Glucose Testing

El Pasoan Ruben Meraz

Ruben Meraz began tracking his glucose levels several years ago. His father and grandfather had diabetes, and he saw the detrimental effects it had on them.

“Both my dad and grandfather died of diabetes – and they were ugly deaths. My dad had his leg amputated because of diabetes and he never recovered from that. He went into a semi-coma after the surgery. And I think he was completely depressed because he lost his leg and that killed him” Meraz said. “My grandfather got progressively worse until he passed away. He was on dialysis and as he aged he fell apart fairly quickly.”

Meraz knew it was better to be proactive about his own health.

“I figured it was going to catch up to me eventually, so whenever I had a chance to measure my glucose level at health fairs, I would do so,” Meraz said. 

He began walking more and eating well, losing about 45 pounds in five months. But his glucose levels were creeping up, reaching 200 during a doctor’s visit in 2016.

“I was given some prescriptions, but I really wasn’t given a lot of information at the time. I got a call from the El Paso Diabetes Association (about a month later) and I was told about their support group, and I went in,” Meraz said.

That marked the start of Meraz’s journey to managing his diabetes, a disease that’s the leading cause of death in the United States and which is increasingly prevalent in the El Paso region.

 

Diagnosis, obesity and death

Some 34.2 million people across the country are diabetic, while another 88 million as considered pre-diabetic – having higher than normal blood sugar levels but not enough to be considered diabetic – according to the U.S. Centers for Disease Control.

Diabetes occurs when blood sugars are too high and the body cannot make its own insulin, the hormone that helps the body use that sugar for energy. 

Type 1 diabetes is less prevalent but more aggressive, making patients dependent on insulin shots or pumps. Type 2 is a non-insulin dependent diabetes.

In El Paso County, nearly 55,500 adults age 20 and older had been diagnosed with diabetes in 2016, the latest data available from the CDC show. That’s about 9.6% of the adult population.

That represents an increase of nearly 24% from 2010, when 44,781 adults in the county had been diagnosed with diabetes.

While you don’t have to be overweight to be diabetic, Dr. Celina Beltran, chief medical officer and family medicine physician at Centro San Vicente, said excessive body fat can lead to insulin resistance.

That in turn prevents the cells in your body to respond to insulin and can’t use the glucose in the body to make energy. As a result, the pancreas goes into overdrive to create more insulin and over time can lead to Type 2 diabetes.

“That is why obesity and Type 2 diabetes can go hand-in-hand,” said Beltran, who estimates that about 68 percent of the clinic’s patients are obese.

“And why are we so obese? We are very sedentary and the foods of our culture are not necessarily the healthiest.”

About 28.5 percent of El Paso County residents over the age of 20 were considered obese in 2016, CDC data show.

“There is a good percentage of people who have diabetes or pre-diabetes who are not even aware of it,” said Dr. Peter Catinella, Texas Tech Physicians of El Paso and chair of the Department of Family Medicine at Transmountain.

“So it’s important that you get an annual exam. It’s extremely important to make sure we can screen people appropriately,” Catinella said.

The high prevalence of diabetes is a combination of a genetic component in the Hispanic population, obesity, and the difficulty to access healthcare, he added.

 

Covid-19 complications

While diabetes has long been a concern in the region, it’s become even more so during the COVID-19 pandemic.

Patients with underlying conditions such as diabetes who contract coronavirus are more at risk for developing complications.

“That’s what’s been seen and it ties back to blood sugar and glucose control,” Beltran said. “If you don’t have your glucose very well controlled that challenges your body ability to fight infection, and we see that when individuals have bacterial infections, but the same holds true for viral infections.”

El Paso County tallied more than  5.800 positive cases of COVID-19 by  June 30, with nearly 130 deaths. Of those who died of the virus, more than 44% had diabetes, while nearly 63% had hypertension, according to city health department statistics.

 

Hypertension connection

Diabetes and hypertension – or high blood pressure – are intricately tied to each other. One in three adults in the U.S. has hypertension, while two of three people with diabetes report having high blood pressure, according to the American Diabetes Association.

In El Paso County, 25% of adults reported having high blood pressure in 2017, the latest data available from the Texas Behavioral Risk Factor Surveillance System show.

That compares to about 22.6% in 2011. Hypertension is most prevalent among those 65 or older. 

The higher your blood pressure levels, the more risk you have for other health problems, such as heart disease and stroke.

Like diabetes, hypertension can be controlled through lifestyle changes, including eating healthy diets and exercising to control your weight, limiting alcohol and avoiding tobacco.

 

Being proactive

Taking preventative measures and educating yourself through local resources is key, area experts said.

“Diabetes is more prevalent among people that have a less than optimal diet and people who are less active,” said Michael Kelly, vice president of programs at the Paso Del Norte Health Foundation. 

“The key is to be physically active and moderate your calories. You could delay early onset of diabetes, and being active creates a strong body and strong mind.” 

The El Paso Diabetes Association hosts regular Sabrosa Vida healthy cooking classes, diabetes management classes and insulin injection and pump training, as well as diabetes prevention and education courses for children. 

“There’s this big misconception that you have to change every aspect of your life, and really here in our classes we are big advocates for eating a variety of foods,” said Cynthia Chacon, the association’s program coordinator.

“But what’s more important is the quality and quantity of the food. So there’s really no restriction as long as you know how to properly measure your portions.”

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