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Tuesday, February 7, 2023


Oct. 7, 2001 – Local residents diagnosed with diabetes mellitus don't have to go it alone. The Diabetes Association of the Virgin Islands, under the direction of its president, Steve Prosterman, is resuming monthly support group meetings.
Diabetes mellitus is a disease in which the body does not produce or properly use insulin, a hormone needed to convert sugar, starches and other food into energy needed for daily life. The exact cause of diabetes remains a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play key roles.
There are two major types of diabetes. Type 1, or juvenile diabetes, occurs when the body stops making insulin. People with Type I diabetes, mostly children and young adults, must take daily insulin injections to survive. Type 1 accounts for 5 to 10 percent of all cases of diabetes. People develop Type 2 diabetes when their bodies becomes unable to make enough — or to properly use — insulin. Type 2, the most common form of the disease in adults, is nearing epidemic proportions, mainly due to increased obesity and sedentary lifestyles.
Data from the Behavior Risk Factor Surveillance System, which involves collecting information regularly on the V.I. population, indicate that diabetes mellitus is the third leading cause of death among residents in the territory.
Prosterman, a diabetic for the last 34 years, started the local association in 1987. "There were lots of good people with information to share, but the word wasn't getting out enough," he recalls. "People with diabetes didn't seem to know they had a say in their disease, or that life-threatening complications weren't inevitable."
At first, Prosterman focused on children with diabetes. "But then I saw there was a need for everyone," he says. The group met regularly for years, then hit a slump in the mid-1990s and became inactive, except for the summer camp he conducts each year at Lameshur Bay on St. John.
Last year, Kieva Rogers, a senior nursing student at the University of the Virgin Islands, approached Prosterman about resuming the group. "Kieva put a lot of energy into it, and it went over well," he says. "We had seven to eight kids and their parents attending through the winter and spring," he says. "My promise to her was to carry on with the group after she graduated."
The purpose of a support group is to share information, suggestions and practical living tips, Prosterman says. "Everyone comes away with something important they've learned. Maybe it's something basic like how to guestimate accurate portion sizes, or something more technical like the importance of testing blood sugar regularly."
Self-care is the first and fundamental step
Speakers include local physicians, pharmacists and ophthalmologists. But often group members themselves help and guide one another. "Many times people who have diabetes are too passive," Prosterman says. "They think if they just pop a pill, they'll be okay. They have to learn the importance of taking care of themselves. If they learn that, they can prevent complications."
The most important advice Prosterman offers for someone who has diabetes is to "start with the basics. Take your medicine, follow your diet and exercise." He says the people he's known "who have had diabetes for many years and who are active are the ones without complications. It's the ones who aren't active that are losing limbs, having kidney failure and going blind."
Another fundamental point, Prosterman says, is to test blood sugar often. "It can be expensive, but without a record of blood sugar readings it's hard for physicians to know what's going on and to prescribe the best treatment," he says. For those afraid of sticking themselves to get blood for a sugar reading, he offers two tips: "Use a little-used finger like the pinky or ring finger, and stick on the sides of the finger where there are fewer nerve endings rather than the middle fleshy part."
Oneday soon it may become easier for squeamish diabetics to monitor their blood sugar. "There is research into a nasal mist insulin and non-invasive blood sugar testing like with the GlucoWatch(r)," Prosterman explains. The GlucoWatch(r) is a glucose-monitoring device that is worn like a wristwatch. It takes glucose readings via an extremely low-level electric current that pulls glucose through the skin and reports readings on a numerical display screen as often as every 20 minutes and for up to 12 hours at a time.
Further in the future is a cure for diabetes in the form of transplants of insulin-producing beta cells from the pancreas. When he spoke at the Juvenile Diabetes Research Foundation earlier this year, Prosterman met a woman who was cured of diabetes after receiving a transplant of such cells. "The problem is that it takes two to three cadavers to get enough beta cells to transplant," he explains. "This means that demand is high but resources are low. That's why stem cell research is so important."
The stem cell is a type of body cell that has a unique capacity to renew itself and to give rise to specialized cell types that can be directed to perform a variety of vital functions, including producing insulin.
Since symptoms of diabetes — thirst, hunger, the urge to urinate often, cuts and bruises that heal slowly, dry itchy skin, feelings of weakness and numbness in hands and feet — can be easy to ignore, it's possible for someone to have the disease and not know it. In fact, statistics indicate that for every person diagnosed as having the disease, there is another person who is undiagnosed.
"If you're overweight and have a family history of diabetes, it's important to get a thorough check-up," Prosterman says. "People often wait until something extremely serious or life-threatening happens, but the complications from diabetes are fairly easy to control with diet, exercise and medication. People with diabetes need to know they have the power to prevent these problems from happening."
The next meeting of the Diabetes Association of the Virgin Islands support group is scheduled for mid-October. For specific information, contact Prosterman by calling 693-1399 or e-mailing to sproste@uvi.edu.

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