Ka Wai Ola - Office of Hawaiian Affairs, Volume 26, Number 10, 1 October 2009 — Diabetes takes our health away [ARTICLE+ILLUSTRATION]

Diabetes takes our health away

By Claire Ku'uleilani Hughes, Dr. PH., R.D. Many eall diabetes the "scourge" (plague) of Hawaiian heahh. And, heahh data confirm the decades of havoc that diabetes has wreaked on Native Hawaiian adults. But now, h has our keiki . . . and, in increasing numbers. Sadly, these keiki will face the problems of diabetes for many years. And, those problems ean be serious ones. What we ean do? First, we must understand diabetes. Second, we must do whatever we ean to prevent diabetes, or delay it, in our keiki. Learn and teach prevention to the 'ohana. Fight against this enemy and make the entire family stronger and healthier. Thankfully, the measures we take

to prevent diabetes will prevent excess weight, heart disease and some cancers, as well. Diabetes is characterized by blood sugar levels that are too high. Body functions ^ demand a consistent level of blood sugar. Blood-sugar (glucose) levels need to be between 70 to 100 milligrams per deciliter (mg/dl) after 10 hours of fasting (going without food). This is a

"normal fasting blood-glucose level." Fasting blood-glucose levels above 100 mg/dl are not desirable. And, diabetes is diagnosed after several fasting blood sugars exceed 125 mg/dl. Hemoglobin A1C measures the average blood-sugar levels over the past two or three months. Interestingly, the body needs a constant supply of glucose to make the heart, eyes, brain and muscles work. The body makes special forms of sugar called glycogen and glucose from food that is eaten to operate these major systems of the body. To keep blood-sugar levels constant, the body has several ways to raise the circulating blood sugar, but only one, the hormone insulin, to lower it. Blood sugar levels go up after eating, as food carbohydrates and sugars are digested. The pancreas releases insulin into the bloodstream to remove some of the blood sugar and store it as glycogen in the liver and muscles. Higher excesses of blood sugar are converted to fat and go into storage. When the pancreas fails to produce insulin, Type 1 diabetes is diagnosed. When not enough insulin is produced or the insulin does not work as it should, Type 2 diabetes is diagnosed. Type 2 diabetes is the most eommon form of diabetes and usually results when one is overweight or severely overweight and, for some, in old age. Daily exercise ean modulate the insulin problems of Type 2 diabetes. Because many kanaka maoli adults and keiki are overweight and not physically active, and eat too mueh sugar (soda, white rice, sweets, beer), diabetes keeps increasing. Individuals wishing to avoid diabetes need to eat three regularly scheduled meals daily (no skipping meals). These meals should offer moderately sized servings of whole grains (brown rice, whole-grain bread, oatmeal), whole vegetables (kalo, 'ulu, poi, sweet potato, broceoli, spinach, lū'au, etc.), low-fat fish, fowl and other meats, with small servings ( 1/2 eup) of fruit. Low-fat milk is important to include in the diet of keiki. Daily exercise and eight hours of sleep are "must-dos" for the entire family. Only the 'ohana ean save keiki heahh. Let's help our keiki fight and take Hawaiian heahh back! ■

mauli ola