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Thursday, March 25, 2004



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RONEN ZILBERMAN / RZILBERMAN@STARUBLLETIN.COM
Diabetic Jill Tsuchitori likes to run with her children, including Aaron, on the bicycle, who also has diabetes. Tsuchitori learned she had diabetes when she was in college. She has Type 1, which means she needs insulin to stay healthy.



Education is key
to fighting diabetes

Individuals who have the disease
are grateful for programs that
offer coping tools


Jill Tsuchitori hoped to allay her fears when she tested the blood sugar of her 2-year-old son who had become very thirsty and kept asking for ice water.

The blood sugar level turned out to be an excessively high 505, she said.

"It just hit my stomach like a rock."

Tsuchitori, an insulin-dependent Type 1 diabetic, had recognized signs of diabetes, which lab tests confirmed.

Now 4, Aaron takes four insulin shots a day, she said.

"He's very good about it. In the beginning, we did it together. He sees me check my blood sugar all the time."

She goes to St. Clement's Preschool every day to give him a shot at lunchtime.

Tsuchitori was diagnosed with diabetes while she was a freshman at Brown University. She became terribly ill and was always thirsty but the school's clinic didn't know why.

"They kept saying, 'Are you sure you're not pregnant?' because I was especially sick in the morning," she said.

Spending Thanksgiving at her sister's in Baltimore, she became dehydrated and couldn't keep anything down. She thought she had the flu, but a clinic confirmed it was diabetes.

She said she took the rest of the semester off, went to Seattle, then her home, and "tried to grab as much information as I could" about the disease.

"Education is key," she said. "There is a lot more (information) now."

She has worn an insulin pump almost 10 years, and said it works well. She had trouble finding a doctor who knew anything about the pump when she first came here about nine years ago, and she started a little support group, she said.

She was a practicing attorney but put her career on hold when she and her husband, David, began having children.

She said that after seeing the film "Steel Magnolias," she figured she wouldn't have kids. But now she has three, including Joel, who will be 3 in May, and Isabelle, who is 4 months.

She said it was easier for her to control her blood sugar when she was pregnant.

"I wish I could figure out why. ... It's something about hormones that balances out my blood sugars."

She "got hooked" on walking and exercising in Seattle, and now runs regularly, about five miles, often with the two youngest children in a double jogger.

"A lot of times it's easier on the treadmill," she said.

She also paddles outrigger canoes and plans to organize a moms' club to pool child care and go out in the morning when the young ones are in school.


As a part-Hawaiian, Helene Kaiwi is in a high-risk group for diabetes. She was diagnosed in 1995 with Type 2 diabetes, which is growing to epidemic proportions nationally.

Her primary care physician was Dr. Chiyome Fukino, now her boss as state Health Department director. Kaiwi, 48, oversees contracts and quality assurance in the department's early-intervention section,

She said Fukino suggested have a urine sample examined after questioning her during an office visit. The test showed her sugar was elevated. Fukino referred her for a blood workout, and her fasting blood sugar level was 120.

"Back in those days they used the term 'borderline.' These days they don't use that term. They say you can't be slightly diabetic. You're either diabetic or you're not."

Her diabetes is medication-controlled but her mother is on insulin, she said.

"For me, it runs through generations."

She said it has been a struggle for her to control the disease from 1995 until now.

She began to educate herself, she said, going to free public meetings offered by the American Diabetes Association and other conferences.

In 2001, she was still trying to get her diabetes under control when Fukino referred her to a diabetes-education program, the cost of which was covered by the Hawaii Medical Service Association, she said.

"Now they don't (cover it), which is ludicrous," she said. The one-hour class is conducted by certified diabetes educator Marie Robello, a registered nurse, at the Queen's Medical Center.

"She brought a nutritionist and psychologist into class. It was wonderful," Kaiwi said. "Now, just older people can take it because Medicare can cover it.

"It was an emotional thing for me. That's what a support group is all about. It provides emotional support."

She still goes to the group once a month and is doing much better managing her diabetes than the previous year, she said.

"I feel excellent," she said.

She participated in the WALK for diabetes last Saturday and plans to attend a diabetes conference Saturday at the Hawai'i Convention Center.

"For me and all the other people diagnosed, it's education -- what do I need to know and how will it change my life?" she said. "I go to all these specialists."


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Learn about diabetes at
Oahu and Maui conferences

Mainland and Hawaii experts on diabetes will discuss the best ways to control the disease at conferences and health fair exhibits this weekend in Honolulu and Wailea, Maui.

The Honolulu event will be from 7:30 a.m. to 5 p.m. Saturday at the Hawai'i Convention Center. The Maui conference will be from 11:30 a.m. to 4:30 p.m. Sunday at the Wailea Marriott Resort.

This is the fifth year for the "Taking Control of Your Diabetes" conferences, founded and directed by Dr. Steven V Edelman, a national and international leader in diabetes research, treatment and education.

Edelman, who has had diabetes since age 15, is a professor of medicine, Division of Endocrinology and Metabolism, University of California, San Diego, and director of the Diabetes Care Clinic at the Veterans Affairs Medical Center, San Diego.

The author of "Taking Control of Your Diabetes," he says learning about how to take care of diabetes isn't enough.

"Getting and staying motivated is what this year's events are about," he said.

An estimated 72,000 to 100,000 Hawaii residents have diabetes, says Jane Kadohiro, certified diabetes educator and state Health Department deputy director. Of those, 25,000 aren't aware that they have the disease, she said.

Native Hawaiians are 2.5 times more likely to have diabetes than non-Hispanic white residents of similar age, according to a National Health and Nutrition Examination Survey of data collected in Hawaii from 1996 to 2000.

In 2002, native Hawaiians, Japanese and Filipino residents age 20 or older were about two times more likely to have diagnosed diabetes than white residents of the same age.

Kadohiro said the thrust of the conferences "is always to help people take control of their own diabetes, to have information they need, to be able to talk to some local resources."

She said that besides attending general sessions and workshops, participants will have opportunities to talk to an endocrinologist, a podiatrist, diabetes educator, dietitian and other experts.

Kadohiro, also a diabetic, will discuss diabetes care and education and what people with diabetes can expect when they go to a doctor.

"A lot of people don't know they should be referred for an eye exam once a year, or have certain lab work done," she said.

Basic practice guidelines have been developed that everybody with diabetes should expect from physicians, she said -- "with the caveat that physicians still have to do an individual assessment and kind of tweak things, depending on the physician's situation."

Dr. Laurie Tom and Viola Genadio are co-directors of the Oahu conference and Rose Foronda is coordinator of the Wailea event.

The registration fee in Honolulu is $30 for one person or $25 per person if two or more register together. It's $35 for on-site registration. The Wailea fee is $20 per person.

For more information, call 998-2693 or 755-5683 or visit www.tcoyd.org.

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