, especially if it's well controlled.
That is where we providers come in to make sure that your diabetes is well controlled. The other misconception I've heard too is "if you have diabetes, you can't live an active life", which is false, because in fact, exercise is one of those things we encourage our patients to do because if you exercise, the glucose gets taken up by the muscles without relying on insulin, and this helps to decrease the amount of glucose in your body and control your diabetes.
Then another important thing I've noticed this, this, some will say, you know, "you don't have to test your blood glucose, you would know when you have symptoms of high or low blood glucose". That's another misconception because you can't rely on your symptoms all the time for blood glucose. Some people don't even know when they have those because their body has grown fatigued from having so many lows and highs and variable blood glucose. So I say the best thing is to check your sugar so that in real time you know what's going on. Plus, you may have some symptoms of other ailments that are going on and that can make you not know whether you're really high or low. So that's why it's important to test blood glucose readings.
Ariana Davis 22:43
Thank you so much for clarifying those misconceptions. Can you please explain to our listeners what diabetes denial and distress are, as well as how they relate to the mental health of diabetics?
Dr. Helen Anaedo 22:57
Great question, Ariana. So diabetes distress is when someone is overwhelmed or frustrated about the disease. It can happen intermittently. You know, there are some bad days and good days. But when it becomes progressive or persistent is when we're really concerned because it can lead to depression, or mental breakdown. So usually at this point -- or before it even gets there -- if it's becoming more persistent, you're having more mood swings and you're having more frustration, or you're overwhelmed, that's the time you need to be talking to your provider, and they are there to help you. There's support groups to help you. And if you need to talk to a therapist, you need a psychiatrist or someone to take care of your mental health, that can also be -- you know -- referrals can be done and we can get you the support and help you need at that point. But yes, it's a real thing that can happen to people living with diabetes.
Ariana Davis 24:01
And what advice would you give to caregivers either to parents of diabetic children, or people whose significant other has diabetes?
Dr. Helen Anaedo 24:13
So having loved ones with diabetes can be very challenging, but we can help in many forms. You know, one of the ways we can help them is by being positive. We shouldn't be too judgmental. We should avoid nagging. We should encourage buying or preparing her healthy meals for them. We should also offer to make and attend appointments with our loved ones who have diabetes because that's a huge help. Sometimes life comes in the wave. They're they're busy doing other things; they don't remember to make up for the appointments. So helping with that also helps. The other thing we can help with is by being observant and help with treatment of law or high blood glucose when it happens, reminding them to test their sugar to take insulin or take their oral medications as needed. And the other thing we can also do is we can plan to exercise with them. We can have, like, a scheduled exercise routine and they can be -- you know -- we can decide to take a walk together to take a run together, make sure the sugar level is good enough before we do those exercises. And very importantly, always remind and show them that you are in this together and you care with a plan to succeed and get the diabetes wall controlled.
Ariana Davis 25:43
Thank you so much, Dr. Anaedo for explaining how important familial support is to the health and well being of a diabetic. My next question is, in your professional opinion, what advancements in technology have been the most groundbreaking in the treatment and/or management of diabetes? And why?
Dr. Helen Anaedo 26:05
Yeah, great question. In my opinion, I think the revolutionary advancements in diabetes management to the development of the continuous glucose monitoring device. It's such an awesome thing, to be able to know what your blood glucose is in real time without having to prick your fingers.
So we have two major types, the one you can put on your arm, the FreeStyle Libre sensor or the Dexom they put on, usually on the belly. And what they do is they check the interstitial fluid and actually measure your blood glucose that way every five minutes. So you really don't have to prick your fingers all the time. Sometimes you have to check to make sure it's correct. I mean, it's not 100% correct, but it helps us to know when we're going low or when we're too high. And then we can make interventions at that time.
The other beautiful things with this, we call them CGM -- that's called continuous glucose monitoring devices -- is that they they are now connected to insulin pumps. So they can predict if you're going low, and the insulin pump will get disconnected at that time and stop giving you insulin. Or if we notice that you're going too high and you're doing your own thing -- you know, you're busy at work -- is we just give you a tiny small bolus to bring your blood glucose down. So that's a big advancement in technology and in the management of diabetes, that gives us some free time so we're not just focused on managing our diabetes, and something is doing it for us at the background. So that's a big advancement for us.
Ariana Davis 27:56
Thank you for explaining that. How these advancements can definitely help diabetics to have that sense of normalcy in their life and not dedicate too much time to their management, which can take away from from other day to day activities. What role does our society play in diabetes education or miseducation? And what do you think can and should be done to reduce the stigma surrounding the disease?
Dr. Helen Anaedo 28:31
Nice question. So the community can organize outreach programs that focus on reducing risk factors by improving the diet promoting physical exercise and weight management. We can also do more by calling Congress or write in to the House of Representatives or by even signing petitions that will ensure the affordability and availability of diabetes medication and devices for patient care. Because sometimes it's difficult to get all the medications that some of our patients need not because one is cost is usually a big issue. And sometimes insurance will cover some sometimes they don't. So actually advocating for diabetes care would definitely help. Another thing we can help with is by setting up support groups and we could also use social media to guide and educate the general public about diabetes. So those are things we can work on that would help. And in terms of stigmatization, we can reduce that when we look out for each other. We should speak up when we see defaming behavior or statements. We avoid blame. So offensive words and In all just we have to be positive and offer encouragement to one another. And also, sometimes just opening up a conversation and sharing our personal experiences can inspire and educate people living with diabetes.
Ariana Davis 30:16
My last question is, what would you encourage the general public to do, especially during this special month dedicated to diabetes awareness?
Dr. Helen Anaedo 30:26
You know, November is National Diabetes Month, recognized since the 1980s, actually. It is a time devoted for communities around the country to team up and bring attention to diabetes. We can participate or organize walks or bicycle rides to create awareness about diabetes. By taking the step up by, you know, exercising and doing something in the name of diabetes. This year's theme is prediabetes, which is found in one out of every three or five individuals who do not even know they have prediabetes, or heading towards diabetes. And actually taking a risk test -- it's found on American Diabetes Association website -- to know where you stand is a good way to actually encourage general public to know, to have that awareness of where they stand in terms of prediabetes or diabetes. Another way we could help is by organizing fundraising or joining the American Diabetes Association and donating to the fight against diabetes. And I will also say, we can obtain resources on how to lighten our load or improve the mental health of either people living with diabetes or for loved ones that have diabetes. So the way we could do that is go to the website to get resources, even just on social media or talking to the providers, they can give us the best resources to help. And if you also go on the website, you can find things about what to do when your insurance does not cover some of your medication. And also, there are a lot of other support groups you could find on the American Diabetes Association website. And there are other websites. So that promotes and have resources that fight against diabetes. Finally, I will say taking time this month, or as frequently as we can, to get more knowledge about diabetes, because as I say, goes, knowledge is power. That can definitely help us to team up to control this epidemic, at improve the lives of 34 million Americans and 88 million Americans with diabetes. So in summary, I would say diabetes in general can, you know, we are here to support people living with diabetes, or if you have a loved one with diabetes, and that can be definitely controlled. And people don't need to have complications from diabetes if it's well controlled. And that's what we're here for: using the resources available to you, and going your providers when necessary, and using the support group will definitely help. Thank you. Thank you for having me on this episode and podcast and I appreciate your time.
Ariana Davis 33:53
And thank you so much, Dr. Anaedo, and we appreciate your time, and all of your answers to our questions. Thank you so much.
Dr. Helen Anaedo 34:01
You're very welcome.
Ariana Davis 34:02
In conclusion, we have taken a primarily objective look at this hidden epidemic. This information is very important, but doesn't depict the subjective point of view -- the personal stories behind each person who is living with diabetes, and no two experiences are identical. We may be aware of a family member friend or co worker who has diabetes, but likely many of our interactions are with diabetics. So we may not even know of the delicate fabric of our existence interwoven with the lives of those who are daily dealing with this chronic illness.
Are you or someone you know impacted by diabetes? Please remember that you are never alone. As an insulin-dependent Type 1 diabetic myself, working on this episode has been a cathartic experience, and I hope that other persons living with diabetes feel supported knowing that others are experiencing something similar, and they are encouraged to share their own story. Diabetes is not a weakness. It's not a dead end. It's a part of you, but does not define you. Thank you for your attention. And I hope that you had a positive listening experience.
Michael Pierry 35:18
Thanks to Ariana for doing such an amazing job with this episode.
Alyssa Bussard 35:21
Yeah. And Dr. Anaedo for agreeing to be interviewed. I learned a lot from this episode. How about you?
Michael Pierry 35:27
Oh, yeah, for sure. I have several family members that have diabetes. So this one definitely hit home for me. Anyway, I hear you've got something special in the works for next month's podcast.
Alyssa Bussard 35:37
I do. December is a month of many holidays and end of the year celebrations, and we know some people get busy, maybe too busy to listen to our very awesome and very detailed podcast. So I thought instead of doing a main focus, we could have a nice cozy episode filled with lots of movie or book or other recommendations.
Michael Pierry 35:57
Oh, that sounds fun.
All that plus the return of our book recommendations, Mike Wheatley's movie recommendations and more. Don't forget to like and subscribe and if you're feeling very generous rate and review us on Apple podcasts. It really helps us out.
Alyssa Bussard 36:12
See you next month.
Transcribed by https://otter.ai