Psychiatrists OK vast changes to diagnosis manual

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CHICAGO (AP) — For the first time in almost two decades the nation’s psychiatrists are changing the guidebook they use to diagnose mental disorders. Among the most controversial proposed changes: Dropping certain familiar terms like Asperger‘s disorder and dyslexia and calling frequent, severe temper tantrums a mental illness.


The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington, D.C., on scores of revisions that have been in the works for several years. Details will come next May when the group’s fifth diagnostic manual is published.












The trustees made the final decision on what proposals made the cut; recommendations came from experts in several task force groups assigned to evaluate different mental illnesses.


Board members were tightlipped about the update, but its impact will be huge, affecting millions of children and adults worldwide.


The manual “defines what constellations of symptoms health care professionals recognize as mental disorders and more importantly … shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care,” said Dr. Mark Olfson, a Columbia University psychiatry professor who was not involved in the revision process.


The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.


The guidebook’s official title is the Diagnostic and Statistical Manual of Mental Disorders. The new one is the fifth edition, known as the DSM-5. A 2000 edition made minor changes but the last major edition was published in 1994.


The manual “seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 … there have been important advances in our understanding of the nature of psychiatric disorders,” Olfson said.


Expected changes include formally adopting a term for children and adults with autism — “autism spectrum disorder,” encompassing those with severe autism, who often don’t talk or interact, and those with mild forms including Asperger’s. Asperger’s patients often have high intelligence and vast knowledge on quirky subjects but lack social skills.


Some Asperger’s families opposed the change, fearing their kids would lose a diagnosis and no longer be eligible for special services. And some older Asperger’s patients who embrace their quirkiness vowed to continue to use the label.


But experts say the change won’t affect the special services available to this group.


Catherine Lord, an autism expert at Weill Cornell Medical College who was on the psychiatric group’s autism task force, said anyone who met criteria for Asperger’s in the old manual would be included in the recommended new diagnosis.


One reason for the recommended change is that in some states and some school systems, children and adults with Asperger’s receive no services or fewer services than those given an autism diagnosis, she said.


Other proposed changes include:


—A new diagnosis — disruptive mood dysregulation disorder, which critics argued would medicalize kids’ normal temper tantrums. Supporters said it would address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings from feeling sad and depressed to unusually happy or energetic. Affected children are sometimes very irritable or have explosive tantrums. The new diagnosis would be given to children and adults who can’t control their emotions and have frequent temper outbursts in inappropriate situations.


—Eliminating the term “dyslexia,” a reading disorder that causes difficulty understanding letters and recognizing written words. The term would be encompassed in a broader learning disorder category.


—Eliminating the term “gender identity disorder.” It has been used for children or adults who strongly believe that they were born the wrong gender — they dispute their normal biological anatomy. But many activists believe the condition isn’t a disorder and say calling it one is stigmatizing. The term would be replaced with “gender dysphoria,” which means emotional distress over one’s gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.


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Online:


Diagnostic manual: http://www.dsm5.org


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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Man killed his father in Wyoming community college attack

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CASPER, Wyo. (AP) — Police released more details Saturday of a grisly murder-suicide at a Wyoming community college, saying a man shot his father in the head with a bow and arrow in front of a computer science class not long after fatally stabbing his father's live-in girlfriend at their home a couple miles away.

Computer science instructor James Krumm, 56, may have saved some of his students' lives Friday by giving them time to flee while trying to fend off his son, Christopher Krumm, 25, of Vernon, Conn., Casper Police Chief Chris Walsh said.

"I can tell you the courage that was demonstrated by Mr. Krumm was absolutely without equal," he said, adding that his actions could offer some measure of comfort to those affected by the killings.

He said police still were trying to figure out what motivated Christopher Krumm to attack his father and girlfriend, 42-year-old Heidi Arnold, a math instructor at the college. Arnold was found stabbed to death in front of the home she shared with James Krumm.

After shooting his father with the arrow, Christopher Krumm stabbed himself, then fatally stabbed his father in the chest in a struggle in the classroom, Walsh said.

Police arrived to find James Krumm dead and Christopher Krumm barely living; the younger Krumm died soon after students fled in a panic. Authorities locked down the campus for two hours.

Police began getting reports about the attack on Arnold soon after they responded by the dozen to the campus attack.

Christopher Krumm had smuggled the compound bow — a type much more powerful and effective for hunting than a simple, wooden bow — onto campus beneath a blanket, Walsh said.

He said Krumm also had two knives with him and the knife used was "very large."

"It's one of those situations you don't think is going to come home. It's not going to happen here," Walsh said.

Arnold died of multiple stab wounds. Her body was found in the gutter of her street. Evidence suggested much of the attack occurred outside the home, Walsh said.

Christopher Arnold had recently driven to Casper from Connecticut and had been staying at a local hotel. He had no significant history of encounters with police.

Police were uncertain what went awry in Christopher Krumm's relationship with his father.

"It's difficult to say. I don't think it was very close," Walsh said.

Casper, population 56,000, is about 250 miles northwest of Denver and Wyoming's second-largest city after the state capital, Cheyenne. Wyomingites refer to Casper as the "Oil City" because it is a hub of the state's small oil industry.

Casper College is one of seven colleges in Wyoming's community college system. The campus was mostly quiet Saturday morning. Fathers and sons shot hoops in the school gym. A small group of drama students rehearsed a play in the school theater just across the street from the attack.

The building where the attack happened remained cordoned off by police tape that whipped in a brisk wind. A security guard let students back in, one at a time, to retrieve belongings they'd left behind.

Andra Charter, a 20-year-old sophomore, emerged with a coffee mug. She recalled hearing screams outside her biology class before getting word about what had happened.

"As we were walking out, there was a girl screaming, 'There's somebody stabbing Mr. Krumm!'" Charter said.

No students were hurt in the attack.

Krumm was head of the college's computer science department. He was born north of London and also spent part of his childhood in Germany, according to the college website.

He held degrees from Casper College, a bachelor's degree and MBA from the University of Wyoming, and a master's in computer science from Colorado State University.

Arnold held a master's degree in mathematics from the University of Oregon and a bachelor's degree in math from University of California Davis.

The college planned a candlelight vigil and memorial service Tuesday.

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Oliver Stone, Benicio del Toro visit Puerto Rico

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SAN JUAN, Puerto Rico (AP) — Benicio Del Toro didn’t wait long to collect on a favor that Oliver Stone owed him for working extra hours on the set of his most recent movie, “Savages”, released this year.


The favor? A trip to Del Toro‘s native Puerto Rico, which Stone hadn’t visited since the early 1960s.












“I told him, you owe me one,” Del Toro said with a smile as he recalled the conversation during a press conference Friday in the U.S. territory, where he and Stone are helping raise money for one of the island’s largest art museums.


Del Toro, wearing jeans, a black jacket and a black T-shirt emblazoned with the name of local reggaeton singer Tego Calderon, waved to the press as he was introduced.


“Hello, greetings. Is this a press conference?” he quipped as he and Stone awaited questions.


Both men praised each other’s work, saying they would like to work with each other again.


“I deeply admire him as an actor, the way he thinks, the way he expresses himself,” Stone said. “Of all the actors I’ve worked with, he’s the most interesting.”


Stone said Del Toro always delivers surprises while acting, even when it’s as something as subtle as certain gestures between dialogue.


“I think Benicio is the master of keeping you watching,” he said.


Stone said he enjoys meeting up with Del Toro off-set because he’s one of the few actors in Hollywood who can talk about something other than movies.


“He is very interested in the world around him,” Stone said, adding that the conversations sometimes center around politics and other topics.


Del Toro declined to answer when asked what he thought about Puerto Rico’s referendum earlier this month, which aimed to determine the future of the island’s political status. He said the results did not seem to point to a clear-cut outcome.


Del Toro then said he would like the island’s movie business to grow, especially in a way that would encourage learning.


“I’m talking about movies in an educational sense, as a way to discover other parts of the world,” he said. “Create a film class. You’ll see, kids won’t skip it.”


Del Toro also shared his thoughts on being a father after having a daughter with Kimberly Stewart in August 2011.


He said the girl is learning how to swim and is discovering the world around her.


“She has her own personality,” Del Toro said. “She’s not her mother. She’s not me.”


Both Del Toro and Stone are expected to remain in Puerto Rico through the weekend to raise money for the Art Museum of Puerto Rico, which is hosting its annual movie festival and will honor Stone’s movies.


Museum curator Juan Carlos Lopez Quintero said the money raised will be used to enhance the museum’s permanent collection, especially with Puerto Rican paintings from the 19th century and early 20th century.


Latin America News Headlines – Yahoo! News


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Jelly Bean update for DROID RAZR HD and MAXX HD set to roll out next week

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Katy Perry, Carly Rae Jepsen get Billboard honors

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NEW YORK (AP) — Billboard named Katy Perry its woman of the year, but the pop star thought her year was 2011.


Perry was interviewed by Jon Stewart at Billboard’s Women in Music event Friday in New York City. The singer said she thought her moment had passed. Perry released “Teenage Dream” in 2010, and it sparked five No. 1 hits on the Billboard charts that spilled over to 2011. This year, she rereleased the album, which launched two more hits and a top-grossing 3-D film.












She thanked her mom at the event, which honored women who work in the music industry.


Newcomer Carly Rae Jepsen also thanked her mom — and stepmom — when accepting the rising star honor. The “Call Me Maybe” singer said she’s happy and surprised by her success.


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Awareness of HIV Risk Has Dropped Among Gay Men Even As Infection Rates Rise

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More than 30 years after the dawn of the HIV epidemic, the significance of the infection and awareness for how it’s transmitted has dropped precipitously among young people, especially among gay men, according to new data from the federal government.


National statistics for 2010 show that more than one-quarter of all new HIV infections are among youths ages 13 to 24. Of the estimated 47,500 new infections in 2010, more than 83% are among men.












Almost three-quarters are attributed to sex between men, and half of all new cases are among African Americans, according to data from the Centers for Disease Control and Statistics.


HIV prevalence among blacks is nearly three times higher than among Hispanics and nearly eight times higher than among whites. Men who have sex with men have prevalence rates nearly 40 times higher than other men,  the authors said.


MORE: HIV Vaccine Under Study May Last a Lifetime


An estimated half of HIV-positive young people are unaware they were infected. The study found that HIV testing was low — only 12.9 percent among high school students and 34.5 percent among people ages 18 to 24. Testing is less common among males compared to females and is lower among whites and Hispanics compared to African Americans.


“More effort is needed to provide effective school- and community-based interventions to ensure all youths, particularly men who have sex with men, have the knowledge, skills, resources, and support necessary to avoid HIV infection,” wrote the authors of the report.


The statistics  are sobering news as World AIDS Day approaches on Dec. 1.


“I think the statistics are alarming and that we should be alarmed,” Chris Collins, vice president and director of public policy at amFAR, The Foundation for AIDS Research, told Take Part. “I think that what we in the gay community need to come to grips with is HIV remains our number-one health equity issue.


MORE: Can HIV Prevention Be Found in a Pill?


In an essay published earlier this month on the amFar web site, Collins and co-author Jeffrey Levi said it’s time to refocus the HIV-prevention campaign among gay men. Young men who have sex with men represent the only group in which HIV incidence appears to be increasing, he says.


The alarming HIV incidence among gay men stands in contrast to the popular perception that the HIV threat is under control. Efforts by the LGBT community in the ’80s and ’90s resulted in an estimated 89 percent decline in HIV transmission over that time period, Collins says.


“I think the advent of life-saving AIDS drugs in the mid ’90s was both a wonderful thing that saved the lives of so many gay people but also meant that the gay community, to some degree, turned to many other challenges — understandably so,” he says.


MORE: More People Than Ever Living with HIV


Since then, efforts to educate a new generation of young people about HIV prevention have faded. The LGBT community is needed to reinforce the HIV prevention message, he says.


“We saw the power of the gay community in the ’80 and ’90s to confront this epidemic and mobilize the public and private sectors to address a problem that was devastating us,” Collins says. “We need to reconnect with our activism and focus from the 1980s and help everyone in the gay community get tested and get access to the care they need.”


AmFar recently published a brief, “Ending the HIV Epidemic Among Gay Men in the United States” that serves as an agenda for progress. The brief calls for utilizing the Affordable Care Act to improve HIV testing and treatment as well as to promote overall better health among LGBT people.


Stigma is another big reason why people with HIV or who are at higher risk for the infection don’t get the healthcare they need, Collins adds.


MORE: FDA Approves Truvada as First HIV Prevention Drug


“We know for sure is stigma is a huge part of the HIV epidemic in the United States,” he says. “It impedes people from learning their HIV status, getting the care they need and talking to their doctors openly.”


The U.S. Preventive Services Task Force, which advises the federal government on health policy, earlier this month issued preliminary guidelines calling for routine HIV screening as part of a check-up.  In 2006, the CDC recommended that doctors routinely test all patients for HIV, regardless of risk,  however only people at increased risk for HIV were eligible for free HIV screening. The USPSTF recommendation would mean more people could be tested without having a co-pay.


The task force also recommended that people at high risk for infection be tested at least once a year.


“The recommendation from the commission is a hopeful sign and the kind of thing we need to encourage health providers to offer testing,” Collins says. “We need to have HIV testing readily accessible and routine in all kinds of environments. It ought to be something doctors and nurses regularly offer. For gay men, they ought to be getting HIV tests regularly, not just every couple of years but perhaps every six months.”


MORE: Transgender Healthcare: A Work in Progress


Collins says he expects HIV prevention will re-emerge as a top priority in the LGBT community. The topic will be prominent at the 25th National Conference on LGBT Equality: Creating Change, in January in Atlanta.


“There are a variety of efforts going on to engage the gay community,” he says. “I think we’re going in the right direction.”


Question: Why do so few young people get tested for HIV? Tell us what you think in the comments.


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Pelosi will try to force vote to extend tax rates

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House Minority Leader Nancy Pelosi (Mark Wilson/Getty Images)


WASHINGTON—House Minority Leader Nancy Pelosi will try to force a vote on the House floor to extend current tax rates for the middle class next week if Republicans do not act, the California Democrat announced on Friday.


During a press conference on Capitol Hill, Pelosi called on House Republicans, who control the chamber, to hold another floor vote on whether to extend current tax rates for individuals who earn $200,000 or less and families making $250,000 or less. If they don't, Pelosi vowed to file a "discharge petition" that would force a vote if 218 House members sign it, which is unlikely.


The bill Pelosi wants to see put to a vote is identical to a measure passed in the Democrat-controlled Senate in July that extends the rates for middle-income earners for one year. House Republicans responded by rejecting the bill and passing their own measure that extends current tax rates for all income brackets.


"We're calling upon the Republican leadership in the House to bring this legislation to the floor next week. We believe that not doing that would be holding middle-income tax cuts hostage to tax cuts for the rich. Tax cuts for the rich, which do not create jobs, just increase the deficit, keeping mountains of debt for generations," Pelosi said. "To that end ... if it is not scheduled, then on Tuesday we will introduce a discharge petition."


Discharge petitions, which allow individual members of Congress to put a bill to a vote without committee or leadership approval, are rarely successful. In this case, Pelosi would need Republican support. But when asked if any Republicans had signaled that they would sign a discharge petition to force a vote, Pelosi responded, "No."


Pelosi said she wanted the bill passed so Congress will have more time to negotiate broader tax reform in 2013.


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Noisy city: Cacophony in Caracas sparks complaints

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CARACAS, Venezuela (AP) — This metropolis of 6 million people may be one of the world’s most intense, overwhelming cities, with tremendous levels of crime, traffic and social strife. The sounds of Caracas‘ streets live up to its reputation.


Stand on any downtown corner, and the cacophony can be overpowering: Deafening horns blast from oncoming buses, traffic police shrilly blow their whistles and sirens shriek atop ambulances stuck in bumper-to-bumper traffic.












Air horns routinely used by bus drivers are so powerful they make pedestrians on crosswalks recoil, and can even leave their ears ringing. Loud salsa music blares from the windows of buses, trucks with old mufflers rumble past belching exhaust, and “moto-taxis” weave through traffic beeping high-pitched horns.


Growing numbers of Venezuelans are saying they’re fed up with the noise that they say is getting worse, and the numbers of complaints to the authorities have risen in recent years.


One affluent district, Chacao, put up signs along a main avenue reading: “A honk won’t make the traffic light change.”


“The noise is terrible. Sometimes it seems like it’s never going to end,” said Jose Santander, a street vendor who stands in the middle of a highway selling fried pork rinds and potato chips to commuters in traffic.


Prosecutor General Luisa Ortega recently told a news conference that officials have started “putting an increased emphasis on promoting peaceful coexistence” by punishing misdemeanors such as violations of anti-noise regulations and other minor crimes. That effort has translated into hundreds of noise-related cases in recent years.


Some violators are ordered to perform community service. For instance, two young musicians who were recently caught playing loud music near a subway station were sentenced to 120 hours of community service giving music lessons to students in public schools.


Others caught playing loud music on the street have been charged with disturbing the peace after complaints from neighbors. Fines can run as high as 9,000 bolivars, or $ 2,093.


On the streets of their capital, however, Venezuelans have grown used to living loudly. The noisescape adds to a general sense of anarchy, with many drivers ignoring red lights and blocking intersections along potholed streets strewn with trash.


“This is something that everybody does. Nobody should be complaining,” said Gregorio Hernandez, a 23-year-old college student, as he listened to Latin rock songs booming from his car stereo on a Saturday night in downtown Caracas. “We’re just having fun. We’re not hurting anybody.”


Adding to the mess is the country’s notoriously divisive politics, which regularly fill the streets with marches and demonstrations.


On many days, the shouts of protesters streaming through downtown can be heard from blocks away, demanding pay hikes or unpaid benefits.


And the sporadic crackling of gunfire in the slums can be confused for firecrackers tossed by boisterous partygoers.


It’s difficult to rank the world’s noisiest cities because many, including Venezuela’s capital, don’t take measurements of sound pollution, said Victor Rastelli, a mechanical engineering professor and sound pollution expert at Simon Bolivar University in Caracas. But Rastelli said he suspects Caracas is right up there among the noisiest, along with Sao Paulo, Mexico City and Mumbai.


Excessive noise can be more than simply an annoyance, Rastelli said. “This is a public health problem.”


Dr. Carmen Mijares, an audiologist at a private Caracas hospital, said she treats at least a dozen patients every month for hearing damage caused by prolonged exposure to loud noises.


“Many of them work in bars or night clubs, and their maladies usually include temporary hearing loss and headaches,” Mijares said. For others, she said, the day-to-day noise of traffic, car horns and loud music can exacerbate stress and sleeping disorders.


Several cities have successfully reduced noise pollution, said Stephen Stansfeld, a London psychiatry professor and coordinator of the European Network on Noise and Health.


One of the most noteworthy initiatives, Stansfeld said, was in Copenhagen, Denmark, where officials used sound walls, noise-reducing asphalt and other infrastructure as well as public awareness campaigns to fight noise pollution.


But such high-tech solutions seem like a remote possibility in Caracas, where streets are literally falling apart and aging overpasses regularly lack portions of their guard rails. Prosecutors, angry neighbors and others hoping to fight the noise will have to persuade Venezuelans to do nothing less than change their loud behavior.


For Carlos Pinto, however, making noise is practically a political right.


The 26-year-old law student and his friends danced at a recent street party to house music booming from woofers in his car’s open trunk, with neon lights on the speakers that pulsed to the beat.


When asked about the noise, he answered: “We will be heard.”


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AP freelance video journalist Ricardo Nunes contributed to this report.


___


Christopher Toothaker on Twitter: http://twitter.com/ctoothaker


Latin America News Headlines – Yahoo! News


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Lohan arrested in NY, charged also for California car smash

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NEW YORK/LOS ANGELES (Reuters) – Actress Lindsay Lohan was arrested outside a New York nightclub on an assault charge early Thursday, police said, while in California, she was charged with reckless driving and lying to police over a car crash in June.


Lohan, 26, was arrested shortly after 4:00 a.m. (0900 GMT) on a third-degree misdemeanor assault charge after punching another woman in the face at a club in Manhattan’s Chelsea neighborhood, New York police said.












The charges in California were more serious, and could result in the “Mean Girls” actress having her probation revoked and being sent back to jail.


Lohan’s publicist and attorney did not return calls for comment on Thursday.


Lohan, who has been to rehab, jail and court numerous times since a 2007 arrest for drunk driving and cocaine possession, is currently on informal probation, following her January 2011 conviction for stealing a gold necklace from a California jewelry store.


A Los Angeles judge had lifted her formal probation in March but told her to comply with all laws and stay out of trouble.


Police in the beach city of Santa Monica said Lohan was formally charged on Thursday with reckless driving and lying to police after telling them she was not driving the Porsche that smashed into a truck on a busy highway. No one was seriously injured in the collision.


Lohan was also charged with obstructing an officer in his duty. A court date has not been set, Santa Monica police said in a statement.


In New York, Lohan was accused of punching a 28-year-old unidentified woman multiple times in the face, said New York Police Sergeant John Buthorn. The victim sustained “minor, minor injuries,” he said.


The actress was released from police custody later on Thursday morning.


The two incidents come during a rough week for the former child star, once one of the most promising young actresses in Hollywood.


Her most recent performance, as screen legend Elizabeth Taylor in the TV movie “Liz & Dick,” was panned by critics. Cable TV channel Lifetime said Monday that a modest 3.5 million Americans watched the film, which premiered last weekend.


Lohan’s recent visits to New York have been peppered with run-ins with police and public spats.


Last month, police were called to the Long Island home of Lohan’s mother, Dina Lohan, after a loud argument, though no arrests were made. In September, Lohan was arrested in Manhattan after a pedestrian told police her car had struck him in an alley, but charges were not filed.


(Reporting by Colleen Jenkins in New York and Jill Serjeant in Los Angeles; Editing by Xavier Briand and Bernadette Baum)


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Diabetes is a manageable disease

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After a family backpacking trip a couple weeks later, he weighed 66.












“It came on pretty quickly,” said Gildon, now 28, reflecting on what led up to his eventual diagnosis: diabetes.


He’s among the 26 million people in the United States with diabetes, according to the American Diabetes Association, which acknowledges November as American Diabetes Month.


The recently published Diabetes Report Card 2012 from the Center for Disease Control (CDC) listed Oklahoma as having had the highest increase in adult diabetes from 1995 to 2010, with nearly one in 10 Oklahomans having the disease.


Diabetes is a group of diseases characterized by high blood glucose, or blood sugar, the CDC’s report explained. With diabetes, the body either doesn’t produce enough insulin or is unable to use its own insulin effectively.


Glucose builds up in the blood and causes a condition that, if not controlled, can lead to serious health complications and even death, the report said.


At the time he was diagnosed, Gildon wasn’t familiar with diabetes.


On the way home from that aforementioned backpacking trip, Gildon kept asking his parents to make pit stops every 20 or 30 minutes. He was also thirsty.


Eventually, he started feeling bad. After the family made it home, their physician said Gildon might have flu, then wrote him a prescription.


That evening, he became sicker still, and couldn’t keep water or Sprite down. That’s when his mother took him to the emergency room.


A normal glucose level is in the 80-100 range, Gildon said. That night in the hospital, his hit 999.


Signs and symptoms of diabetes can be subtle and increase over time, said Dr. Laura J. Chalmers with the Harold Hamm Oklahoma Diabetes Center at the University of Oklahoma, 4444 E. 41 St.


Those signs include being more thirsty, urinating more often, waking at night to drink and go to the bathroom, and weight loss, Chalmers said. The appetite may also be increased, and some people will have nausea and vomiting.


Gildon was diagnosed with juvenile diabetes, or type 1 diabetes (T1D), one of the three most common forms of diabetes, according to the CDC. Another, type 2 diabetes (T2D), makes up for about 95 percent of diagnosed diabetes in adults; the third, gestational diabetes, develops and is diagnosed as a result of pregnancy in 2 to 10 percent of pregnant women.


With T1D, the body is unable to produce insulin, a hormone secreted by pancreas to regulate blood sugar, Chalmers explained. Treatment for T1D is insulin.


In T2D, there is insulin resistance, she continued. Treatment for T2D involves weight loss, dietary changes and medications that help the body secrete insulin and overcome the insulin resistance. In some situations, patients with T2D require insulin.


Onset of T1D is typically before age 20 but presentable from approximately 6 months of age into adulthood, Chalmers said.


Annette Jones was 24 and pregnant with her youngest daughter when she was diagnosed with gestational diabetes.


“When women get gestational, it usually goes away after delivery,” said Jones, alluding to the 2 percent of women who remain diabetic after pregnancy.


Jones has had diabetes for 27 years, more than half her life. Like Gildon, she wasn’t too familiar with diabetes, other than having family members who were diabetic – but she was too young to understand what that meant.


“I knew there was not a cure and that you had to take shots,” she said.


Lori Maisch was 45 when she was diagnosed with T1D. She had lost 25 pounds from May to September that year – “all the yard work I had been doing,” she thought.


Constantly thirsty and going to the bathroom every 15 minutes, even at night, Maisch finally attracted the attention of someone in a doctor’s office: her neighbor, who noticed her “sweet odor.”


“It’s the same scent I smell on patients that have diabetes,” Maisch recalled her neighbor saying. “That prompted me to make an appointment with my primary care physician, be tested and diagnosed.”


More than one diabetes


Misconceptions abound regarding diabetes, Chalmers said.

For example, T1D is treated with insulin and carbohydrate counting, she explained. Patients with T1D should have a healthy diet but are allowed to have cake, ice cream and other sweets within reason – as long as they take their insulin to cover the carbohydrates in the food they consume.


Maisch used to be one of those folks with preconceived notions about diabetes, she said. Since her diagnosis, people assume she has T2D because she’s an adult.


“Then they say, ‘I thought that only happened to children,’ ” she said. “Some will say, ‘Oh, if you eat right and exercise more, you can control it.’ No, that’s type 2 – I am insulin-dependent.”


Or she might have people tell her she can’t have certain foods, like birthday cake, refusing to cut her a slice because “you can’t have it,” Maisch said. “I just need to adjust my insulin to eat it.”


Most people don’t know that there is more than one kind of diabetes, Jones said. Others she’s met don’t think that it’s a big deal because diabetics take insulin.


“They don’t realize the deadly consequences that occur with this disease,” she said. “I have actually had people say to me, ‘You have diabetes? You’re not even fat.’ I could go on and on.”


Sometimes, people with diabetes might have a change in mood, experiencing “highs and lows,” as Maisch said.


“If I am having either, I can come across irritable or out of it,” she said. “I don’t mean to but can’t help it sometimes. I’ve found a lot of people don’t understand that part of the disease.”


Having diabetes can be expensive, too. Even with insurance, the two insulin shots Maisch needs each month are $ 100 each. Plus, she has test strips and syringes to buy. In all, it’s about $ 400 out of her own pocket each month.


“I used to be more impulsive,” Maisch said, “but now am more mindful regarding my meals and making sure I have my T1 pouch – blood glucose monitor, test strips, glucose tablets, insulin, syringe – every time I leave the house.”


It takes planning


Another challenge is always having to be more prepared than the average person.

Like if a buddy of his asks him to go on a spur-of-the-moment bike ride, Gildon has to know what his blood sugar is, possibly take extra food with him in case he takes too much insulin or exercises too heavily.


If he goes on a long trip, he has to think ahead in case his insulin pump breaks – what would he do then? Gildon has to have a back-up plan.


When he’d go on a Boy Scout camping trip, Gildon and his dad crafted a case out of PVC pipe for his insulin so he could keep it in his sleeping bag on freezing nights – and insulin doesn’t freeze.


One of the main challenges for Jones was changing her eating habits, like cutting back on carbs.


“Simplicity is gone,” she said. “I can’t go anywhere – store, work, park, ride my bike – without a plan, a snack or juice, something to treat low blood sugar.”


Jones has to have her blood monitor with her at all times, and she checks her blood at least four, sometimes eight times a day.


Like Gildon, she wears a pump 24-7. “It is still better than six to seven shots a day,” Jones said – but added, “I don’t feel free.”


Such adjustments aside, a normal, active life is achievable for most diabetics.


Jones wanted to have another baby after her second daughter, but the doctor said it was “probably best” she didn’t.


“This was 27 years ago, so that mentality has changed now,” said Jones, who has three beautiful daughters.


“God worked everything out,” she said. “Maybe not the way I had planned it, but just perfect anyway.”



Stop diabetes before it starts


American Diabetes Month takes place each November in order to raise awareness of this disease.

According to the American Diabetes Association (ADA), it is estimated that nearly 26 million children and adults in the United States have diabetes. Another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes.


To stop this disease before it starts:


Get moving. Physical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes. The ADA recommends a half-hour of mild aerobic activity five times per week.


Eat more whole grains. White bread, white rice and potatoes have a high glycemic index, which can cause spikes in blood sugar and insulin levels. Whole grain foods help with diabetes prevention because they slow down carb absorption.


Limit your sugar intake. Be sure to read nutritional labels and steer clear of anything that lists sugar, sucrose, corn syrup or other sweeteners, such as evaporated cane juice or molasses, as one of the first ingredients.


Stop smoking. According to a Harvard School of Public Health study, smokers are about 50 percent more likely to develop diabetes than nonsmokers. New research shows that inhaling secondhand smoke may also lead to an increased risk of diabetes.


Get more sleep. Not getting enough sleep increases hunger, which leads to weight gain and, therefore, raises your risk of getting diabetes.


Check your glucose levels. The ADA recommends blood glucose screening for everyone age 45 and older. Generally, this testing is repeated every three years. But if you have known risk factors (like high blood pressure or obesity), discuss them with your doctor.


For more, visit the ADA’s website tulsaworld.com/diabetes


And to learn more about Hillcrest’s Center for Diabetes Management, visit tulsaworld.com/hillcrestdiabetes



Support for diabetes


After being diagnosed with type 1 diabetes and not having a support system in place, Lori Maisch went into action.

She looked at the American Diabetes Association, JDRF (formerly the Juvenile Diabetes Research Foundation) and local support groups.


“I found that there were great meetings for type 2 (diabetes), for children with type 1, but none specifically for adults with type 1,” Maisch said.


So she formed a group called T1Tulsa for adults older than 18 living with type 1 diabetes. They meet once a month. Sometimes they have speakers; sometimes they just visit and learn from one another.


“It is a special meeting for me, as it is the one time month I can look around the room, say anything, and everyone gets it,” she said.


If you’re interested in T1Tulsa, email Maisch for meeting details, [email protected]


Original Print Headline: Diabetes a race that can be won



Jason Ashley Wright 918-581-8483
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