By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

On the long-running CBS hit Touched by an Angel, Della Reese was a party to many miracles. Now in real life the actress hopes to create life-changing results for those suffering from diabetes.

Reese's heavenly intervention began with what potentially could have been a near visit from the Grim Reaper.

"We were taping Touched by an Angel and I was coming down the stairs of my house in Salt Lake City and it felt like someone split my head in half and I blacked out," Reese recalls. "I don't know how long I was there but when I came to I didn't feel anything so I just went on to work."

During the taping Reese continued to feel dizzy and unwell and was eventually rushed to the hospital where she was diagnosed with type 2 diabetes.

"The thing was there were no symptoms," says Reese, who is an ordained minister in Los Angeles, California. "I was feeling great. So I don't even know how long I had had type 2 diabetes. I have no family history of diabetes whatsoever."

What Reese did know was she was scared.

"What was so upsetting was I didn't really know anything about diabetes except that Ella Fitzgerald lost her legs and later died from it," Reese states. "So I all knew was you lost your limbs and you died from it. I was scared silly."

But from darkness Reese turned to the light.

She is now compensated as the national spokesperson for an educational awareness campaign called "Della Reese:  Stronger Than Diabetes." Sponsored by GlaxoSmithKline, the campaign is designed to help people with type 2 diabetes learn to manage their disease. A free booklet and CD are available by calling 1-866-INFO-DIABETES or by visiting www.delladiabetes.com. 

Reese quickly learned that her problem was with what doctors call insulin resistance, one of the underlying causes of type 2 diabetes. Type 2 diabetes is a condition characterized by high blood glucose levels that occur when the body either cannot make enough insulin or does not respond appropriately to the insulin present.

This latter condition is called insulin resistance. While an estimated 16 million Americans suffer from type 2 diabetes, approximately 60 million have insulin resistance. More than 90% of diagnosed type 2 diabetics is insulin resistant. 

Diabetes basics

And the problem is getting worse as America loses its battle with the bulge because of lack of exercise and over-eating. With more than 61% of the population now overweight or obese, diabetes has also reached epidemic numbers.

"We're not precisely sure how fat affects insulin response," notes Robert Ratner, an endocrinologist and vice president of scientific affairs for Medstar Research Institute.

"But as you gain weight, fat spills over from the sub-cutaneous depot to the abdominal cavity, and ultimately into the liver and the insulin-secreting cells of the pancreas.  As a result, the liver fails to respond to insulin normally and the pancreas fails to secrete insulin in response to a carbohydrate challenge."

It is the insulin resistance that concerns many experts like Ratner.

"You begin by having a situation where you don't respond to insulin as effectively as you should," Ratner explains. "The compensatory factor is that you make more insulin. However there are people who have a genetic propensity to be unable to make enough insulin to overcome this insulin resistance. At which point the blood sugar level goes up and we define diabetes."

Without proper management diabetes can seriously impair a person's health.

Microvascular (small blood vessel) complications of diabetes include:

• diabetic retinopathy - the leading cause of blindness
• diabetic nephropathy - the leading cause of renal failure
• diabetic neuropathy - one of the leading causes of impotence and pain and numbness in the legs, and ultimately leg amputation

Macrovascular (large blood vessel) complications include:

• a two-fold risk of stroke
• depending on sex, a 1.5 to four fold increase in heart attack risk
• leg ulcers, exertional pain, and increased amputations

Once diagnosed through a random glucose test, a fasting glucose test or a glucose tolerance test, treatment depends on the stage of disease an individual presents with.

Early on in presentation, lifestyle modification is recommended. This requires an increase in physical activity which directly improves insulin sensitivity and modifies body weight and fat, as well as a decrease in total calorie consumption.

"My doctor explained that exercise and diet changes might help and that I also might need a medication," Reese says. "He told me to lose weight, to exercise more and to watch what I eat.  I can still enjoy the foods I like I just eat much smaller portions now. And of course I've had to give up that southern style way of cooking."

Getting under control

For Reese changing her diet wasn't nearly as difficult as exercising.

"The exercise I do now is a mammoth change for me because I never did any exercise ever," Reese explains. "Now I walk every where I can. I also ride a stationary bicycle for a total of 30 minutes. I do it three or more times a week now and I have lost 20 pounds."

But for many who present late, medications as well as lifestyle changes are required.

"If someone is symptomatically ill, we will frequently go directly to insulin injections," Ratner states. "Even for these seriously ill subjects, their diabetes ultimately may be controllable with oral medications."

Among the many pharmacological interventions for type 2 diabetes are:

• Insulin secretogogues - these oral medications help the body make more insulin and are part of a drug family called sulfonylureas. Essentially they help beta cells to be more efficient in making insulin in response to glucose.
• Meglitinides - A new class of drugs that are also insulin secretogogues. They are faster-acting and are taken whenever you eat.
• Biguanides -- This class of agents acts on the liver and turns off or limits the amount of glucose produced.
• Glitazones - These work on the muscles and fat cells and improve insulin action.

Reese's doctor prescribed Avandia which targets insulin resistance by making the body more sensitive to the insulin it is already making.

"The medication is helping me a lot," Reese says. "I don't have to take insulin because I have been able to make these changes and take this medication."

With appropriate diagnosis and intervention Ratner says doctors have the means of delaying or preventing the disease from occurring at all. But once diagnosed, controlling diabetes is critical to minimizing the risk of complications.

Several studies show that for people at high risk for developing type 2 diabetes, early intervention with lifestyle changes can reduce the development of diabetes by as much as 58%.

"You don't have to wait to get diagnosed with diabetes," Ratner advises. "We can stop it before it develops."

Reese agrees with Ratner wholeheartedly.

"I learned to do what was necessary because I am fighting for the quality of my life," Reese says. "I don't want my husband to push me around in a wheelchair. I don't want someone to lead me around because I'm blind. You don't have to let your life be destroyed by diabetes. You can reclaim your life. You just have to take charge and develop a maintenance plan with your doctor."

For Della Reese's diabetes information, click here.

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 10/19/2003  -  John Morgan & Stephen A. Shoop, M.D.
Reviewed: 10/19/2003  -  Donnica Moore, M.D.