How to stop diabetes before it's too late

Gloris Xynos-Taylor (MS ’09) thinks that everyone should eat like they have diabetes. A diabetes educator at St. Luke’s Hospital in Chesterfield, Missouri, Xynos-Taylor has been treating patients for 17 years and has seen the same patterns emerge. “None of us need the processed food or the added sugars,” she said. “And we all need to look out for fat and salt in our diet.”

One out of every 10 people in the United States has diabetes—a total of more than 30 million people, according to the Centers for Disease Control and Prevention (CDC). Most cases of diabetes are type 2, which occurs when high blood sugar levels are caused by the body’s inability to regulate the hormone that controls blood sugar: insulin. Elevated blood sugar levels can cause problems in patients’ eyes, kidneys, nerves, or heart. While a family history of the disease can lead to a diabetes diagnosis, most instances of type 2 are preventable, spurred by obesity or physical inactivity.

People with diabetes are at a higher risk for heart disease, stroke, kidney failure, and blindness. The disease can also cause nerve damage and ulcers that may ultimately result in the loss of the toes, feet, or even legs. And on average, diabetes patients will spend twice as much on medical care compared to people without the disease, given the cost of medications and specialist visits.

Managing the disease

Xynos-Taylor helps her patients and other people in the greater St. Louis area manage existing cases of diabetes or adjust their lifestyles to prevent diabetes in the future. She hosts health screenings and community wellness events to educate people about diabetes risks, introducing fun ways to exercise and teaching how to structure the diet by reading food labels and controlling portion sizes.

Some of her community events include local grocery store tours that show participants how to read a label and which foods are healthiest to grab during their weekly shopping; a Day of Dance for exercise education every February; individual health coaching sessions at libraries, coffee shops, and community centers around St. Louis; and diabetes management and weight management classes at the hospital.

Food management is a pillar of any diabetes treatment plan. “I focus on what you can eat, which creates a positive attitude towards food. Most people with diabetes come in with a very negative attitude towards food,” Xynos-Taylor said. “I advocate for people to include half a cup of beans in their daily diet, as well as whole grains and plant-based foods for fiber.”

In addition to a healthy diet, people with diabetes should exercise, get plenty of sleep, and work with their doctor to identify the right type and amount of medication.

Treating the two types

While type 2 accounts for 95 percent of diabetes cases, there are still instances of type 1 diabetes, which was previously called juvenile diabetes. Type 1 diabetes patients do not produce enough insulin. While type 1 is more common in young people, it can be diagnosed at any time in a person’s life.

Treatment for type 1 diabetes involves insulin pumps and injections, while treatment for type 2 relies on oral medications that help the body identify and process insulin. On the horizon is the development of an artificial, bionic pancreas. Once built, it will determine how much insulin a person needs automatically and supply it without user intervention; current insulin pumps require people to administer the insulin manually. The FDA approved the first system of this kind in 2016, and researchers are currently in the clinical trial phase with hopes that it can be available to mass-market patients in the near future.

Be aware: Understanding prediabetes

An estimated one in three adults have prediabetes, which means they are at risk of developing type 2 diabetes within five to 10 years. But a prediabetes diagnosis isn’t reason for despair—Xynos-Taylor said that it presents an opportunity to make lifestyle changes, like increasing your physical activity or altering your diet, that could prevent the onset of the condition.

According to the CDC, nine in 10 people with prediabetes aren’t aware they have it. Xynos-Taylor pointed out that the A1C glucose test used to diagnose diabetes is not typically included in standard wellness exams. “If your fasting glucose test is abnormal—measuring at levels of 100 or higher—and you have some of the risk factors for diabetes, don’t wait for your doctor to offer, ask for the A1C test,” she said.

Knowledge is power

While people 45 and older are more susceptible to diabetes, Xynos-Taylor said that anyone 18 or older—even those who outwardly appear healthy—can have prediabetes.

During one of her diabetes awareness campaigns, Xynos-Taylor conducted the A1C test on-air with a local news broadcaster, who was shocked to find out that she tested positive.

“She eats well, exercises, goes to the doctor every year, and had been told she was OK, even though her mom has diabetes. But when we did the test, she came out in the prediabetes range,” Xynos-Taylor said. “She was diagnosed super early, so hopefully that shows people that the earlier you get diagnosed, the more opportunity you have to address your health and wellness concerns and hopefully prevent the disease.”

Xynos-Taylor said that ultimately, prevention and care come down to education and proper planning.

“We’re very involved in our 401K planning or family vacation planning, but when it comes to health care, we don’t function in the same modality,” Xynos-Taylor said. “We put a lot of trust in our provider and take what is given to us, or we Google and assume we’ve found the right answer. I think being a little bit more engaged in how to get your information, interpret the information, and make a conscious decision about care with the information is key.”