Introduction

diabetes.jpg
There are about 111,000 diabetics in Hawaii. To monitor their blood sugar, they must prick their fingers to get a blood sample using blood glucose meters such as this one.

Diabetes In Hawaii

People who know me well might be puzzled by my choice of topic. I love animals and the environment and I've never shown much interest in health-related issues. But, my reasoning is that people who are unhealthy won't be able to make a better world. For this project I wanted to choose something that was an issue, not just in Hawaii, but worldwide, so that if this project actually takes off it will be of greater significance. I also know a diabetes sufferer, and one of my best friends is hereditarily at risk for contracting this disease. But, my most significant motivator is that the majority of diabetes is totally preventable. Diabetes, in the most basic explanation possible, is when you have too much sugar (from food you eat) in your blood. Your body is unable to properly use or store the excess sugar, which causes problems. There are two types of diabetes. Type 1 diabetes, often surfaces in childhood and as far as I know is incurable and unpreventable. Type 2 diabetics, are usually obese adults and the disease can usually be prevented or controlled by eating healthy and exercising. Type 2 diabetes, which is what the majority of diabetics have, is so preventable that it's wrath-inspiring that this has become such a widespread health crisis. By completing this project, I hope to make myself and others more aware of how we can prevent this disease in ourselves and share the knowledge with the people we love.

Comments from Ms.Y (re: Step 1):

Lindsay- I really like your first sentence above. That is exactly what I was first thinking when saw your topic choice. But your reasoning makes sense and is valid and important. I just have two small comments: 1) I would suggest going a tiny bit further in your "basic explanation" of diabetes. Why would someone have "too much sugar"-can't their body deal with differing amounts? (I'm asking to point to where clarification could occur), and 2) I would suggest using a different word than 'stupid'. I agree that this crisis is preventable and sad that it is so widespread, but 'stupid' almost implies that the people are 'stupid' for not preventing this in themselves...Other than this, it is a great start.


Research


Source 1: " Retired Hawaii teachers warn of diabetes dangers"

http://www.honoluluadvertiser.com/article/20080923/NEWS01/809230357/-1/diabetes

diabetes_education.jpg
Irene Takeshita


Summary:
This article is about two retired school teachers (Carl and Irene Takeshita) who do public presentations on diabetes in different places around the islands. Although only some of the attendees are children, each presentation uses a "classroom" method of teaching the lessons. An example of this method is that they often use audience participation, simple explanations, and large visuals. Their talks address both diabetes in Hawaii, complications of diabetes, and treatment and prevention. Irene originally got started on these preesntations because diabetes runs in her family. Through these presentations, Irene herself has learned a great deal about diabetes and has improved her own life and would like to improve the lives of many others.
Reflection:
This article was comforting because now I know that this and other education programs have a positive effect and this is not an insoluble problem.
Further questions that I have:
1. If this "classroom" style of program is so effective, why isn't it done in more schools? (Maybe it already is, but just not discussed specifically?)
2. What makes this program so effective and how can we get the same results on a larger scale? (Is it that it's easy to understand? Something else?)

Source 2: " 'Silent disease' eating at Hawaii's health"

http://www.honoluluadvertiser.com/article/20080907/NEWS01/809070304/-1/diabetes

Summary:
This article discusses the rising amount of people in Hawaii being diagnosed and the "costs" it has for people with the disease. These costs include huge medical bills, stress and suffering of diabetics and their families, and the rising number of deaths attributed to diabetes. The article also lists some causes of diabetes that are specific to Hawaii. One of the scarier things is that many ethnicities in Hawaii are predisposed to diabetes. Like the rest of the nation, Hawaii is also suffering from an increase in obesity (which is linked to diabetes). A grim fact mentioned in this article is that more people die from diabetes then the number of cases that are reported because people tend to ignore the disease.
Reflection:
I loved all the interesting and powerful facts this article had. This is the material people need to see that will cause them to change their lifestyles and make a healthier community.
Further questions that I have:
1. Is it genetics or cultural practices that cause a higher risk of diabetes in some ethnic groups (Native Hawaiians, Pacific Islanders, and Asians)?
2. What factors contributing to the rise of diabetes can we control (besides diet & exercise)?

Source 3: Video: "How diabetes affects your blood sugar"

http://www.mayoclinic.com/health/blood-sugar/MM00641

Summary:
This video is a very simple explanation of how diabetes works with very realistic, effective illustrations. It also gives definitions for both types of diabetes. If the video is not working or if you just don't want to watch it, it has all the information covered in the video in a box beside it. It is put out by the very reliable Mayo Clinic website. The clip doesn't address any further health complications of diabetes or how to treat it, but the website has many more links related to diabetes on the same page (although the website contains nothing about diabetes in Hawaii). This video is the best clinical explanation of diabetes that I've found so far.
Reflection:
It is not specific to Hawaii, but is good if my (admittedly lacking) explanation of diabetes was unclear. The graphics in this video were cool because they're easy to understand and more effective than just reading about insulin and glucose.
Further questions that I have:
1. What are some of the "serious health complications" of diabetes?
2. Is your blood sugar the only thing that diabetes directly effects?

Source 4: "Overview of Clinical Complications of Diabetes"

http://www.umm.edu/diabetes-info/complica.htm

Summary:
This page is put out by the University of Maryland Medicine. It lists the numerous complications of diabetes along with some of the symptoms of the disease. The site also contains some information on treatment of diabetes. It does not go very in depth for any one item, but it addresses a lot of information. It has no information specific to Hawaii. But, here are a lot of good statistics on this page.
Reflection:
It's horrible how many things can go wrong when you're a diabetic, everything on this list is a definite motivator to change.
Further questions that I have:
1. Out of all the complications, which are more rare and which would the average diabetic get?
2. Are some of these complications inevitable with or without treatment?

Source 5: "Ethnicity Alters Diabetes Risks"

http://diabetes.webmd.com/news/20060713/ethnicity-alters-diabetes-risks

Summary:
This article talks about which ethnic groups in the US have a higher prevalence of diabetes. This information is posted by the reliable website WebMD. It is an interesting article with information that could be applied to life in Hawaii. But, it contains no specific mentions of Hawaii. It concludes that Blacks, Hispanics, and Asians have a higher rate of diabetes than whites although diabetes in these ethnic groups may be easier to treat.
Reflection:
Even though this article does not specifically talk about Hawaii, we can still apply the information here. Because of our ethnic diversity, this information is especially relevant and sad.
Further questions that I have:
1. Where did diabetes originate (This might explain why certain races have different diabetes risks.)?
2. Is this information also true for people with type 1 diabetes?


Source 6: "Juveniles and Diabetes"

http://www.khon2.com/news/health/27563029.html
Summary:
This article is about a public service announcement video contest how in Hawaii, and how most young diabetics suffer from type 2 diabetes instead of type one.
Reflection:
This is scary, because most people with type two diabetes get it in their 50s or older and are expected to live about 20 more years. But, what if you're just a teenager when you get diagnosed?
Further questions that I have:
1. What's the life expectancy of a type 1 diabetic versus a type 2 diabetic?
2. Does diabetes effect adults and adolescents differently?

Data Table:

Diabetes Information
Type 1
Type 2
What is it?
Your body does not produce insulin.
Your body does not produce enough insulin or the insulin in ineffective.
Who does it affect?
Usually diagnosed in adolescence and continues into adulthood.
Usually diagnosed in 50s+. Ethnic minorities and people who are obese are most at risk.
Causes
Usually hereditary.
Obesity, ethnicity, aging, and it can also be hereditary.
How to Prevent it
Insulin treatments, monitoring blood sugar, healthy lifestyle.
Same.

Comments from Ms. Y (re: Step 2 & 4):

Lindsay-You've found some excellent sources here. The video explanation is the best I have seen (perhaps you will use this in your presentation to the class at the end of this project?). I also liked the post-it idea described in the first article (perhaps this is something you could do in your Action Plan-with our class?). You have asked thoughtful questions here, which build on the information learned in the articles and yet, ponders info they left out. Your data table is clear and a good summary to help one understand and distinguish the two types. The only suggestion/comment I have is that your summaries and reflections were supposed to be a paragraph each, going more in depth on what you learned and your thoughts regarding the specific information mentioned.

Interview


wilhite.jpg
Mrs. Wilhite


Date of interview:
Dec 17
Person being interviewed: Kari Wilhite (A Punahou School nurse)

1. Are there any cultural things in Hawaii that make us more susceptible to diabetes than in other states?
Theres’s no real cultural practices that makes us more succeptible. It’s mostly that a lot of Hawaiians and other minorities are more likely to have the disease.

2. Is there an age group that is more likely to have diabetes than others?
It’s dependent on what type of diabetes it is (whether it’s insulin-dependent or not). Because with type 1 diabetes; anybody can have it. But, with the other type we see mostly older people in their sixties.

3. How do most diabetics in Hawaii deal with their disease?
Once again, it depends on what type of diabetes they have, and there are a lot of variations. Some people have to get regular shots, some people just have to take a pill, so it really depends.

4. How life changing is diabetes?
It again depends, but for most cases, it is very life-changing. Because, you have to be on a constant schedule of when to eat and when to take a shot. And, most of the time you have to eat immediately after you get the shot. So, you can’t wait an hour to get into a restaurant, and you can’t go on a trip unless everything goes exactly on schedule.

5. What’s being done to help prevent this disease in the Punahou community?
Well, there’s not a lot of diabetes education at Punahou, but we have gotten a lot better in terms of nutrition. We’ve also been trying to teach the kids about obesity, because that is definitely a factor in a lot of diabetics.

6. What percentage of diabetes is hereditary?
Depending on what type you have, it can be hereditary. But, anybody can get diabetes even if it isn’t in their family.

7. How serious is diabetes in reality?
I think as a nation, it is a very serious problem. And, it’s getting worse as more people are getting obese and changing their eating habits.

8. I’ve heard of people becoming blind or having to have amputations because of this disease. Is this common?
Well, it always depends. Some people can afford to see a doctor and they’re probably going to be okay. But, a problem arises for homeless people and people that can’t afford to get treatment. Because, these things can happen if the diabetes is not controlled.

9. Is there any piece of information that you feel is important to share with my generation about diabetes?
Well, I know it’s tough for kids with diabetes. And, I know that younger kids might see one of their friends behaving strangely on the playground or they might see them having to go take a snack break in the middle of class. So, I’d just want everybody to be kind and understanding towards individuals with this condition.

10. Is there anything that I could do to help raise awareness in the Punahou community?
The only thing I can think of is to just raise awareness about nutrition and childhood obesity. Because that is an effective way of not letting this disease affect more people than it has to.

Action Plan


For my action plan, I decided to create a short powerpoint presentation that I could share with my bio class. I knew that I wanted to raise awareness, and even if it was only within my class I knew that my powerpoint could accomplish that. The powerpoint itself is filled with the information I collected during the research stage. My wish is that it will give information that most people don't know about diabetes. Below are the slides in picture form.
Slide1.jpgSlide2.jpgSlide3.jpg
Slide4.jpgSlide5.jpgSlide6.jpg

Final Comments:
Lindsay-I'm glad you were able to get caught up with your project. I liked the questions you asked of Mrs. Wilhite, and learned some new things and hope you did too. It is interesting that she said that we aren't doing too much with diabetes education here. I wonder if that is because they feel it isn't so important for our specific population. I also wonder what percent of students here are diabetic (but not sure she would be able to share that information). Your powerpoint looks good. It seems to the point and your presentation of information is effective with bullet points and graphics as you have it. I'm sorry you did not have enough time in class to show your powerpoint which was a big part of your Action Plan. If there is a way you can save this differently on your wiki or elsewhere (such as in an imovie or vodcast) then perhaps I could share this with other teachers to use (they won't be able to use it in their classes as is from this wiki). If you read this message, let me know your thoughts via an email! Thanks.