Sunday, June 15, 2014 | 2 a.m.
Risks of abnormal blood-sugar levels
Improperly regulating their insulin, food intake, exercise or alcohol use puts diabetics at risk of hypoglycemia or hyperglycemia.
• Hypoglycemia (low blood-sugar — less than 70 milligrams/deciliter): Diabetics with low blood-sugar levels can feel shaky, impatient, clammy, sweaty, anxious, dizzy, sleepy, weak and uncoordinated.
• Hyperglycemia (high blood-sugar — more than 200 milligrams/deciliter: Diabetics with high blood-sugar levels often will feel tired and thirsty and need to urinate frequently.
Normal blood-sugar level after 12 hours of fasting is less than 100 milligrams per deciliter. Shapiro’s highest blood-sugar level was more than 600, so high that his glucose meter couldn’t read the level. His lowest blood-sugar level was 25.
Percentage of adult Nevadans who had diabetes in 2010.
The difference between Type 1 and type 2 diabetes
Type 1: Previously known as juvenile diabetes, this condition occurs when the pancreas fails to produce insulin. There is no cure, but it can be managed with proper treatment, including insulin injections. Symptoms can come on suddenly and include constant thirst, frequent urination, extreme hunger, weight loss, fatigue and blurred vision.
Type 2: This is the most common form of diabetes, which can be managed by a combination of eating well, exercising and maintaining a healthy weight. Type 2 diabetes occurs when bodies resist the effects of insulin or do not produce enough insulin. Symptoms are similar to those for Type 1 diabetes, but they tend to develop slowly.
Bob Shapiro resembled a chemist as a teenager, handling glass syringes, test tubes and metal needles daily.
His life depended on it.
After he was diagnosed with Type 1 diabetes as a 13-year-old in 1964, Shapiro’s survival relied on a strict diet and society’s then-limited understanding of his autoimmune disease. Diabetes wracks the pancreas’s ability to produce insulin, the hormone responsible for converting sugar to energy.
Doctors told Shapiro he might not live long. But 50 years later, he is alive and well, with an insulin pump attached to the left side of his stomach and a blood-sugar monitor attached to the right.
The American Diabetes Association estimates that 5 percent of people with diabetes in the United States have Type 1, formerly known as “juvenile diabetes” because of its likelihood to appear during childhood.
This summer, Shapiro will travel to Boston to participate in a study of diabetics who have managed the chronic condition for 50 years or more. The Harvard-affiliated Joslin Diabetes Center, which is conducting the study, recently sent him a medal honoring his health achievement. Engraved on one side is the word “triumph.”
“It’s not what you have, it’s what you do with it,” Shapiro said, explaining his outlook. “I’ve always felt diabetes is a challenge I’ve been given, but it’s also given me lots of opportunities to create a healthy lifestyle, to be active physically.”
Active is an understatement.
Shapiro, 64, is an avid dancer, skier and rock climber who travels the world with his wife to attend Argentine tango and folk-dance festivals. That’s on top of his job as a physician’s assistant at St. Rose Pediatrics and his volunteer work at diabetic youth camps.
Part of his success can be credited to medical advances that have made it easier — and more effective — for him to control his diabetes.
As a teen, he monitored sugar levels in his urine via chemical reaction in a test tube, but the method yielded questionable results. Blood-sugar testing didn’t debut until the early 1980s, Shapiro explained.
Today, Shapiro can check his blood sugar with a few taps on an iPod-shaped device. A continuous glucose monitor, attached to his stomach with a tiny needle, wirelessly transmits his levels to the handheld device.
Gone, too, are the days of multiple insulin injections. An insulin pump attached to the other side of Shapiro’s stomach delivers necessary hormone doses.
Technology has enabled Shapiro to enjoy a greater selection of food and even indulge in sweets every now and then. When he was younger, Shapiro adhered to a limited menu carefully calculated to keep his sugars in check.
Shapiro’s self-restraint likely kept his health intact all these years. He has experienced only one diabetic-related medical issue: changes in his vision that required laser treatment in one eye.
Shapiro said he has refused to feel sorry for himself or sacrifice his dreams and goals because of his diabetes.
“If you don’t make the decision to live life fully and make those wonderful journeys, it’s not going to happen,” he said.