Johannsen to talk about prediabetes at Saturday program

Posted: Monday, Jan 9th, 2012 in the Huron Plainsman Newspaper
BY: CRYSTAL PUGSLEY

An ounce of prevention is worth a pound of cure when it comes to recognizing signs of prediabetes and taking steps to decrease that progression to diabetes, said a former Huron Nurse Practitioner and past leader of the Huron Area Diabetic Support Group.

Sue Johannsen, GNP, PA-C, will be the guest speaker at a program, “Diabetes for Life,” from 1 to 3 p.m. Saturday at Holy Trinity Church, 425 21st St. S.W. The program is hosted by the Holy Trinity Health Cabinet and the Huron Area Diabetic Support Group.

“Diabetes has been my passion for a long time,” said Johannsen, who lives in Brandon and works with the state’s quality improvement organization, the S.D. Foundation for Medical Care in Sioux Falls.

“I started teaching diabetes a long time ago when I did home care,” said Johannsen, who is a certified diabetes educator. “It’s a very challenging disease that is closely linked with others —obesity, high blood pressure, it affects a tremendous number of people.”

Her work with the S.D. Foundation for Medical Care focuses on patients on Medicare and Medicaid who are sent home from the hospital only to be readmitted later for that same diagnosis.

“Either the medication didn’t work well, no follow up, or they didn’t understand – there was some type of failure in that handover between the hospital and home,” Johannsen said. “Maybe they could have stayed out of the hospital if we had worked things out differently.

“This is the government agencies trying to cut and reduce costs, improve patient care, and make the patient the center of care again,” she said.

Johannsen said those with prediabetes have blood glucose levels higher than normal but not high enough to be classified as diabetic. They have an increased risk of developing type 2 diabetes, heart disease and stroke.

Diabetes is a disorder of metabolism that affects the way the body can digest food for growth and energy. Most of the food people eat is broken down into glucose, which is the form of sugar present in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin, a hormone produced by the pancreas, must be present.

In people with diabetes, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Type 1 diabetes is an autoimmune disease in which the body’s immune system attacks the insulin-producing beta cells in the pancreas. This is most apt to develop in children and young adults, although it can appear at any age, and requires daily replacement insulin to survive.

Type 2 diabetes results from insulin resistance, a condition in which the body fails to properly use insulin, often combined with the body not producing enough insulin. After several years, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes accounts for 90 to 95 percent of all diagnosed diabetes cases in the United States.

For those who are prediabetic, the progression to diabetes is not inevitable, making it even more important to educate people before diabetes is diagnosed, said Johannsen.

Those who take steps to lose weight and increase their physical activity can prevent or delay diabetes and return their blood glucose levels to normal. The Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, showed that lifestyle intervention reduced developing diabetes by 58 percent during a three-year period. The reduction was even greater, 71 percent, among adults aged 60 years or older.

In South Dakota, 6.6 percent (39,967) of South Dakota adults have been diagnosed with diabetes, and an estimated 13,322 South Dakotans do not know they have diabetes. The Center for Disease Prevention and Control analysis shows 25.9 percent of adults age 20 or older have prediabetes. In South Dakota, this percentage would equal about 149,250 adults with prediabetes.

“We’re trying to focus on people who are prediabetic,” Johannsen said. “For those people, if we intervene soon enough, we can decrease that progression to diabetes.”

Johannsen also serves as chairman of the coordination panel for the S.D. Diabetes Coalition.

“When I came to Huron the Coalition had created a tool kit,” she said. “It’s an educational video, pedometers and printed information on prediabetes. I will show the group the tool kit and we’ll talk a little bit about diabetes for life. Once you have diabetes it’s pretty hard for it to go away.

“The coalition put the tool kit together and we dispersed them free of charge to organizations in the state to get it out to their people so they could educate the community,” Johannsen said. “It’s absolutely a wonderful tool. It allows a whole lot of education that might impact people who are not full-blown diabetics but on the cusp. We all know prevention is much better than trying to catch it.”

The S.D. Diabetes Coalition has a new website, www.sddiabetescoalition.org.