Cases of diabetes increasing in state / LJWorld.com

Kansas and regional news

Lawrence’s only endocrinologist relocating

January 12, 2006

Diabetes hasn't stopped Michael Williams from living a full and active life, but the disease has been complicated - and costly - to manage.

There are blood-monitoring tests. The insulin pump. The medications to ward off potential complications such as heart problems. Regular visits to the doctor. Even with insurance, Williams ends up spending as much as $300 a month out of pocket to stay healthy.

"It adds up really quickly," said Williams, 34, a computer technician at Lawrence Memorial Hospital. He added, "You pay now or you pay later, and it's more expensive later."

It's a growing expense, either way. Just less than 4 percent of Kansans had diabetes in 1992; that number had grown to 6.5 percent in 2004 and is still rising. At Lawrence Memorial Hospital, officials say they see 500 new diagnoses of diabetes each year.

"In the beginning, I didn't even do this full-time," said Pat Hohman, who has been with the Diabetes Education Center at LMH since 1992. "Now I do this full-time."

Photo by Richard Gwin

Michael Williams, of Lawrence, gets a demonstration on a new infusion set for a pump he uses for his diabetes, as Pat Hohman, Law-rence Memorial Hospital's diabetes educator, talks about the system.

She added, "We know right now we're seeing epidemic levels of diabetes."

Even as the disease grows, the city is losing its only full-time endocrinologist, who specializes in glandular conditions, including diabetes. Dr. Richard Fairchild is taking his practice to Topeka. Another endocrinologist, Dr. Chryse Sindler, visits Lawrence from Topeka twice a month.

Medical officials say Lawrence's diabetes patients still will be able to get help with their disease from family practice doctors and aren't far from endocrinologists in Kansas City and Topeka if they need specialized care.

Williams, though, is concerned.

"It will have an impact," Williams said. "I don't think that primary care physicians can keep up with diabetes the way a specialist can."

Growing costs

Diabetes is a disease in which the body cannot produce or use insulin to convert sugar and other food into energy. As much as 95 percent of all cases are Type II diabetes, which has a variety of possible causes: old age, family history and race.

It's another possible cause - growing obesity rates - that is being blamed for the rise in diabetes cases in Kansas and nationwide.

"We're on the same (rising) overweight curve that everybody else is," said Dr. Joseph Kyner, an endocrinologist and assistant dean at the University of Kansas Medical Center in Kansas City, Kan.

While diabetes rates in Kansas lag behind the national average of 7 percent, the growth of the disease here has alarmed state leaders. The Kansas Department of Health and Environment estimates that the price of diabetes in the state - both from direct medical expenses and indirect costs such as lost productivity - amount to $1.3 billion a year.

Paula Marmet, director of the Office of Health Promotion at KDHE, said more than half of those costs are borne by state and federal governments.

Rising diabetes rates will increase that tab, she said.

"We did a forward projection on costs," Marmet said. "Based on 2002 national estimates, we projected that the cost would rise to $1.8 billion in the next 15 years. And I have to say that's a conservative estimate."

Resources needed

Over time, diabetes can lead to heart disease, blindness, skin sores, foot problems and other complications. Kyner said Kansas doctors can expect to see growth in such problems in coming years.

"Those don't come on overnight, in a week or even a year. It usually takes five to 10 years to develop," Kyner said. "This so-called epidemic has just been in the last five to 10 years, so I don't think we've seen all the complications we will see."

Williams staves off such problems through a variety of medications and monitoring, including quarterly visits to Fairchild, his endocrinologist. Hohman, of the LMH Diabetes Education Center, said Williams' schedule of visits to the specialist is typical.

But Fairchild's departure, she said, shouldn't be cause for alarm.

"For the most part, the primary care physician can take care" of diabetes patients, Hohman said.

Patrick Ayers, executive director of the American Diabetes Assn. chapter in Overland Park, disagreed.

"It's obviously a concern to anybody with diabetes," Ayers said Wednesday. "Primary care physicians or family doctors are nice people, but they're not the best people to treat diabetes. Endocrinologists are the specialists."

It's not just Lawrence's problem. There are just 40 endocrinologists to treat 326,000 diabetics in the 50-county area of Kansas and Missouri served by his organization, Ayers said.

"We need to attract people to the field of endocrinology," he said. "I think in the past, diabetes hasn't been a very sexy field to get into."

That could change, though, as the rate of diabetes continues to rise.

"It's a concern because it's a chronic disease that affects a broad cross-spectrum of the population," Kyner said. "It's not just a disease that covers the wealthy or the poor. It covers everybody."

Discussion

LJWorld.com doesn't necessarily condone the comments here, nor does it review every post.
Read our full policy. Also, read about banned accounts and harassing comments.

12 January 2006
at 11:30 a.m.

Suggest removal

Permalink

Jamesaust (Anonymous) says…

Given that something like 40% of the U.S. population has health care provided by one part of government or another, this is a concern for everyones' pocketbook.

Most type II cases are preventable. That incidences have been increasing at a rapid rate represents an epidemic. That children contract diabetes at any rate exceeding 20/100,000 is shameful, and frankly reckless indifference by the parents.
12 January 2006
at 11:39 a.m.

Suggest removal

Permalink

tell_it_like_it_is (Anonymous) says…

I realize that this is a bad disease. But everything these days is an “epidemic” according to the doctors and big drug companies. According to my mother in law who works in Dr office they have lowered the number that they use to say you have diabetes by leaps and bounds in the last few years same way with blood pressure and cholestrol. Maybe this is a little to blame for the epidemic?
12 January 2006
at 1:48 p.m.

Suggest removal

Permalink

harrierist (Anonymous) says…

I have known a number of people who acquired diabetes later in life (50's) who did not realize why they felt tired or lost wieght, but lived into their 70's before the died of the problem and the doctors back tracked and would say “judging fromthe exent of the disease you have have this condition going back 20 years or silghtly more.” I know three people who lived with this over 20 years and then in their 70's, infection in their cracked figure tips and toes just finally would not heal, so they went to a emergent healing center, where their they got the news they actually have diabetes. I think cases appear to be growing, but instead people now days are just more aware of their problem.
12 January 2006
at 3:25 p.m.

Suggest removal

Permalink

opinionated2 (Anonymous) says…

I have had diabetes for almost 20 years, I found out that I had it when I was 10. And Jamesaust, it had nothing to do with my parents!! (except their genes)

My great g-ma, grandma, and aunt (mom's twin sister) all have/had it on my mom's side and my grandpa's twin sister and my great-aunt on my dad's side had/has it.

Yes, if it is in your family and you watch your diet well, you have a better chance of it not developing/getting to the point that you need medication for it, but if it is not in your family's medical history, it rarely has anything to do with the way your parents take care of you.

If you are not diabetic, You have NO CLUE what we diabetics go thru as with any chronic disease!!!

This is a VERY costly disease, especially if you do not have health Insurance (as I do not). The job I have at this time only offers limited insurance coverage and it will not cover more than $30.00 of perscriptions and you have to pay $80.00 premiums a month…doesn't make sense to me. So, I have to pay $160.00 out of pocket a month in insulin (meds) alone, and that doesn't even count the doctor visit every three months, insulin pump supplies, bloodsugar monitoring (finger sticks), etc.

Dr. Fairchild is the best doctor I have been to since I went to Dr martha Barnard (KU Med/ Pediatric Endo.) as a child. I am just fortunate that I too, plan to move to the topeka area. I feel for the ones who are losing an awesome Doctor!!! It is very hard to find a good diabetic Doctor that you like and knows what they are talking about!

If there any diabetics out there that are in my (insurance) situation, or know of any resources that may help, I welcome your advice.

I offer my best wishes to those of you out there with diabetes or a chronic disease. God Bless!
Thank You!
12 January 2006
at 4:07 p.m.

Suggest removal

Permalink

b_asinbeer (Anonymous) says…

A lot of pharmacists are educated in diabetes and such. If you can't find a doctor who can help you with this, a pharmacist is also a great option.
12 January 2006
at 4:28 p.m.

Suggest removal

Permalink

tell_it_like_it_is (Anonymous) says…

Okay this is gonna come off mean I'm afraid and I apologize in advance. But I've always wondered why people who have these awful diseases that are herditary take a chance and have kids. I really don't think I myself would take a chance on having kids if a disease like that ran in the family. I think I would adopt if I wanted kids.
12 January 2006
at 5:06 p.m.

Suggest removal

Permalink

opinionated2 (Anonymous) says…

Hereditary diseases do not always hit every generation. That would be like saying I don't want to have kids because there is a very small chance they may have a birth defect. In most cases you never know of even a chance of a disease or birth defect until the children are here or even later in life.

At least give them the chance. We are all god's children and we are all here for a reason!

I for one am very glad my parents took the chance and decided to have me, even if I have to live with diabetes, if they hadn't I would have the pleasure and experience of life.

Although I do not agree, I respect your opinion.

Have a nice evening.

12 January 2006
at 6:18 p.m.

Suggest removal

Permalink

kcwarpony (Anonymous) says…

Diabetes is the number one health problem in Indian Country today. We no longer ask one another “Do you have diabetes?” We ask, “Are you taking pills or shots?”

My nation is doing a lot to fight this disease. Two Wellness clinics have been built in the last two years and in our schools the students are taught prevention classes with the emphasis on becoming and remaining active, not to mention nutrition. Our tribal newspaper dedicates two pages worth of diabetes information every month.

I have noticed that elders who had no blood sugar problems are now having problems are the ones who are no longer able to take care of themselves like they used to. Meaning they are no longer doing they own cooking. These elders are the ones who stuck with a more traditional diet but are now eating more processed and prepackaged foods instead of foods they used to prepare, foods that were in the category of what you could hunt, pick, grow, and gather.

In generations past, a lot more time was spent on finding, obtaining, and preparing what we eat. It would seems that our modern lifestyles may be trying to kill us.
12 January 2006
at 8:12 p.m.

Suggest removal

Permalink

tell_it_like_it_is (Anonymous) says…

opinionated2..I'm glad your parents made that choice also as you sound like a very nice person. I certainly didn't mean any offense I only meant that for me at least it would give me cause for concern. But that is just me and who knows maybe if you already knew you had that history you could watch your kids diet and execise really close and hopefully things would be okay. I certainlly wish you all the best in managing your disease.
12 January 2006
at 8:40 p.m.

Suggest removal

Permalink

hottruckinmama (Anonymous) says…

i'm a afraid i have to agree in a way with tellit. my ex got diabetes when he was 28 we couldn't figure out why. his mom and dad had been divored thus he was not close at all with his dad for years. they finally got to talking again after years apart and come to find out almost his dads whole side of the family had it. his grandparents had both had it and died from it and most of his aunts and uncles and even cousins had it and had gotten young and bad.
we got divorced a few years later but now i kind of worry about my kids. my boys are on the skinny active side so hopefully they will be okay. my daughter is active but a little on the heavy side. i worry what might happen if she ever has kids. will she be okay?
don't get me wrong i love my kids and wouldn't trade them for the world but i do worry about what might happen when they get older.
if i had known his family history i might have thought twice about having kids.
13 January 2006
at 11:03 a.m.

Suggest removal

Permalink

opinionated2 (Anonymous) says…

tell_it_like_it_is…
I appreciate your later post, I do have to admit, you did strike a nerve…then again I am usually on defense when it comes to diabetes. Simply because those without the disease sometimes/usually think they have all the answers. I feel much better about your comment after the clarification. Thank You.

Thank you for your words of kindness. I do believe that if you live your life in fear, you miss out on a lot!!! So, I would/will have children without a thought!! You are also right in saying that those with diabetes, know that they have to stay on top of it and that means being prepared! I hound my entire family about getting checked every 6 months to a year for diabetes. Most of the time, the faster you catch it, the easier it is to control it.

hottruckinmama…
Your kids are going to be fine!!! (sounds like) They have a well educated mom who knows about the disease and that it is out there. I don't know your ex's medical history, but I do know that older folks who have diabetes did not have the technology that we have today and had a much harder time controling their disease. My advise, if you would like it, is to:
1. Educate them on what it is and how to control it/prevent it. There are precations that you can take to catch it before it hits at all. Most of the time you can take care of yourself and follow a healthy diet and even though they may have it, they may be lucky enough to control it by diet (borderline diabetes) or just take the pill (and check your bloodsugars) to control it (type II) and may never have to know what it is like to have to take shots or be on an insulin pump (which I fully recommend to any insulin-dependant (type I) diabetic).
2. Keep getting them checked by their doctor, for diabetes. At least every year. I tell my family every 6 months to a year.

The best defense to diabetes is knowledge and understanding. Best wishes to all.
Thank You.
13 January 2006
at 11:50 a.m.

Suggest removal

Permalink

mztrendy (Anonymous) says…

Gee, my dad is a diabetic. He found out when I was 13. Diabetes didn't run in our family. It ran on my moms side and not my dads. I wonder if they wish they never had me? Do some of you realize that not all people die that are diagnosed with diabetes? Just because you are diabetic doesn't mean that you aren't going to have a healthy life. Its something that has to be controlled and taken care of, but it certainly isn't a death sentance.
13 January 2006
at 12:01 p.m.

Suggest removal

Permalink

opinionated2 (Anonymous) says…

mztrendy…

Very well said!! Thank You!
13 January 2006
at 2:04 p.m.

Suggest removal

Permalink

hottruckinmama (Anonymous) says…

opinionated…thank you for your kind words! i'm sure they will be fine too! i don't dwell on it but i do watch them close. i was just a little floored to find that it ran so badly in the family and no one knew about it not even his mom. but then his mom and dad where only married a short time.
my mom often reminds me that i am worried about the wrong thing. that i should worry more about them inheriting his temperment and character (he had a lot of issues) and i know she is right :)
anyway i sure do wish you luck and hopefully you will have kids and things will be just fine.
13 January 2006
at 2:24 p.m.

Suggest removal

Permalink

crazyks (Anonymous) says…

Getting diabetes isn't always related to weight…Mary Tyler Moore has had it for years, and she's never been overweight.

13 January 2006
at 3 p.m.

Suggest removal

Permalink

opinionated2 (Anonymous) says…

crazyks…

You are right, it doesn't ALWAYS have to do with weight. BUT, type II is also commonly referred to as 'Adult Onset'. It is common in older folks *and* overweight folks. So, it is important to watch your weight especially if diabetes runs in your family history.

I only weighed 96 pounds in the eighth grade when I was diagnosed.

hottruckinmama… I failed to mention, if you don't already know, that *some* common symptoms are:

-Frequent urination
-Elevated thirst
-Tiredness
-Blurred vison/headaches
-shakiness <-(spelling)

Thank you for your kind words and much luck to and your children as well!!
16 January 2006
at 1:30 p.m.

Suggest removal

Permalink

crazyks (Anonymous) says…

My aunt had Type 1…was insulin dependent, and had to take three shots a day. She wasn't diagnosed with it until she was in her 50s. And there was no family connection that I'm aware of.

If doctors really knew what caused diabetes, they'd be able to prevent some people from getting it…and to possibly cure some of those who already have it.

Truth is, too much of the time they really have no idea…
26 April 2006
at 10:43 a.m.

Suggest removal

Permalink

kindredCare (Anonymous) says…

Hello. Kindred Care is a Diabetic supply company located in Lawrence KS. We supply the diabetic strips and insulin pump supplies.

We are working extremely hard to help keep the local physicians up to date on the advances in technology for treating diabetes. You have an excellent resource @ Lawrence Memorial Hospital. Pat Hohman is a diabetic educator that is also a diabetic using an insulin infusion pump. The loss of Dr Fairchild should not mean that you need to look at Topeka or Kansas City for a physician to help treat your diabetes. With resources such as Pat and Kindred Care, you can stay current with all the advances in diabetes control.