Cooke County — Diabetes is referred to as the “silent killer,” and with good reason. While those challenged with the chronic illness may not even be aware of it, the condition may be damaging to the eyes, kidneys, nerves, blood vessels and heart.

Managing diabetes is usually a challenge, Pharmacist and Certified Diabetes Educator Jerry Meece said, but it is essential.

Meece, who works with Plaza Pharmacy and Wellness Center in Gainesville, is passionate about his work with diabetes, and lectures and holds classes and workshops throughout the country to educate diabetics and to work with professionals to help them be more successful in working with diabetics.

“Keeping blood glucose levels under control and faithfully following a good diet and getting exercise are key points in education,” Meece said.

“There are ‘three legs of the stool,’” he said, in his example to show the balance needed between medication, exercise and nutrition. “We try to get that balance in their life.”

Medication depends on the type of diabetes the individual is dealing with, Meece said. Type I diabetics are dependent on insulin and must continually work to adjust it. Type II diabetics often rely on oral medications such as a pill, to help maintain normal blood glucose levels. If the disease progresses then insulin comes into the equation.

Exercise is essential, he added. He asks people, “What can you do to be more active?” and tells them that anything they do to be active is better than not being active at all. If the best they can do is walk around the block, let’s start with that.

Nutrition is also important so diabetics must eat right, Meece continued. The diabetic must understand the foods that make blood glucose go up and what keeps it normal. Trying foods and meals and checking glucose before the meal and then two hours after the meal to see what happens is a good practice.

Meece usually works with diabetics when they attend one of his local classes.

“What we do when we have a class is we bring in a group of people and we sit down and talk with them a whole lot about what is on their mind. You have to address their concerns,” he said. “I ask them, ‘What is the most difficult thing you need to do in dealing with your diabetes?’ Typical challenges for diabetics include how do they get all of their medications prescribed for them taken at the right time and how do they afford their medicine?”

During class, Meece said they talk about what is working and what is not working in their management of the condition. It’s important to try to help diabetics understand that getting control of diabetes is like eating an apple.

“It’s one bite at a time,” Meece continued. “On the bright side, what is really hard for them now, changing diet, becoming more active and consistently managing their medication and chronic illness becomes easier. They need to just incorporate it into their life.

“Its one of my true passions in life to sit down with people who have diabetes and often they are like a cork bobbing in the ocean, not sure what to do, how to approach it, so I help to give them some direction,” he said. “Part of that is helping them to find the community resources and places to get what they need, because they will be doing this a long time.”

Meece said that encouraging the diabetic is so important because one small detail can make a difference for that person. One small change in what they do can make a world of difference.

“One of the most rewarding things is when a diabetic has one of the big aha moments,” Meece said, “when the light comes on, it’s the way that means, they get it, that they need to take care of themselves. I can show them what to eat, but I can’t eat for them, I can’t exercise for them, I can’t inject their insulin. They still have to make their own decisions. It’s a 24-7 commitment with no time off for good behavior.”

Pharmacist and Certified Diabetes Educator Shelly Rains of Hometown Pharmacy listed the three major symptoms of diabetes: being tired, thirsty and having to urinate frequently.

“People often have diabetes an average of seven years before they know it,” she said. “One statistic shows that one-third of the United States population has diabetes.”

Rains said there is one test to determine and check diabetes, the hemoglobin A1C, which can show the status of the last three months of their blood sugar level.

The most important thing to do to manage and maintain diabetes is to test the blood sugar level consistently and eat accordingly, she continued, because when the blood sugar level is too high, the effects can cause damage to the body and have especially detrimental effects on vision, kidneys and can damage nerves which can lead to amputations.

While diabetes may just be a word to those not familiar with the condition and struggles of the chronic illness, to those with the condition, managing it well can be a matter of life and death.