Malamalama’aga o le Kanesa
An American born in 2000 has a 1 in 3 chance of developing diabetes in his lifetime1.’ That would mean that your 12 year old childhas a significant risk of sufferingfrom the symptoms of diabetes. The typical foods eaten by our children today, including soda and fast foods, increase the risk that diabetic symptoms will appear in more children and at younger ages.
A diagnosis of diabetes subtracts roughly twelve years from one’s life and living with the condition incurs medical costs of $13K a year compared to $2500 annually for someone without diabetes1.’ Given that the per capita income in American Samoa is $8,000, you can imagine how difficult it will be for your child as an adult, living and working in the Territory, to afford adequate health care for diabetes2. This situation will reduce his life span by more than the estimated 12 years.
An estimated 80% of cases of Type 2 diabetes could be prevented by a change of diet and exercise1.’ Yet, a 2007 report of non-communicable disease risk factors states that 93.5% of the American Samoan adult population age 25 to 64 was overweight or obese and 47% are diagnosed diabetics3.
80% of diabetics will also suffer from heart disease1.’ High blood sugar caused by diabetes damages the blood vessels in the kidneysthat filter waste from your blood. An estimated 40 out of every 100 diabetics will suffer from kidney damage due to diabetes. As kidney damage worsens your blood pressure rises. Blood pressure is a measure of how hard the blood pushes against the walls of your arteries as it moves through your body. Drugs can be taken to combat the symptoms of high blood pressure and diabetes but over time the kidneys are unable to clear the body of the toxins in thedrugs themselves due to the ongoing damage to blood vessels if insulin is not kept at the optimum level.
Symptoms may include swelling of the feet and hands, weakness, loss of appetite, and trouble sleeping but more often these symptoms are subtle and go unnoticed. When blood pressure is high, it starts to damage the blood vessels, heart, and kidneys. This can lead to heart attack, stroke, kidney disease, and other problems.Heart disease is the number one cause of death in American Samoa.
The facts are a somber assessment of the health of our community. Beginning in childhood, lack of understanding (not lack of available information), obesity and poverty lead to diabetes, heart disease, cancer and early death. While children in other third countries suffer malnutrition caused by lack of food and early death caused by infectious diseases, our children are malnourished due to lack of nutritious foods and their life span is threatened by non-communicable or preventable diseases like diabetes and heart disease. It is not that the nutritious foods are unavailable, or that our people don’t know any better. It is individual choices, and a lifetime of unhealthy choices, not the lack of hospital services or public education that turned our community into one of the unhealthiest in the world.
It is individual health choices, beginning with each adult, and their choices for their children that will cause a change in how we view food and health.
There are no symptoms in the early stages of diabetes. In people with type 1 diabetes, kidney damage usually develops 5 to 10 years after the onset of diabetes. People with type 2 diabetes may find out that they already have a small amount of protein in the urine at the time diabetes is diagnosed, because they may have had diabetes for several years.
The best way to prevent kidney damage and heart disease resulting from diabetes and high blood pressure is to keep your blood sugar in your target range and your blood pressure at a target of less than 130/80 mm Hg. You do this by staying at a healthy weight, exercising regularly, and taking your medicines as directed.
And there are other steps you can take:
Work with your doctor to keep your cholesterol level as close to a healthy level as you can. You may need to take medicines for this.
Keep your heart healthy by eating a low-fat diet and exercising regularly.
Watch how much protein you eat. Eating too much is hard on your kidneys.
Watch how much salt you eat.
Don't smoke or use other tobacco products.
What you eat has a major impact on the health of your kidneys. Protein, sodium, fluids, and certain minerals are especially important.
When protein breaks down in your body, it forms waste products. When you have kidney disease, the kidneys have trouble getting rid of waste products. Eating more protein than your body can handle can make you very sick.
Sodium helps you keep the right balance of fluids in your body. When you have kidney disease, your kidneys have trouble clearing extra sodium from your body. Eating too much sodium can cause fluids to build up.
Healthy kidneys flush excess fluids from your body which can raise your blood pressure and force your heart to work harder.
Healthy kidneys keep the right balance of minerals such as phosphorus and potassium in the blood.
The LBJ Diabetes educator, Loata Sapili and Registered Nutritionist, Ianeta AhPingare available for consultation. Call the LBJ at 633-1222 and ask for them by name. They offer educational materials, counseling for healthy lifestyle changes, and information on medication to control symptoms.
1. Pollan, M. ‘In defense of food’ (NY: Penguin , 2008)
3. World Health Organization American Samoa NCD Risk Factors STEPS Report, March 2007