By By JOHN EBY / Dowagiac Daily News
Alan Kott can think of four reasons for managing his diabetes.
His wife and three grandsons, including the 7-year-old he was able to keep up with chasing him up Sugar Loaf Mountain.
Kott, a retired chemical engineer from Midland who played tennis six times a week, has gone from blood sugar readings off the high end of the chart and devastation at his diagnosis to becoming an A1C Champion who makes inspirational speeches all over Michigan, as he did Thursday for Ann Turner, diabetes educator at Borgess-Lee Memorial Hospital.
A1C Champions have lived with diabetes long enough to know that it need not control his or her life.
No one chooses to have diabetes, but the way you choose to react to it helps determine what effect it has on your life.
Whether that effect is good or bad is largely up to you, emphasized Kott, who has managed his for 14 years.
"I have learned to do things I don't want to do and I've turned them into habits that work," Kott said, noting that forming new behaviors takes three to four weeks of daily practice and repetition to take hold.
Don't give up too soon.
There is no cure, but knowledge about this progressive disease grows every day, thanks to ongoing research into the cause of diabetes and medications – which for Kott came to include insulin in December 1997 – and the value of tight blood sugar control to help reduce the risk of developing complications such as blindness or limb loss.
Kott spoke about the importance of the A1C test.
People with diabetes used to be monitored only by urine or blood tests.
Those tests told only the approximate level of control at the time of the test.
The A1C blood test shows an average of where your blood sugar has been over the past two to three months.
Kott explained the chart depicting how plasma glucose levels relate to the A1C test.
The American Diabetes Association (ADA) recommends keeping your A1C under 7 percent. In general, reducing your A1C by just 1 percent can greatly reduce your risk of diabetes complications.
For example, decreasing your A1C from 8 percent to 7 percent may reduce your risk of complications by 40 percent.
Kott recalled how "ignorant and confused" he felt when he diagnosed himself after suffering blurred vision while playing tennis.
When a doctor agreed to see him, he didn't eat anything for five days.
While not eating is not a proper response, his fast eased blood sugars which had been "off the charts" at more than 300.
Kott's mission is to recast the "long list of negative 'have-tos' " people associate with diabetes, a condition where the body has a higher than normal blood sugar level on a regular basis.
Such build-up over time and "drift" can seriously damage the body.
Kott said insulin injections for 11 years now proved less painful than he feared. He encourages people with diabetes to focus on the positives of enjoying a long, productive life, instead of dwelling on the cost or the hassles.
Kott said the most important thing to know about diabetes is that while you have no control over getting it, you do have the choice of how to react.
You can choose to take an active role in managing it – or not.
If you choose not to address diabetes head on, you risk complications and serious health problems. Diabetes isn't curable, but it's treatable, with the benefits of taking control of it tremendous.
Virtually all movement of sugar into and out of your cells depends on the key hormone, insulin. Insulin helps sugar move from blood into parts of the body to keep them working.
In a person with type 1 diabetes, the pancreas ceases insulin production.
Those with type 2 diabetes produce reduced amounts of insulin, or the body doesn't use insulin as intended.
Either way, the body requires help to deal with high blood sugar levels.
Help can come in the form of healthy eating, physical activity and stress reduction.
Some people take oral medications. Others benefit from insulin and/or a combination of them all.
Human bodies work to strike a safe, healthy balance of three things – the level of sugar, or "fuel" taken in; the amount of fuel the body requires; and the amount of insulin needed for the body to be able to use the sugar.
Balance among these three important areas is what can help keep an A1C level under control, where the fluctuations are more gently rolling, like Lake Michigan in July, than spikes like Lake Superior surf in November.
Food and drink we ingest become sugar in the bloodstream.
Different foods give the body different amounts of sugar. A glass of water gives the body no sugar, but a glass of juice does.
There are slight ups and downs throughout the day with meals and physical activity, but usually below 180 for the post-meal range.
The A1C level would be below 7 percent if this person maintained such a pattern of blood sugar control for two to three months.
A graph of uncontrolled diabetes shows huge swings between the high sugar caused by too much food and/or too little insulin and low sugar, which may be a result of too little food, too much insulin or too much physical exertion.
It is the extreme swings which take their toll on the body, mind and emotions, with significant damage occurring over time.
To "control" diabetes means matching food intake to physical activity, medications and/or insulin on a continuous basis.
A finger stick reading shows how well blood sugar is controlled at the moment. An A1C level indicates how well blood sugar was controlled over the past two to three months.
There is no such thing as "borderline diabetes." Some cases are more serious than others, but diabetes is what it is, and it won't go away if you ignore it.
It's not your fault. It's not contagious. It is a serious disease, but running from it in fair makes it harder to be able to control it.
Kott, who arms himself with information from a variety of periodicals and online newsletters, says a better choice is to learn as much as you can about diabetes so that you can take control of your health team and support system.
Knowledge alone is not power, but rather knowledge put into action is power.
And though it may seem like it sometime, you're not alone.