Smoking a major risk for diabetes patients

Margarita Persico | 10/7/2009, 5:15 a.m.

Rivera had several strikes against him: He’s Latino, he smoked, he was overweight and diabetes runs in his family.

“All my family on my father’s side is diabetic except my grandfather and his wife,” Rivera said. His great-grandmother was also diabetic.

Rivera said his father, who lives in Puerto Rico, has been a diabetic for more than 30 years. He has developed complications such as diabetic neuropathy, a condition in which nerves become damaged as a result of high blood sugar levels.

The problem presented in Rivera’s father after he stepped on a nail, and his toe did not heal.

“They amputated a toe and he continued with the illness. They are going to amputate the foot,” Rivera said.

Angela Villaman-Curran, a registered nurse and patient educator at GLFHC, said that is one of the problems with neuropathy. Since patients may have no sensation in their extremities due to the nerve damage, if they get cut or something becomes embedded in their skin, they may not feel it.

“The object stays in there, and when they realize what has happened, there is a large ulcer and they end with amputations,” she said.

Now, like his father, Rivera is having problems with neuropathy. He’s already had surgery on one foot.

He had an early warning seven years ago, when he said his doctor told him to follow up with regular medical visits to check on his blood sugar reading. At the time, his sugar was measured at 300, more than three times the desired level. But, Rivera admits, he did nothing to treat himself until his hospitalization in 2007.

There are many negative consequences of not actively treating diabetes.

“The awful things [are] … kidney failure, or eye disease, heart attack, strokes, amputations,” said Dr. Elisha H. Atkins, an internist at Massachusetts General Hospital’s Chelsea HealthCare Center.

Some complications can be fatal, according to Tellez of the Greater Lawrence Family Health Center.

“Most people die of heart disease, and having diabetes triples your risk of heart [disease],” he said.

Rivera said his diet was not helping, either.

“I used to have my dinner with three cans of soda, diet or regular. Now I don’t like it,” said Rivera, who said he never liked other types of sweets, but ate fast food regularly due to his work schedule.

Now he worries about his 17-year-old son.

“When my son was young, he did not care much for sweets,” Rivera said. “Now he wants to eat at Dunkin’ Donuts, and I tell him no.” Rivera said he allows his son to eat at the fast-food restaurant only once a week.

“It’s not easy,” he said.

Today, with the help of insulin, Rivera’s diabetes is under control. Since becoming a regular patient of nurse educator Villaman-Curran, he said he’s learned a lot about managing his disease. When he was first diagnosed, he did not know how to use a syringe. Now, when necessary, he is able to inject himself with the insulin formula Levemir.

“Since we do not learn about diabetes in school, at least people like [Villaman-Curran] and the other doctor … orient me,” said Rivera.

Rivera said he made too many mistakes in the past when it came to dealing with his health, but now he’s ready to try to do things right and be a good role model for his son.

He said he never misses education programs and medical appointments, and now believes preventive behavior is key — since that fateful December 2007 hospital visit, he has not touched a single cigarette.

“Observe and look at what you eat,” he recommended. “For those who have and don’t have [diabetes], take care of yourself and go for checkups every six months. Be informed.”