Diabetes 'scared me to death'

Dorothy Manley knew something was wrong nine years ago because whenever she ate sweets, she grew sleepy.

Manley, 77, of Gary, visited a local health fair and was advised to see her doctor.

“That’s when I found out I had diabetes,” said Manley, a former U.S. Postal Service supervisor who retired with 30 years of service in Chicago. The news frightened her because a former neighbor with uncontrollable diabetes lost an arm and both legs to amputation.

“He couldn’t take care of himself or manage his condition and that concerned me,” Manley recalled. “It scared me to death. I didn’t want that to happen to me.”

She was right to be concerned. Diabetes disproportionately affects African-Americans like Manley and was the fifth leading cause of death in Gary in 2007, according to the latest available figures from the Indiana State Department of Health.

But Manley learned from Gary family practitioner Chiedu Nchekwube that a diagnosis of diabetes isn’t a death sentence and many with the condition can learn to manage and control it. At Nchekwube’s urging, she took a proactive approach.

“First of all, I very seldom eat out now,” she said. “I cook for myself so I can be sure of what’s in it. I eat more vegetables and fruits, but not the sweet, sweet fruits.”

Prior to her diagnosis, Manley admitted, she wasn’t watching what she ate.

“I ate subconsciously. I often skipped breakfast and ate later. And I used to dine out a lot,” she confessed. “Now I eat three times a day.  I don’t eat that much bread and try to control my intake of foods that are high in carbohydrates, like corn, ice cream and pasta.”

Complicating her health are two other conditions, hypertension, or high blood pressure, and glaucoma, an eye disease common among older diabetics. Manley said glaucoma runs in her family. “My mother went blind,” she said.

Once or twice a day Manley pricks her finger to test her blood sugar levels. She also exercises regularly, walking, gardening and working outside when the weather permits.

Support helps manage condition

She also attends a monthly diabetes support group meeting through The Methodist Hospitals.

“My doctor suggested I go there every month and that’s where I learned most of what I know about my condition,” she said. “What I like is that it’s tailored to an African-American audience, because there are some cultural and dietary differences.”

She said the Methodist support group presents the information in a culturally relevant way that resonates with her, focusing on African-American foods, cooking styles and traditions.

“Many people overlook diabetes until it’s too late, but there’s no excuse for that. People are losing their eyesight because of diabetes and high blood pressure,” she said. “They just don’t pay attention. If you read the papers or watch the TV news you’ll see this is serious. This is an epidemic in our community and we have to do something about it. We have to get the message out.”

Nchekwube, a Nigerian native who has practiced in Gary since 1981, said about 30 percent of his 5,000 patient practice are diabetic or prediabetic and 40 percent have co-morbidities, like hypertension, obesity or heart disease.

“My approach is lifestyle changing,” he said. “That’s where it really starts — teaching patients to take care of themselves with good information, education, exercise and nutrition. I address it as a disease, but point out that they can control it by changing their habits so they don’t feel so helpless. I empower them to take charge over their lives.”

Nchekwube said Gary needs to recognize its health problems and begin to address them as a community.

“We need leadership from our medical and political leaders to help people access the care they need and need to educate through the schools and churches about diet, nutrition, cooking and leading healthy lifestyles. People can be poor, and we have many poor people in Gary, but being poor and ignorant is a deadly combination and is killing our community.”

Cynthia Thompson of Munster, a certified diabetes nurse educator at The Methodist Hospitals, said the support group is aimed at meeting the needs of its members.  

“We bring in pharmacists and dieticians and have had wound experts as well, because many diabetics have slow-healing wounds,” Thompson said.

“We also have a strong focus on children and diabetes. Unfortunately, we’re seeing diabetes, cardiac and weight issues among children. We’re trying to help with diets and preventive measures to help them lead healthier lifestyles.

She said the program has intensified community outreach efforts to community fairs, churches and schools and has assisted school nurses in developing educational programs.

Thompson said the program is making a difference and counts several hundred patients who participate in the programs. “We continue to see new diabetes patients coming in, but they are more knowledgeable about their conditions,” she said. “The word is out there. And with that knowledge, we’re seeing greater compliance. We have to be able to reach out so people can understand that even though they have diabetes, they can have a rich, satisfying life and enjoy it.”

She said increasingly community physicians are referring diabetes patients early on after a diagnosis, but the program is also seeing many patients who have been diabetic for 10 years or more.