 Aloha, Hawaii. I'm Wendy Lo, and I'm your new friend as we journey to take your health back. We are coming to you live from downtown Honolulu, from the studios of Think Tech, Hawaii. Today our topic of discussion will be on powering over diabetes. So let's stop and let's take diabetes back and conquer it together, because together we can. But I'd like to introduce you and welcome Laurence Duenis, or as we know you as LJ. Around town, we call you LJ, it's much easier. He is the director for Hawaii for the American Diabetes Association. Welcome. Thank you. And we'd like to welcome Doug Park. And Doug Park is also with the American Diabetes, but from the volunteer point of view, I believe you're one of the lead volunteers of the American Diabetes Association. And you're also a cyclist extraordinaire. Is that correct? Yes. Yes. Welcome aboard, gentlemen. So let's begin. How does diabetes affect us here in Hawaii? And can you share a few statistics with us? Sure, Wendy. And first of all, thank you for the opportunity to be here and talk to your audience about diabetes. Very good. Thank you. In Hawaii, every day, about 21 people are diagnosed with diabetes. This has become an epidemic. When we look at statistics, about half of our population, or over half of the population, 600,000 to be exact, are affected by prediabetes or diabetes. And when we look at that, that's about one in every two people in our state. But why is that? The ADA is looking at research and results to identify why certain populations in the community are more affected by diabetes or predisposed to the risk factors. When we also look at complications of diabetes, we know that heart disease is and continues to be the number one killer in the United States, as well as in Hawaii. But when you look at diabetes and heart disease, diabetes by itself is the strongest risk factor for heart disease. So if we can control diabetes, we can control heart disease, essentially controlling deaths associated with heart, heart disease and diabetes. Other than heart disease, other complications include kidney disease, a vision loss, stroke, and also lower limb amputations. In fact, 98% of all non-traumatic lower limb amputations is affiliated with diabetes. In addition to all of that, there are economic burdens that people with diabetes are affected by. In our state, we spend about $1.5 billion a year to care for diabetes. It's expensive to have diabetes. We see that many people can afford to pay for their medication and their test strips or other devices used to treat or manage their condition. So if we are able to come together and find ways to prevent what we can prevent and manage what we can manage well, we can definitely bring down the burden that diabetes has put on our community. Wow. Do you know about, you know, this is such a big problem with this diabetes. One of two will be diabetic in the state of Hawaii. That's terrible. What kind of cost are we looking at, you know, running, taking care of all the diabetics here in Hawaii? Well, when we look at just insurance cost, a person with diabetes, their cost for medical and other types of insurance-related expenses is about 2.3 times more than a person without diabetes. So that roughly could be estimated about $14,000 a year. And so you look at that and you look at what our employers contribute to insurance coverage. It's a big toll on many of our employer groups in our community, in our Medicaid and Medicare population, and also because there are co-pays involved in these types of insurance claims that many people with diabetes are out. Wow. And that's why we have a lot of different events going around raising monies so that we can raise awareness. And I'd like to draw some attention to Doug. He's number one ADA volunteer extraordinaire. I always say that because wherever there's a diabetes, stop diabetes sign, there's Doug. And you go out unconditionally every day, standing on corners, going to job sites to do presentations and just talk and educate work sites. And I'm just so amazed that you give so much of your time. And we are considering you a paraprofessional and just doing everything possible for you. I mean, you are the role model of a volunteer. And I just hope that when you go out, others can get contagious with what you give and give as much as you do. So in layman's term, tell us a little bit about what is diabetes? Well, basically, when the diabetes, and I'll just kind of read from a statement here, it covers, of course, the area that bothers or affects a lot of people is the pancreas. It's a major gland. And it's part of both your digestive and endocrine system. It makes digestive enzymes that breaks down foods that you eat. It also makes the hormones insulin and glucagon. I'm using all these terms, of course. But anyway, these help ensure that you get the right amount of sugar in your bloodstream and in your cells. If you don't make any insulin, which is the case for many people who are type one diabetics, your blood sugar levels can be very dangerously high. In type two diabetes, the pancreas usually makes some insulin, but not enough. And there's also a third type, basically, and it's gestational. And it affects women that are who become pregnant. And usually in the second trimester, that's when they're affected. And people, women who are usually with children already, there's usually the second child that's affected. You know, Doug, I know you did have to read it from the paper because you are so experienced with all of this, the symptoms and the effects. I understand that you are a diabetic. Yes, I am. So you have experienced diabetes type two? Yes. Can you share with us today that you were diagnosed with diabetes type two? Well, to be frank, I'll tell you, I can't really fully remember because I'll tell you, I've been a diabetic for 48 years. Wow. And because of that, I can only tell you that vaguely, I can say that my doctor when he first, and this is my third doctor I've already lived through. And he probably told me, well, you got diabetes and, you know, you better start taking care of yourself. But being young, et cetera, I didn't pay very much attention to it until much later in life, unfortunately. But that's basically what happened probably 48 years ago. So that means you're in your teens at that time? Yeah. Well, I wish I could say that. But thank you very much. But unfortunately, I was 28 or 29 at that time. And so Doug, when you were diagnosed, what did you do? I mean, did you go out and say, I've got to change my lifestyle? I've got to do this. I've got to do that. What was running through your mind at that time? Well, to be honest, I treated like any other day in my life back then, being a little younger and not as wary of what diabetes has been doing to a lot of people's lives as much as it is today. So I would have to say that, frankly, I took it as another day in my life and just went about living and doing things normally, which in retrospect is not what I should have been doing. But having said all of that, we are where we are today. So is that part of your mission, the ones that are being diagnosed to get them information and huddle around them so that they be more proactive and not let time go by with not addressing the issues? Yes. I think the key word here is education. And that's where many of us are involved with the diabetes programs, that we need to try to educate as many people as we can. And that's the challenge of today in many cases. So from the time you were diagnosed to the time you really were proactive on your lifestyle change, there was a period of time. Did you experience any complications during that time? Yes. I would have to admit that there was a period about 15 years ago when it started to really affect me. And I had to make some drastic changes in my lifestyle. And that woke me up to what I needed to do with my doctor's approval of course and support, medication changes, changing the way I ate and putting the nutrition into my system. And but one thing good about the whole thing that I was doing is that fortunately I was very actively involved, not only in the community but in sports. So that kind of helped me and actually delayed some of the effects that normally most people would be affected by. So it was a benefit by exercising and being out there and training. So that kind of helped delayed it for me. Wow. So you've touched on some very key points, you know, awareness, you know, education, and then being physical, doing something about it. Even unintentionally, you were just living that lifestyle. So you prolonged health, healthier life, even though being diagnosed with diabetes. Yes, absolutely. And so if you don't mind, what are some complications that you did face related to diabetes? Well, I'm not the normal case. Unfortunately, even more so, although there's a tremendous amount of passion in me to make some changes for a lot in helping a lot of people. But the major changes that affected me is that in changing my lifestyle, I found out that of course nutrition, one of the major areas, I had to make some changes. And that's of course eating the right foods and balancing your meals. I guess portion control is one word comes in mind that many people may not fully understand, but something I live daily, as well as eating three square meals a day, which for a diabetic is very important. And also taking medication. Daily is something that a lot of diabetics forget sometimes that they need to take their medication. They're so busy with their lifestyles that they get wrapped up in doing so many different things. But having said all of that, the major things that affected me were physical also. I had some major operations of a lifestyle that I think relied the fact of what I should be doing. I didn't do. And it affected me that way physically. I had some major operations, as I said. And that changed me also. When I woke up one day after that major operation, I made a promise to myself that I needed to make some changes. And that was to not only my lifestyle, but to do as much as I can to help others with diabetes. Well, you've got a lot of history, 40 years in the making. So when you were diagnosed with diabetes till now, what are the major changes you feel as far as managing your diabetes? Well, number one is education again. And it comes back to not only my beginning to educate myself, and that's what started me on the right track, but educating others, of course. The educational benefits I learned along the way is the outreach programs and being able to speak to doctors who have a lot more knowledge than I did at the time. And based on that, I started to learn a lot more of my condition, what needed to be done. And the fact that diabetes is a recent illness, really, when you look at it was discovered in 1969 only. So that tells you that it's a recent illness when you compare it to the rest of the world as far as history. But all of that comes back down to, again, the word education. It's educating yourself and getting to how to improve your lifestyle and doing so much more for yourself. Well, you know, for a fit cyclist, I just want to ask you, you're on the road, you're biking with the team, you meet with all kinds of people, and you're encouraging them every day. So how do you feel? How do you personally feel living with diabetes? I feel really great. I've been, actually, I can't really speak for others, but speaking for myself, my life every day that I wake up is a thankful moment because compared to many others who have challenges more than I do, compared to my age, I am way ahead of the game and very fortunate and very blessed that I'm here today to be able to speak about diabetes even. And that's one of the telling points of my wanting to do as much as I can for others. Well, that's, I mean, darn amazing, and that you feel the urge and the desire and you're doing it. You're not just talking about it, you know, sitting back in a rocking chair saying, oh, oh, me, I wish I could do something about it. You are out there daily. I mean, we called you to do this interview with us and you're Johnny on the spot without hesitation because your heart says, I need to get the word out and every opportunity we can, we need to reach the people out there. Absolutely. Yes. So education, the takeaway right now is just again, again and again, education, education, education. And the more that we can get volunteers and staff members of ADA out to share this information, you know what, we're going to beat this. And that's our goal is to find the cure for diabetes. Right. So at this time, we're going to take a short break. And I just want to say thank you, Mahalo, both of you for just sharing your heart and your wealth of knowledge with us. And when we return, we're going to continue on different issues of diabetes. So stay tuned and we'll be right back. Good morning. I'm Andrea Gabriele. I'm the host for Young Talent's Making Way here on Think Tech, Hawaii. We talk every Tuesday at 11 a.m. about things that matters to tech, matter to science, to the people of Hawaii, with some extraordinary guests, the students of our schools who are participating in science field. So Young Talent's Making Way every Tuesday at 11 a.m. only on Think Tech, Hawaii. Mahalo. Aloha, everybody. Here we are at Think Tech, Hawaii. And we're visiting with LJ from the American Diabetes Association and with Doug Park, volunteer extraordinaire. And Doug was just sharing with us his heart of how he, you know, his life was saved through a lot of knowledge. But when he was diagnosed with diabetes, he did an act on it right away. He took a few years in between to proactively work on the quality of life that he enjoys now. And so with that, the takeaway for us is education, education. And then when you receive it, share it out. And that's exactly what both of you are doing right now. And, you know, when we talk about diabetes, you know, what is it, what, how do we manage it? But there's a lot of complications around diabetes. And so with that, I'm going to ask LJ, who is from the American Diabetes Association office. He's our local representative. And by the way, I got to throw a shout out, ADA of Hawaii. As we mentioned earlier in the show, there's about over 600,000 diabetes, diabetics here in Hawaii. And if you go to their office or when you go to their office, there are three live bodies in their office, surrounded with one or two interns and powerful volunteers like Doug. And there are so many in that office that come together. But a shout out to LJ, to Danielle and to Robin and go around interns, but really just mahalo for their love and their commitment to stopping diabetes and just bringing awareness to the people of Hawaii. So LJ, would you like to share with us a little bit about some of the complications around diabetes? Sure. Again, thank you, Wendy, for those kind words. And also, we thank you for all that you do as a volunteer and also as a board member. So thank you. So just to, just to share a little bit about some of the complications, serious complications people with diabetes face, these complications include heart disease, stroke, lower limb amputation, kidney disease, among other things, and including vision loss. Fortunately, though, these complications in recent years has dramatically decreased more so because of ADA's yearly updates on our standards of care. Basically, what this is, it's like a car manual. It tells you what to do if this is what's wrong, giving physicians and other healthcare professionals an algorithm or a system of care approach when working with people with diabetes. And so we've seen dramatic decreases in heart disease, like I said earlier, which is our number one killer in Hawaii and the United States. So it's important that people understand that we not only go out in the community and educate on diabetes, but we're also behind the scenes turning research from science labs into translational medicine where we can share with physicians and other healthcare professionals. And some of the latest and greatest results from research projects across the country and also across the world. It's important that we talk about these complications because our mission is one to prevent and cure diabetes and to improve the lives of all people affected by diabetes. And that's what we do is we work to improve. We work to make sure people can thrive and make sure that they know where to look for support until we are able to find that cure. Of course, the cure right now is prevention, but there are instances where we can't prevent diabetes. That one diabetes cannot be prevented. We don't know what causes it. And so there's research that looks at meal plans or diets, beta cell or eyelid replacements, the artificial pancreas. So these are things that we're invested in, along with other research partners in the diabetes sphere. We find opportunities in challenges. These opportunities are one that there are people with prediabetes. And what this means is that we have an opportunity to educate, reach and turn people with prediabetes into people who had prediabetes. So giving them the resources that they need to be able to make better decisions when they are able to so that they can delay or prevent the onset of type 2 diabetes. You know, I'd like to interject. I honestly, being a local girl from Miley, I didn't have any concept of diabetes. The people around me weren't diabetic, so I wasn't in that world. Mine was more heart related and cancer. But diabetes, I didn't know much about it. When I was asked to sit on the board of directors for ADA, I said, why me? And I scratched my head. I didn't know anything about it. But that was why they chose me, because they could, from scratch, teach me and share with me their heart so my heart would be open to others as I learned and educated myself. Now I'm so passionate about this issue that I'm never going to step from the down from the board unless you kick me off. But you know, just the whole idea and you talk about prediabetes. I mean, myself, I used to own a chocolate factory. So I ate chocolate every day like it was going on a style. And so now, as I'm retired, I make better health choices because of what I learned through dog, through all of you at the office and just being out there at all the different presentations. It does matter. And we can take it into our hands and it can help towards, from prediabetes going to the next level. So I say no to that. So I'm learning and learning and I keep listening to everyone so that I won't be calm. So I thank you for all that knowledge and information, but please share with us how more can the people of Hawaii not, I mean, be more like me prevention and work on that part. Well, you know, just going back to, like I mentioned, we find opportunities in these challenges, right? We also know that many people are interested in diabetes. We have great volunteers like Doug, volunteers from the Hawaii Alliance Club. We have health systems and federally qualified health centers really vested or invested in diabetes and supporting people at risk. We also know that technology in diabetes treatment and management has been amazing in just a few years. You know, I've been a part of the American Diabetes Association. I've seen so many great innovations, including the external artificial pancreas or a continuous glucose monitor that replaces finger sticks. These are ways that we are working to improve the lives of people with diabetes. More so, these are devices that people with type one diabetes would be best candidates for, but there's opportunities here for even people with type two diabetes to benefit from. So, you know, it's a good time to have diabetes because there's so much support out there, but still it's going to be a better time when we find a cure. For sure. And, you know, LJ, what are other initiatives that the ADA leads to combat diabetes? Sure. So, you know, we do a lot in the community. Yes, you do. We work with employer groups to bring health and wellness into the workplace. Reason being is that we have a captive audience and we have support from corporate executives in these types of initiatives. We also know that community involvement in health is important. We partnered with restaurant chains in recent years to provide a healthier option menu for their customers with a restaurant train of 24 stores. That's amazing. Right. You know, that's a great way. And we appreciate all that they step up to support us with. It gives people with diabetes and pre-diabetes the option to choose healthier. We also have a program that is upcoming, which is our Hawaii camp program for kids with type one diabetes. Yes. And so happy to bring that back to Hawaii. We are so excited to hear about that, LJ. So, what it is, is basically the children with diabetes can come together and hang out for a few days in a camp, in a secure, safe environment with all the right physicians around us so that they can come and say, you know, have a good time with each other, versus, why me? Why me? They can say, hey, you too. You know, and let's combat this together. Let's support each other through this journey versus them being all alone one by one. So, tell us more about that, the camp upcoming. Sure. So, we are looking to host the camp from Saturday, or I'm sorry, Friday, November 9th through Sunday, November 11th at the YMCA camp Erdman. Again, it's for children with type one diabetes. And you said it perfectly. It's an opportunity for kids affected by type one diabetes to come together, create lifelong friendships, because the best support that these kids and families will have is each other. So, you know, I know we talked about lifestyle and we talked about all the solutions that are going behind, which is education and all of that. Is there a healthier diet for a diabetic or someone who's just diagnosed with diabetes? You know, I'll let Doug interject in a little bit, but what we, ADA, we focus on sharing with our customers a diet. We don't like to use the word diet. Creating a meal plan that's going to work for you. We see plant-based diet working very well for people with diabetes. We see very low-carb diet working very well for people with diabetes, but also for people without diabetes. And so, it's really in moderation what will work for you and something that's sustainable, because if it's non-sustainable, it's not going to work for you. Doug, would you like to add something in there because you're living it? Well, you know, basically, Wendy, I think in, I guess, follow up with what LJ has said right now. And, you know, it comes down to meal planning. And if a person can set aside during the week looking at their schedule and to see how their shopping will be, the foods that they have to buy for their meals, that in a sense already is a step in the right direction, they're planning ahead. And in doing so, knowing, realizing that we're talking about a couple of areas of importance, which is number one is portion control. And that helps them with their planning already. And of course, making sure that moderation is another keyword that is followed, so that the meals that they plant for themselves are quite balanced. And they don't really have to go on a strict diet. No one really has to go on a strict diet regarding diabetes. But what they need to do is moderate and enjoy the foods they eat well and basically that's healthy for their system. We don't like the word denial, because that really causes a problem for most people. And the other one, of course, is acceptance. Accepting that you need to do certain things besides the food that you eat, of course, is taking your medication during those hours that you should be and with meals. So the nutrition and the medication goes hand in hand. So that's where food comes into play, definitely. All right. So that's, I mean, there's a lot of great takeaways from today. A lot of great takeaways on portion control, eat and moderation, exercise, the right diet for you, and lots of water and sleep, of course. So at this time, and oh, before we stop, I wanted to say, you know, this apple. So like the doctor says, right, in apple day keeps the doctor away. So this is part of your diet, right? You're eating more of this and just making better right choice, diet choices for yourself. So at this time, I just want to say mahalo to both of you for doing such a great job. The people of Hawaii appreciate you that you are here live and present. We have an office here and give us your website and your phone number, LJ. Sure. Our website is diabetes.org slash Hawaii. You can also call us at 808-947-5979. So I just want to say mahalo to both of you gentlemen. And you know, we're going to work on this and we're going to, you know, we're going to let's stop diabetes together because together we can and that's the only way we can do it if we all join together and take healthy back. And that's what we want to do. And this is what this show is all about, taking health back into your hands and take health back. So please join us every other Tuesday at two o'clock as we talk about different aspects of health. Health being overall wellness and just being aware of what your body needs and how we can best manage it. And a lot of joy and happiness of course matters. So for now until next week, Tuesday, aloha from ThinkTech Ba'i.