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Myths and Fears Steer Many To Go Untested, Undiagnosed

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What you don't know can hurt you Diabetes experts say persistent myths and misconceptions cloud understanding of diabetes. Among them: Norman Hente of Granite City, Ill., started having trouble with his eyesight when he was 49. He thought it was just another sign he was getting older.

''I couldn't read the road signs, the big ones,'' he says.

Glasses helped, but at his next physical, his doctor checked his blood.

''He said, 'Guess what, Norm. You've got diabetes,' '' says Hente, 63.

Even though his father was a diabetic who died at 45 of a heart attack, Hente didn't recognize signs of the disease in himself.

New statistics to be released later this week estimate that as of the end of 2002, 18.2 million Americans have diabetes, up from 17 million in 2000, Health and Human Services Secretary Tommy Thompson told USA TODAY.

Of those, 5.2 million people are unaware they have the disease, a drop from the 5.9 million undiagnosed in 2000.

That indicates more people are being tested and treated, Thompson says, and that's encouraging. Diabetes is ''a rapidly growing, ever-expanding disease that is adversely impacting the quality of life of millions of Americans,'' he says. ''The earlier you find out about it, the sooner you can get treatment.''

Yet many people -- Hente included -- fall into high-risk categories because of a family history, age, ethnicity or obesity, and they avoid being tested out of fear or denial. Often, knowledge of the disease is based on popular myths about diabetes. Complicating matters is the fact that the symptoms, when there are any at all, can be subtle and easy to miss.

But there's nothing subtle about the results. Diabetes is the leading cause of end-stage kidney disease and of blindness in working-age adults. It at least doubles the risk of heart disease and accounts for 60% of lower-limb amputations not caused by accidents.

For Hente, it was only in hindsight that he realized how ill he had been feeling. ''I noticed afterward that I had been tired a lot and worn out, just really worn out, no energy at all. That is one of the signs of diabetes.'' Soon after beginning treatment, he says, his vision returned to normal, and his energy level soared.

Many people don't perceive themselves as being at risk for diabetes, even when they should, says Barry Goldstein, director of the Division of Endocrinology, Diabetes and Metabolic Diseases at Thomas Jefferson University Hospital in Philadelphia.

A September survey by the American Diabetes Association (ADA) found that more than half of overweight people interviewed named obesity as a major risk factor for diabetes, but 59% said they personally were not at risk.

''There's a lot of denial,'' Goldstein says. ''People don't want to find out they have diabetes.''

That denial comes at a price. ''If you don't look for it, you're not going to find it, and you're not going to treat it,'' he says.

Meanwhile, diabetes can silently be doing its damage to kidneys, eyes, nerves and the heart. A large study in the United Kingdom found that 50% of people had at least one of the complications of diabetes at the time they were diagnosed.

Sometimes managing your care means facing your fears. For Hente, the thing he dreaded most was having to go on insulin. His father, who had been on insulin, died young, so ''I saw it as the last step before the coffin.''

But diet, exercise and medications were not enough to keep his diabetes under control, so Hente took the big step, adding insulin once a day to his regimen. The results were dramatic, and he feels great. ''Frankly, if I'd had any real understanding of it, I'd have gone on it sooner,'' he says.

Now, Hente speaks to groups as a diabetes advocate. His message is that people need to be aware of their risks for diabetes, and if they have it, they need to take charge.

''With diabetes, in particular, the patient ends up handling their disease most of the time,'' he says. ''There's not someone else standing there telling them what to do, making sure they take their medicine, get exercise, eat right. They're really treating themselves.''

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© Copyright 2003 USA TODAY, a division of Gannett Co. Inc.

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