By Peggy O'Farrell
The Cincinnati Enquirer

Mary Harvey, a diabetic, walks up a hill on Walnut Street in Dayton, Ky., as part of her daily exercise routine. (Gary Landers photo) | ZOOM |

Mary Harvey knows what diabetes can do.

Her older sister has struggled with it, suffering nerve damage and foot ulcers that won't heal, even losing a toe to the disease.

So when Harvey, 53, was diagnosed with it, she was determined not to let diabetes get the better of her. After losing 55 pounds, making exercise routine and learning healthful eating habits, she no longer needs medication to control her glucose - or her blood pressure or cholesterol.

"People have no clue how serious diabetes is," Harvey says. "It affects everything from the top of your head to the bottom of your feet."

About 17 million Americans have diabetes; roughly 9 million are women.

Two to 5 percent of all pregnant women develop gestational diabetes, which puts them at increased risk for Type 2 diabetes later.

Women also suffer more serious complications than men: Diabetes can cause miscarriage and fertility problems in women, as well as premature death and birth defects in their babies. Women are more likely to lose their eyesight because of diabetes. And women are more likely to develop and die from heart disease, one of the most serious complications of diabetes.

Harvey gets her eyes and heart function checked; so far, she's doing great.

Harvey was diagnosed with Type 2 diabetes in August 2001. She went in for a checkup because she was tired all of the time. She assumed she was entering menopause.

Angel Denson of West Chester Township must check her blood sugar level anywhere from three to six times a day. (Glenn Hartong photo)

"So the doctor did some blood work and - bingo! - I was diabetic," she says.

Her sister and brother both have the disease, so she wasn't surprised by the diagnosis. Harvey blames genetics and being more than 50 pounds overweight at the time.

She started taking Glucophage to regulate her blood sugar; she didn't need insulin.

She also changed her eating habits and started exercising regularly. Most days she walks for an hour around her Bellevue neighborhood. When the weather's bad, she jumps rope.

"I feel guilty now if I don't do it," she says.

New habits succeed

Her new habits worked: She doesn't need the Glucophage anymore, or the medications she was taking for high cholesterol and high blood pressure.

"I have a new lease on life or something," Harvey says. "I just have all this energy. I do anything I want now."

Angel Denson, 58, of West Chester Township was diagnosed with Type 2 diabetes in 1998.

"I started having concentration problems and memory problems and feeling tired a lot," she says.

Eventually, she had to quit her job because of her health problems. Now she works part time, keeping her condition under control with medication.

She checks her blood sugar three to six times a day, "depending on how I'm feeling."

Madalyn St. Clair, 77, of Clermont County's Union Township learned she had diabetes after a physical in 1985. She never had any reason to suspect she had it.

Now St. Clair takes insulin daily and exercises by walking and working in her garden.

"My eyes and feet are doing really well. I don't think I've had any problems."

Risk factors

Women can track their diabetes risks across their life stages, says Dr. Vina Bajaj, an endocrinologist at St. Elizabeth Medical Center South in Edgewood.

In addition to increased risk during childbearing years, menopause, age and increased weight raise the risk of diabetes and heighten its potential to damage the cardiovascular system: Postmenopausal women lose estrogen's heart-protective benefits, so when diabetes is added to the mix, there's more risk for death or disability related to heart disease.

Other factors also increase women's risk for diabetes: They are more likely than men to be overweight.

They live longer, and age is a primary risk factor for diabetes. Women tend to have lower-paying jobs and less access to health care as they get older, which makes diagnosing and managing diabetes and its complications more difficult.

Women are also more likely to have Syndrome X, a combination of obesity, high blood pressure, high cholesterol and insulin resistance that often precedes Type 2 diabetes, Bajaj says.

Lifelong commitment

Diabetes is a lifelong balancing act. Denson is fighting a weight problem, but making progress. St. Clair struggles especially with low blood sugar.

For Harvey, finding out she was diabetic was a wake-up call. Once restless since retirement from Cincinnati Bell and exhausted from diabetes, she's now energized with regular exercise.

She's even planning on going back to work - just as soon as she finishes her training to become a custom framer.

"I was diagnosed and I got my life back in gear. It's changed my life," she says.

How not to get diabetes

Many of the risk factors for Type 2 diabetes can't be avoided: Genetic factors, race and aging all play a big role in who gets the disease.

But findings released last year by the Diabetes Prevention Program Research Group found that lifestyle changes (eat right, exercise, don't get too heavy) substantially cut people's risk of developing diabetes. The group's findings:

People who lost 7 percent of their body weight in one year (about 12 pounds, on average) reduced their risk of diabetes more than people who used metformin, a drug used to treat diabetes. On average, subjects who lost weight cut about 450 calories a day and cut their fat intake by about 7 percent.

Test subjects who exercised at least 150 minutes a week (that's half an hour, five days a week) reduced their risk of diabetes more than subjects who took metformin.

Overall, the incidence of diabetes was 58 percent lower among test subjects who lost weight and exercised than subjects who took a placebo in last year's study.

The decrease was 31 percent among test subjects who took metformin.

Lifestyle changes were successful for test subjects in all higher-risk ethnic groups, including blacks, Hispanics, American Indians and Asians.

Diabetes at a glance

Women make up more than half - 9.1 million out of 17 million - of Americans with diabetes. The federal government, in cooperation with the American Diabetes Association and other groups, is working to educate women on the dangers of diabetes and reduce its incidence among women. Some facts about diabetes:

Approximately 8.9 percent of American women have diabetes, but roughly a third of them don't know it.

Two to 5 percent of all pregnant women develop gestational diabetes, which disappears when the pregnancy ends. But women who develop gestational diabetes are more likely to develop Type 2 diabetes later in life.

Women with diabetes are more likely to die from heart disease than men and women without diabetes. Over the last 30 years, heart disease deaths have increased 23 percent among women with diabetes, while heart disease deaths have decreased 27 percent among women who don't have diabetes.

Women with diabetes are 50 percent more likely than men with the disease to develop diabetic ketoacidosis, or diabetic coma caused by lack of insulin.

Women with diabetes are 7.6 times as likely to suffer peripheral vascular disease - decreased blood and oxygen flow to the legs and feet - than non-diabetic women. Intermittent claudication, or pain in the thigh, calf or buttocks during exercise, is the principal symptom of peripheral vascular disease.

Diabetic women with intermittent claudication are three to four times more likely than non-diabetic women to die of coronary heart disease, stroke or heart failure.

Diabetic women are more likely to suffer complications during pregnancy than non-diabetic women.

Complications

Diabetes is the sixth leading cause of death among American adults, and it contributes to many other potentially fatal ailments, including heart disease and stroke. Diabetes contributes to:

Heart disease

Stroke

High blood pressure

Blindness

Kidney disease

Nerve damage

Lower-limb amputations

Dental disease

Pregnancy complications, including birth defects and miscarriage

Coma

Immune vulnerability

Sources: American Diabetes Association; Centers for Disease Control and Prevention; Diabetes Prevention Program Research Group

E-mail pofarrell@enquirer.com