Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.
Deborah Howell (Host): Hello, welcome to the show. You're listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. I'm Deborah Howell. Today's guest is Linda Kerr, a nurse practitioner and certified diabetes educator. Kerr specializes in diabetes management across all settings, including private practice, acute outpatient care, and community programs. Kerr is the diabetes program director at Long Beach Memorial, where she developed a comprehensive diabetes education team committed to providing diabetes-related resources, clinical interventions, and education to hospitalized patients. She developed the Adult Outpatient Diabetes Program, achieving American Diabetes Association ADA recognition in spring of 2012, and led the team to achieve the Joint Commission's Advanced Inpatient Diabetes Disease Specific Care Certification for Long Beach Memorial in fall of 2012. A lot of big words, but it just means she really loves what she does. Welcome to you, Linda.
Linda Kerr, RN: Thank you, Deborah.
Deborah Howell (Host): Okay, let me set things up and then I'm gonna let you roll. We will be talking about diabetes today. Nearly twenty-six million Americans have diabetes, according to new estimates from the CDC. In addition, an estimated 79 million U.S. adults have prediabetes, a condition in which blood sugar levels are higher than normal. Okay? Now, diabetes is the seventh leading cause of death in the United States. People with diabetes are more likely to suffer from complications like heart attacks, strokes, high blood pressure, kidney failure, blindness, and amputations of feet and legs. It just goes on and on and on. So Linda, my first question to you today is what is prediabetes?
Linda Kerr, RN: Prediabetes is what people used to call borderline diabetes. It's that place in between where you don't have diabetes and the place where you do have diabetes, the diagnosis. And it just means that at some place in your day or in your week, your sugars run higher and they just don't trend back down into a normal pattern. The nice thing about prediabetes is that you can hold off diabetes indefinitely with lifestyle changes.
Deborah Howell (Host): Okay.
Linda Kerr, RN: And that just means paying attention to good nutrition and being active. And looking after your blood pressure and your cholesterol, making sure that your numbers are there or within the recommended targets, and you can live healthfully, indefinitely without progressing on to diabetes. What people need to know about prediabetes, however, is that it does carry with it, if untreated, as high a risk for heart attack and stroke as diabetes.
Deborah Howell (Host): That's incredible. And I bet many, many people are walking around with pre-diabetes that don't even know it.
Linda Kerr, RN: Many people are. Many people are. So it's just a simple blood test now. We call it a hemoglobin A one C. The doctor can order it and add it onto your labs. You go to the lab to get your blood drawn and it's just one of the blood tests that can be done and it can really tell your physician and you where you are in the diabetes spectrum.
Deborah Howell (Host): Boy, if more people did that, they could really, really help themselves out.
Linda Kerr, RN: This is true. This is true. And people sometimes are nervous about knowing whether they have diabetes or prediabetes, blood pressure, cholesterol. And yet if you are armed with knowledge and the goal to make good nutrition choices, to make yourself a little bit more active and just the knowledge that you can make really good changes in your health with very small adjustments really.
Deborah Howell (Host): And you'll feel better mentally too, right?
Linda Kerr, RN: Absolutely. Absolutely.
Deborah Howell (Host): What are the signs and symptoms of diabetes?
Linda Kerr, RN: Well, first of all, if you - iit sort of begins with a discussion of what is diabetes and we think of diabetes as either type one or type two. And type one diabetes is an individual that just doesn't make insulin at all. So they have to bring their insulin in with shots. And symptoms for somebody with type one diabetes onset, it's very dramatic, it's very noticeable. Thirst, blurred vision, lots of urination, a big weight drop, very rapid weight drop, and maybe ten or so pounds in a week. It's very noticeable. For type two diabetes, now this is a person who still makes their own insulin, maybe they make plenty of insulin, but they just can't get over there and use it very efficiently. We call that insulin resistance. And about eighty percent of people with type two diabetes have a state of insulin resistance. And this by far is the most common type of diabetes. So what I wanted to say about type two is that the symptoms are therefore very subtle and quiet. You can have type two diabetes for five to ten years and never know that you have it. And it's because your fasting blood sugar holds normal for a very long time. And when you go to get your labs drawn, you go to get your blood drawn, your doctor tells you to go fasting and so the blood sugar looks pretty good for a long time. It's your two hour post meal blood sugar that goes up and stays up.
Deborah Howell (Host): I see.
Linda Kerr, RN: And so therefore a lot of times with type two you're not really aware that you have the slow onset of blurred vision or thirst or that you're urinating more, you're getting up more in the middle of the night to go to the bathroom. But these things are kind of creeping up slowly.
Deborah Howell (Host): That's fascinating. Okay, so what if your father has diabetes? Does that raise your risk?
Linda Kerr, RN: The interesting thing about type two diabetes, it does have a strong link to genetics and if you do have a family history of diabetes, likely you're hardwired with the ability to go on and develop type two diabetes and so therefore it's just more information. It's good information to know. Look, I have it in the family. And therefore I have to look after a few things. I have to make good nutrition choices. I have to stay active. As a female, I would like my waist circumference to be less than thirty-five inches. As a male I'd like my waist circumference to be less than forty inches.
Deborah Howell (Host): Okay.
Linda Kerr, RN: And just stay healthy because I know in the family I have diabetes.
Deborah Howell (Host): Can diet or exercise really prevent diabetes?
Linda Kerr, RN: Diet and exercise are very excellent lifestyle interventions that one can do. This is empowering to an individual because this is something that we have control over. So it makes a very large difference. Exercise, just a thirty minute walk most days of the week will adjust your blood sugar from something a little bit higher to a little bit lower. And it's just so much better than once a week an hour in the gym. And almost every day.
Deborah Howell (Host): Even if you're working around the house, you almost do that thirty minutes in a day.
Linda Kerr, RN: If you're cleaning the house and you have a sustained activity of twenty or thirty minutes going around and vacuuming and dusting and doing all of those things, it's all beneficial.
Deborah Howell (Host): So, what steps can people take to create a healthy eating plan to help control their blood sugar and manage their weight in addition to the exercise?
Linda Kerr, RN: Nutrition is a very big topic and this is a topic that most people who have diabetes or they're thinking about they have prediabetes and they'd like to make some good changes. These are the big questions for people with diabetes. And I will tell you that everything that I know about nutrition and all of the pearls and the really good stuff I picked up from my dietitian friends. And so I really encourage people with diabetes to make that connection with their dietitian because they're just gonna learn so much. The things that I share with my patients are three categories. Decrease and monitor the amount of carbohydrates that you have per meal. A carbohydrate is anything that's a starch, a bread, pasta, rice, potato, all your fruits, your vegetables, your milk, your cereals. You would like to have as a female two to three servings of carbohydrate per meal.
Deborah Howell (Host): Okay.
Linda Kerr, RN: A male, three to four servings of carbohydrate per meal. And you would like your choice of carbohydrate to have lots of good natural fiber. And that's why we say fresh fruit, fresh vegetable, whole grain, because that fiber is going to break down very nicely in your system and not allow all of that sugar to absorb over into your body.
Deborah Howell (Host): Wonderful information. Now for our listeners who may have diabetes, we are out of time, but I think we have time to get information about any support group that you'd like to share.
Linda Kerr, RN: Oh, excellent. We have both English and Spanish support groups. They meet on the fourth - the English support group meets on the fourth Monday of each month. The Spanish support group meets on the fourth Tuesday of each month. Those support groups meet at the Columbia Building here on the Long Beach Memorial hospital campus. And we are in suite two ten. And the address is twenty eight forty.
Deborah Howell (Host): Thank you so much, Nurse Linda Kerr! You can get more information on the MemorialCare Health System website. We want to thank you so much for being on the show and wish all of our listeners a very fantastic day. I'm Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness.
