MARIPOSA -- Diabetes is unlike any other disease -- it's complicated and the success or failure is in the patient's hands.
Dr. Robert Horvat, an endocrinologist specialist at John C. Fremont Healthcare District in Mariposa, said the disease is so complex that he had to spend two years training specifically to learn about it. Once a person becomes inflicted, diabetes will never go away.
Horvat says about 90 percent of the responsibility to treat the disease falls on the diabetic. "You are responsible for its daily treatment," he said.
There are three types of diabetes. Type I is mostly found in juveniles. Type II is commonly found in adults. Type III, which is gestational, is common in pregnant women. Horvat said type II is the main one, and is mostly caused by lifestyles, such as being overweight or obese.
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Some 34 percent of residents in Merced County are obese, according to a UCLA Health Policy Research study. The county has the second-highest obesity rate in the state.
Mariposa County is not so far behind. About 25 percent of the residents in the county are obese, according to the study.
Dr. Kenneth Smith, who works at the emergency room at the health care district in Mariposa, said many of the cases seen in the emergency room related to diabetes stem from high-blood and low-blood sugar, as well as infections. High-blood sugar in diabetics is caused by missing a dose of medication, not following a diet or by infections. Low-blood sugar is often caused by too much medication. "I'm sure it's hard to be perfect," he said about the steps that need to be followed for daily treatment.
People don't die of diabetes, but of complications related to the disease, Smith said.
Horvat said the long-term health complications of diabetes include heart attacks, strokes, amputations, kidney failure and blindness. "The most common reason for blindness in the U.S. is diabetes," he added.
According to Horvat, the longer a person has diabetes, the worse it becomes. The key is learning how to control it.
He has five patients in Mariposa who are over 90 years old, have a 30-year history of diabetes and are still around. "They are still walking," he said. "It can be done."
Most importantly, diabetes can be prevented.
Horvat said a person can avoid the disease with a low-fat diet and at least 30 minutes of exercise every day. "It doesn't matter what kind of exercise," he said. "Just don't sit."
Chuck Newcomb, a consulting dietitian for the health care district, said if a person faces limits in exercising, emphasis should be placed on the nutrition side.
People should spread carbohydrates throughout the day and eat more whole grains and fibers, he said. They also should limit fruit to one portion at a time, and eat no more than one teaspoon of salt a day. "Whatever you do, try to make sure it's something you can do for the rest of your life," he said of a healthy diet.
One in every four Americans has pre-diabetes, and many of them don't even know it, according to Horvat. Latinos suffer a much higher diabetes prevalence.
The experts spoke about the disease during a community wellness program Wednesday evening in Mariposa. The program, meant to educate the community about health issues, was presented by the health district, the John C. Fremont Hospital Foundation and the Mariposa County Health Department.
Reporter Yesenia Amaro can be reached at (209) 388-6507, or firstname.lastname@example.org.