DIABETES DEMANDS DAILY CARE

Hamner Hill, 37, is chairman of the philosophy department at Southeast Missouri State University in Cape Girardeau, an avid bicyclist, coach of the university fencing team and an active competitor in the sport, and also is a student of the martial arts.

At first glance, you'd never suspect that Hill also is a diabetic who must take daily shots of insulin.

Hill is one of more than 13 million people in the United States who have diabetes, a disease in which the body does not produce or properly use insulin.

Insulin is a hormone the body needs to convert sugar, starches and other food into energy.

Janet Stewart, a registered nurse and diabetes patient educator at Southeast Missouri Hospital in Cape Girardeau, said the cause of diabetes remains unknown, although its origin appears to be linked both to genetics and environment.

Unfortunately, diabetes is a chronic disease. And although there is no cure, diabetes can be controlled.

Stewart said there are two types of diabetes: insulin dependent and non-insulin dependent.

"Children and adults with Type 1 diabetes are not able to produce any insulin from their pancreas and must take daily insulin injections to stay alive," she said. "Those with Type 2 diabetes are able to produce enough insulin to control the diabetes with oral medication."

Stewart said many people first become aware that they have diabetes when they develop one of its life-threatening complications, such as blindness, kidney disease, poor circulation that often results in the amputation of the legs or feet, heart disease and stroke.

When diagnosed early, diabetes can be controlled and the person can lead a nearly normal lifestyle.

Hill, a native of the Washington, D.C., Beltway in northern Virginia, was diagnosed as a diabetic in the summer of 1985, while he was a graduate student at Washington University in St. Louis.

Like most diabetics, Hill was unaware he had the disease. In addition to the normal stress of graduate work, Hill also was cycling 50-60 miles per day, and participating in competitive fencing.

"I had lost a lot of weight and I couldn't gain any weight," said Hill, who weighed only 130 pounds when he was diagnosed. He now weighs about 195. "I always felt tired and thirsty, but I attributed all of this to my physical activities."

Then one day Hill read in a magazine a public service ad that highlighted the seven symptoms of diabetes.

"The next day, I went to the university clinic and told them I was diabetic," he said. "They gave me a urine test and said I was right."

The physician who examined Hill also was a diabetes counselor, so Hill immediately learned how to give himself the daily insulin injections.

"The doctor told me, `You're going to be doing this everyday for the rest of your life, so you might as well learn how to do it right now,'" Hill said. "She handed me a bottle of insulin and a syringe, and I gave myself my first insulin shot."

Unlike many diagnosed diabetics, Hill did not have to make any drastic changes in his eating habits or lifestyle.

"I already had what you could call a pretty healthy diet with very little sweets and lots of carbohydrates, fruits and vegetables, so I did not have to make much of an adjustment," he said.

Stewart said that when a person is diagnosed as a diabetic it involves other family members as well. Hill's wife, Peggy, quickly learned how to help her husband control his diabetes.

She learned to watch for the warning signs of diabetic shock, and how to give the insulin injections in an emergency.

Stewart said the warning signs of Type 1 diabetes are frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue, and irritability.

The warning signs of Type 2 diabetes are any of the Type 1 symptoms, in addition to frequent infections, blurred vision, cuts or bruises that are slow to heal, tingling or numbness in the hands or feet, and recurring skin, gum or bladder infections.

Hill said that once, a few months after he was diagnosed, he was walking in the yard and, the next thing he remembered, he was in the back of an ambulance en route to the hospital after suffering diabetic shock.

Now, no matter where Hill goes, he takes along a small black bag that includes his insulin supply, extra syringes, glucose tablets and an electronic blood test machine.

At least twice a day, Hill tests his blood to determine the level of blood sugar. The test enables him to take the right dose of insulin.

On more than one occasion, Hill has raised eyebrows when going through baggage inspection at airport terminals. He said, "When the inspectors open the bag and see the syringes and the electronic equipment, they really get excited until they find the bottles of insulin. Then they put it all back in the bag, and I'm on my way."

Unlike most diabetics, Hill takes his insulin shots four times a day. This gives him more freedom at work and for recreational activities. He continues to ride his bicycle, participate in competitive fencing, and martial arts.

"Of course when I compete I have to be careful to watch my blood sugar level," Hill said. "But overall my diabetes has not had that much of an impact on my lifestyle. I've just learned to adjust to the demands of the disease."

Hill said the primary drawback, as a native Virginian, is his inability to enjoy his favorite desert -- pecan pie -- which he said is "loaded with sugar, sugar, sugar."

He's also had to replace glazed donuts for breakfast with bagels. Salad lunches also present problems if there are no carbohydrates are available.