Diabetes management goes high-tech; new devices, personalized care help to control deadly disease

IT'S a disease that affects nearly 21 million people--about 7 percent of the United States' population--including 1 in every 8 African-Americans. And while diabetes has no cure, new high-tech tools--as well as good, old-fashioned, hands-on education--are being used in an effort to make it easier to manage the deadly disease.

From computerized glucose monitors to wireless insulin pumps that self-inject a person at a proqrammed time, devices that use the latest technology have hit the market, promising to make diabetes care more concise and more compassionate. "Today, there is so much more science that is being discovered and many new technologies for improved diabetes treatments," says Andrea Williams, a certified diabetes educator at Chicago's Rush University Medical Center and chair of the American Diabetes Association's African-American Project Team. "Translating that science and helping people understand how to cope with the treatment options is [the] main focus" of the health care community.

In recent years, more devices have come on the market that allow users to more easily keep track of glucose levels, including many that contain LCD screens with downloadable software. More waterproof devices--that give people the ability to safely shower, bathe or swim without worry--also are on the market.

And many of these devices have replaced bulky, outdated catheters with reservoir-based, insulin-management systems that are so small that they are virtually undetectable. In addition, numerous disposable and non-disposable pens that inject insulin now need only a small droplet of blood (the size of a pinhead), and allow the user the freedom to extract that blood from a variety of places on the body.

"When you see how small and how easy these new devices are to use, people don't have a reason to say, 'I don't want to do this,'" says Michelle C. Sheldon-Rubio, diabetes educator coordinator at the University of Maryland Joslin Diabetes Center. "As technology makes it easier to fit into a person's life, then it doesn't seem like diabetes is such a burden."

Aiding these new devices are a new group of medicines--neurotransmitters--aimed at mimicking hormones in the body, while at the same time having a secondary effect of weight loss.

Diabetes has reached epidemic levels among African-American women, with 1 in 4 women older than 55 having the disease, a rate that is two times higher than that of White women. It is estimated that the direct and indirect cost of diabetes is more than $130 billion each year, making it one of the most expensive diseases. It is also one of the deadliest, with conservative estimates placing it as the sixth-leading cause of death. Heart disease and stroke account for 65 percent of deaths in people with diabetes, while complications such as kidney disease, high blood pressure, blindness and leg amputations are also prominent with people afflicted with the disease. Overall, the risk of death among people with diabetes is about twice that of people without the disease.

The good news is that diabetes can be controlled, and even prevented, doctors say. By following a healthy meal plan and a low-impact exercise program, losing some weight, and taking oral medication, many people with diabetes can control their blood glucose.

Using the latest technology, the American Diabetes Association has developed Diabetes Personal Health Decisions, or Diabetes PHD, as a new Internet-based, health-risk model program that is designed to give those affected by the disease the information needed to make healthy changes. Diabetes PHD takes basic health information--age, height, weight, family history, and basic factors like blood pressure and cholesterol--and calculates a person's 30-year risk of developing a serious health problem like diabetes, heart attack or stroke.

"Diabetes PHD doesn't just show you what the risks are and how you can change them, it provides information on how you can make those changes," says Matt Petersen, director of information resources for the ADA. "There are explanations of what the risks are and what can be done to improve them, with extensive links to additional information on how to get started on improving your health. Most important, the program allows you to make realistic changes in your health profile and see what effect that change can have on your health risks."

Washington, D.C.-area residents Minnedore Green, Detra Battle and Linda Bostick have helped take technology-based diabetes care to a new level. All diagnosed with diabetes, they participated in the making of "Diabetes: Living My Best Life" an innovative CD-ROM that combined a technology-based interface with a self-paced interactive platform.

The women allowed program coordinators at HealthMark Multimedia Agency--which received funding for the project from the Centers for Disease Control and Prevention--to shadow them for months, monitoring their meal plans, exercise, medical care, and spiritual and emotional care. The challenges they encountered in managing their diabetes were incorporated into the CD-ROM through personal stories from the women, as well as an interactive exercise log and nutrition guide, and several self-management tools.