Dealing with diabetes: Lifestyle change, insulin manage disease, as Cape Girardeau man shows

Tuesday, April 21, 2009
Robert Stephens measures out his daily insulin shot Saturday in Cape Girardeau. Stephens, who has had diabetes for a decade but only began taking insulin last year, calls it a" mild inconvenience," but not life changing. (KIT DOYLE ~

In one year, Bob Stephens's health changed dramatically. But he didn't let it sidetrack his approach to life.

It started more than 15 years ago, when the Cape Girardeau man decided to quit his pack-and-a-half daily smoking habit, working his way down to "10 or 12 cigarettes a day," he said. "Then my appendix burst, which was completely unrelated."

But the emergency surgery and a week in the hospital completed his conversion to a smoke-free lifestyle.

After the incision didn't heal as well as expected, his doctor tested Stephens and diagnosed a mild form of Type 2 diabetes.

Diabetes is what happens when the pancreas either cannot make insulin (Type 1 diabetes) or the body can't efficiently use the insulin produced (Type 2 diabetes). Pregnant women sometimes develop a temporary insulin resistance, called gestational diabetes.

Insulin is a hormone that helps cells use glucose, a form of simple sugar that works to fuel the body the way gasoline works in a car. Uncontrolled, diabetes can cause such complications as blindness, kidney damage, nerve damage and cardiovascular disease, or require foot or leg amputations.

Symptoms can include some combination of unexplained weight loss, extreme hunger, sudden vision changes, frequent urination, tingling or numbness in the hands or feet, more infections than normal and slow healing and unusual tiredness. Stephens said his only symptom was the post-surgical healing problem.

With a balanced diet, exercise and other lifestyle changes, the effects of diabetes can be reduced or eliminated. More than 90 percent of diabetes diagnoses in the United State are for Type 2, according to the U.S. Centers for Disease Control and Prevention.

Robert Stephens gives himself an insulin shot every morning. (KIT DOYLE ~

Mary Etta Dunaway, a registered dietitian and certified diabetes educator with Southeast Missouri Hospital's Diabetes Center, said people are often devastated to learn they have diabetes. Stephens was surprised by his diagnosis.

"I don't have any history of diabetes in my family," Stephens said. The Cape Girardeau man laughed when recalling that, initially, he didn't need to take any medication, but his doctor suggested losing 15 pounds.

"I'm 6-foot-4 and back then I weighed about 180 pounds," he said, shrugging. At first, he modified his diet and didn't need any medication. Now 66, Stephens does take insulin twice a day, administering the doses using a small syringe.

He checks his blood sugar levels daily, faxing information on a monthly basis to his doctor, and keeps quarterly office appointments to monitor the diabetes. Though he recently started exercising at least three times a week at Saint Francis Medical Center's Fitness Plus, Stephens said he has not let the diabetes create roadblocks in his lifestyle.

"I do what's reasonable. For me," he said.

Dunaway said the most confusing aspect of diet management for the newly diagnosed is figuring out how to use or avoid carbohydrates by creating a personalized meal plan.

"Milk, breads, starches, fruit -- all of those foods are good for you, but too many will raise your blood sugar," she said.

Eating at regular intervals, "whether you want it or not, whether you're hungry or not, whether you have time or not," Dunaway said, gives the body an even supply of carbohydrates, keeping the blood sugar on an even keel and will reduce cravings and inappropriate snacking.

Stephens -- whose busy life includes attending health lectures, hobbies such as volunteering for Civil Air Patrol, and enjoying close relationships with his three adult children and grandchildren -- said he sparingly includes his favorite food in his diet. At Thanksgiving and Christmas, his family knows there will be chocolate cream pie for dessert.

"You're not 'cheating' or being a 'good' or 'bad' person because you choose to eat a piece of chocolate pie," Dunaway said. "We never use the word 'willpower.' We say you make a conscious choice to eat off your plan. The result is an occasional higher blood sugar reading, but over three months, it won't change your blood sugar that much. Food is not the enemy."

Dunaway said Stephens seems to have found a "common sense, real-life approach" to managing his diabetes. Stephens, a retired U.S. Air Force mechanic, said he relies on a set of nine rules gathered during his world travels. He often hands out copies to those he meets.

Stephens' rules are: 1. You can only function to the level to which you have been trained. 2. We can only do so much; I (the person speaking) will only do so much. 3. Someone's failure to plan is no reason for me to panic. 4. There are some things that you have no control over. 5. You have three choices -- good, fast or cheap. Pick one. 6. We have been doing so much with so little for so long, now we are expected to do everything with nothing forever. 7. We will leave at the end of the shift. 8. I will be paid for all hours worked. 9. If you're not going to like the answer, don't ask the question.


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