When he was in second grade, senior Roman “Roma” Sarapin received a piece of news that changed his life. After not feeling well for a few days and drinking an entire 24-pack of water bottles due to extreme thirst, his mother took him to the hospital where he received the diagnosis: he had diabetes.

“I didn’t even know what it was. I didn’t really understand when they told me, ‘You have Type 1 diabetes.’ I had never even heard of the disease and it took me awhile to understand,” Sarapin said. “I was in the hospital for a month or so. They were teaching me how to handle it, and they were just stabilizing me. But I wasn’t scared; I felt like I was scared at first, but then they explained everything to me, and I calmed down.”

Sarapin is not alone. According to a June 2011 study conducted by the American Diabetes Association (ADA), the number of people with diabetes worldwide has more than doubled in the past 30 years. In 1980, there were approximately 153 million diabetics. Since then, the number of diabetics has increased by 56 percent, with over 347 million people now living with the disease. It is projected that by 2020, more than half of the adult population will be living with diabetes.

According to Melissa Cavaghan, an associate professor of clinical medicine at the IU School of Medicine who has been studying diabetes for 15 years, the significant spike in the number of diabetics is a new phenomenon. She said she attributes the increase to the fact that Americans now eat much more and exercise much less than in the past.

“Genetics haven’t changed,” Cavaghan said via email. “There is a group of Native American people, some of whom live in Mexico and some of whom live in south Texas. They are genetically identical. Those who work the farms in Mexico have about a 3 percent diabetes rate. The ones who live on the reservation with much less physical work and plentiful food have about a 50 percent diabetes rate.”

Scary Diagnosis

Indiana is following this same trend. According to “F as in Fat: How Obesity Threatens America’s Future 2011,” a report from Trust for America’s Health and the Robert Wood Johnson Foundation, Indiana is now the 15th most obese state in the country. Because of this rise in obesity, the number of people with high blood pressure and diabetes has also increased. As of 2009, over 450,000 Hoosiers had been diagnosed with diabetes, according to the Centers for Disease Control and Prevention.

On a more local level, Hamilton County, while generally regarded as a more affluent and therefore healthier area, also has seen an increase in the number of diagnosed diabetics. In 2008, 8.5 percent of the county’s residents were diabetic, compared with 7.1 percent in 2004. In comparison, the current national rate is 8.3 percent, according to the ADA.

School nurse Carol Gelatt said the percentage of CHS’s student body that has diabetes is about the same as that of Hamilton County. She said all CHS diabetics have Type 1 diabetes. According to her, Type 1 diabetes, which Sarapin has, occurs when the pancreas stops producing insulin, which reduces blood sugar and generally is more related to genetics. Gelatt said there are no CHS students with Type 2 diabetes, and she said she is unsure as to why that is the case. In Type 2 diabetes, the pancreas excretes insulin but in an insufficient amount, which causes patients to have larger amounts of blood sugar. Gelatt said Type 2 is generally more associated with age, obesity and lifestyle.

Managing Diabetes

To help students like Sarapin manage their diabetes, the nurse’s office has an individualized action plan on file for each student that explains the student’s diabetic management plan that was set by their physician and approved by their parents. The plan identifies the student’s correction dose and food dose and what to do in case of low or high blood sugar. Gelatt said diabetes is managed through insulin that is injected via syringe, insulin pen or pump and occasionally oral medication. Exercising on a regular basis and eating a balanced diet can also help.

In addition to the action plans, nurses may also notify teachers that a student is diabetic because it can affect the student’s attendance and his abilities in the classroom.

“If they have a low blood sugar, it’s not a good time to take a test or a quiz. They need to feel better first to be able to think clearly,” Gelatt said. “Or if their blood sugar is high, they’re not feeling well; they could be nauseous, have a stomachache or not be able to think clearly. It’s important for the teachers to recognize those symptoms because low sugar and high sugar can both be life threatening.”

For Sarapin, who has been swimming for six years, managing his diabetes is a bit more difficult than most since he is an athlete. He receives hourly doses of insulin through his insulin pump to keep his blood sugar level stable, and he must check his blood sugar eight to 10 times a day.

“When I exercise, my blood sugar goes low, and it’s hard to control that sometimes because it fluctuates; it goes from being high to being really low,” Sarapin said. “But I can still get through my sport, and I have to get out for practice sometimes. I have to get out for like 20 to 25 minutes every day actually to fix my blood sugar.”

Diabetic and senior Stephanie Stromquist said she can relate to Sarapin’s frustration. Since her diagnosis in eighth grade, she has had to count the amount of carbohydrates she eats, check her blood sugar and give herself insulin shots.

“I was sad when I was diagnosed, but I was scared because my grandma had diabetes, and she didn’t take care of herself. She had Type 2, but she died because she didn’t take care of herself,” Stromquist said. “So I was like, ‘Oh my gosh, am I going to die?’ but they were like, ‘No, you’re fine, just take care of yourself.’”

Stromquist not only manages her own diabetes, but has paid it forward and cares for others. She babysits young children who have been recently diagnosed with diabetes. Stromquist said when children and young adults are newly diagnosed, parents worry and feel that they cannot leave their children at home alone, so she helps alleviate some of that stress since she can relate to the children and help them manage their diabetes.

“It’s just about knowing other people who go through it and stuff, so I babysat a sixth-grade boy named Nick with Type 1 diabetes, and he had just been diagnosed,” Stromquist said. “It’s kind of cool because we could relate. We were talking like, ‘How do you feel when you feel low and how do you feel when you feel high?’ and ‘What’s the hardest part about it for you’ and stuff.”

Prevention

While both Sarapin and Stromquist’s Type 1 diabetes could not have been prevented, Cavaghan said there are lifestyle factors that can be improved, like eating habits and community planning, which could halt the growing trend shown in the ADA study. She said feeding children sugary drinks, which have an average of eight teaspoons of sugar in each can, and providing unhealthy snacks is a “terrible habit to teach,” primarily because continuous consumption of soft drinks is bad for one’s weight. According to Cavaghan, diet and exercise are the best and the least expensive ways to prevent diabetes.

“Lifelong habits of consuming too many calories set up our young folks for a lifetime of poor health,” Cavaghan said. “We don’t have required gym in school every day. We drive everywhere instead of walking because of poor community planning and poor public transportation, and one in four Americans eats at McDonald’s every day. Physical exercise needs to increase, but healthy eating is the most important.”

Gelatt said CHS students who are friends with diabetics like Sarapin and Stromquist should try to understand their friend’s illness so they can help them when they have or are not feeling well.

“I think it’s important that if you have a friend who is diabetic to talk to that friend and help them understand what their diabetes means to them and how they can help them,” Gelatt said. “Diabetes is manageable. They live normal lives; it’s just that they need to take insulin to help them function normally.”