[Interviewer:] Do you happen to have diabetes?
[Woman 1:] No I don't.
At least I don't know if I do.[Interviewer:] Well...
[Woman 1:] I get checkups every year, but not for diabetes.
[Man 1:] I don't feel like I got it. I never had any problems with my health.
[Interviewer:] Well, have you had a checkup recently?
[Man 1:] A year ago, x-rays. From one of these mobile units.
[Interviewer:] What is diabetes?
[Man 2:] It's when um you don't have enough of...that chemical that dissolves your blood...
dissolves your sugar...you don't have enough of it um, I can't think of the name of it right now.
[Woman 2:] It's a disease a, I don't know, you've got too much sugar
or you don't have enough, something in your blood.
[Interviewer:] You have too much or not enough?[Woman 2:] Something like that...no...
yeah too much that's what it is.
[Man 3:] I don't think it's sugar in your blood, it's sugar in your pancreas.
[Interviewer:] Do you know what diabetes is?[Woman 3:] Yeah.
[Interviewer:] What is it?
[Woman 3:] Well, it's an accumulation of sugar in the system.
[Interviewer:] What are the symptoms?
[Woman 3:] Well, you're thirsty I know,and I believe loss of weight, and nervousness.
[Interviewer:] Have you ever had it?[Woman 3:] No, I never had it.
[Woman 4:] Well, the symptoms is you go into a coma, you can go into a coma,
or you have sugar in your urine, you have it in your blood.
[Interviewer:] How would you know if you have diabetes?
[Woman 4:] I don't know. Many times I think I have it myself.
[Narrator:] Well, maybe she does have it, anyone can get it.
But three out of four diabetics are over 40 and overweight, and the majority are women.
All the people interviewed know something about diabetes, but none of them had a very clear idea.
They were aware that it has something to do with too much sugar in the blood
or in the urine, or somewhere.
Before we go further, let me explain.
Diabetes is too much sugar in your blood, and some of this overflows into the urine.
What causes this?
Not having enough or the right amount of insulin,which comes from the pancreas.
How does this affect you?
Well, let me introduce you to some people who have diabetes.
Mr. Mundt, who is a mechanic.
Mrs. Cook, a club woman.
Mrs. Jessick, a grandmother.
Kathy Nicannon, a young girl.
Mr. Altock, a retired baker,
and Mrs. Levine, a housewife.
Some are old, and one at least is quite young, but whether old or young,
diabetes hasn't dampened their spirits.
This isn't surprising among those who know they have diabetes.
For them, it's a matter of taking their treatment and keeping the disease under control.
It's the ones who have diabetes and don't know it who are likely to be dispirited.
In fact, one of the early signs of diabetes is having no energy.
However, there are more obvious symptoms than that.
Let's hear from the people you just met and find out
how they first discovered they had diabetes.
Take Mrs. Levine, for example.
She has a family history of diabetes.
In fact, this is true of one out of every three diabetics.
[Mrs. Levine:] I had been told by the doctors that the possibility of me
becoming a diabetic was very strong.
Both my parents are diabetics and I've lived with it most of my life.
[Narrator:] Mrs. Levine had an early warning when routine tests during her pregnancies
indicated a tendency toward diabetes.
But it wasn't until some time after her children were born--fine normal babies but rather big--
that the three main symptoms thrust themselves upon her.
Thirst, excessive urination, and hunger.
The family tendency to have diabetes asserted itself,
and Mrs. Levine was diagnosed as a diabetic.
On the other hand, some people have no warning at all.
[Mr. Mundt:] I was driving along and all of a sudden I felt faint, so I moved over to the curb.
I blacked out.
I just got unconscious, and then I went back to the doctor.
I came to the doctor, he examined me and...
[Narrator:] At first Mr. Mundt had what appeared to be a fainting spell.
It wasn't until his second attack that the diagnosis was made.
[Mr. Mundt:] About six months later I, all of a sudden I felt dizzy.
I pulled over to curb, and I stood there for a minute or two, or a couple of minutes, and I came back to
it, and they sent me down to take a blood test and a urine test,
and I found out that I had diabetes.
[Narrator:] Other symptoms of the disease are infections that will not heal, crops of boils, itching.
In Mrs. Jessick's case it was boils.
[Mrs. Jessick:] And thereafter I had about 30 boils, so I went to see the doctor about it,
and the doctor sent me to a cardiologist for a test,and he discovered that I had diabetes,
not much, but diabetes nevertheless.
[Interviewer:] Though most diabetics are middle- aged or older when they find they have it, this was
not so with Kathy Nicannon. Kathy is one of quite a large family, and is the only diabetic among them.
She is now 13.
[Kathy:] I've had diabetes for two years, since I was 11.
I had a large infection on my leg and my mother decided since it wasn't healing,
we should go to the doctor and have him check it,and she was also worried about symptoms I had
because I was urinating frequently and drinking a lot of water.
[Interviewer:] The doctor took a urine test and the slow-healing infection proved to be
a symptom of diabetes.
The same thing happened in Mr. Altock's case.
Another accidental discovery.
[Mr. Altock:] I was taking a box down from the rafts when the box slipped and hit me right in the eye,
right here above the eye it cut the skin.
Then I was going to my doctor see, when he couldn't find out why this didn't heal that cut, see,
and then he said there's something wrong with you.
All right, then he took a test and then he found sugar in my urine.
[Interviewer:] Finally there was Mrs. Cook,who noticed no symptoms and came very close
to dying before she found out she had diabetes, but let her tell you about it.
[Mrs. Cook:] I went into a serious state of shock.
Nobody will tell me what happened, but I know that it was serious because there were about four
four nurses and I don't know what about my bed,and they started intravenous stomach,
I forget what they call it but it was a stomach pump anyhow, and intravenous feeding, and I know that
they brought the priest into me and gave me the last rites.
I was conscious a moment or two and then I'd fade out.
But I was in that state for three days.
[Interviewer:] Fortunately for Mrs. Cook, she received excellent medical care immediately.
Had she been alone when this happened, she might have died.
You have met six people out of the million and a half Americans
who are under treatment for diabetes.
Known diabetics.
It is estimated that another million and a half have diabetes and don't know it.
These are the diabetics unknown.
They range from the mildly afflicted, who have no other symptoms than tiring easily,
to those who have persistent signs of thirst, excessive urination, and hunger,
to those who will only find out that they have diabetes by going into a coma,
in which case they may not live to find out.
Just how these signs and symptoms relate to what is happening inside the human body is something
that you should understand, so we are going to show you some animation.
In the normal person, sugar that has been eaten goes from the intestine into the liver.
Some sugar is kept by the liver and the rest makes its way into the bloodstream by way of the heart.
Some sugar enters the muscle cells, where it is burned at once to provide energy.
Some is converted into fat and stored for later use.
What is left over travels to the kidney and back again into the blood system.
Insulin is a chemical produced by the islets of Langerhans in the pancreas.
Its function is to make it possible for sugar to penetrate the cells,
particularly the muscle and fat cells.
In the normal person, the flow of insulin decreases if smaller amounts of sugar are taken
into the system, and increases with more sugar.
Just the right amount for the occasion is fed into the blood system to enable the sugar
to enter the muscle, liver, and fat cells.
The diabetic's chemical problem is that he does not have a natural flow of insulin.
It is either deficient or nonexistent.
Since the sugar can't get into the cells, it remains in the bloodstream,
so the diabetic has high blood sugar.
Since the blood reaching the kidney has too much sugar, some passes into the urine,
so sugar in the urine is another indication of diabetes.
The diabetic drinks a great deal of water to enable the kidneys
to get rid of the excess sugar.
This water passing through the body rapidly results in frequent urination.
Without insulin, the cells cannot burn sugar for energy, and so the body begins
to burn stored fat instead.
Similarly, the fat cells cannot take in more sugar to replenish their supplies of fat.
As the store of body fat is used up, the diabetic yearns for more food,
trying in vain to replenish the fat cells.
Instead he usually gets thinner. It's a vicious circle.
One great danger of diabetes is that the burning of these abnormal quantities of fat
may produce excess acidity in the body, acidosis which induces coma and even death.
This is why until quite recently, diabetes was a terrifying word.
Today, except among diabetics unknown, acidosis rarely occurs.
The remarkable discovery of insulin in 1921,and the recent development of new medicines
that can be taken in tablet form makes it possible for diabetics to live normal, happy lives.
Actually, some diabetics keep the disease under control without any medication whatsoever.
However, all diabetics have this in common: they must watch their diets
and take the right amount of exercise.
In fact, for the diabetic, medication, diet, and exercise are interrelated.
Keeping the balance between these three is what every diabetic must learn to do.
In the beginning, it's hard, as Kathy's mother found out.
[Kathy's mother:] She was used to eating her lunch at 11.
We had been shopping, the excitement of her shopping and trying on clothes and so forth,
and at 12 o'clock I heard the whistle and I said gee, we better get her her lunch.
As we went into the ice cream parlor, she said to me, "I don't feel well," and she was breaking out
into a sweat, which is the fact that she had more insulin than she had sugar.
So I immediately asked for a glass of orange juice which they gave me very quickly.
[Narrator:] Kathy felt better right away.
Like all diabetics should, she carries a card that identifies her as a diabetic
in case of an emergency.
However, now that she has learned to balance her diet and insulin against her activities,
there is little likelihood that she will have any trouble.
When she goes bowling or to dances, she knows she can eat more and she does.
Experience has shown her how to adjust almost without thinking about it.
[Kathy:] They usually have cookies and I eat some of them, because I'm exercising, dancing.
[Narrator:] It's up to the doctor to decide which, if any, medication the patient should have,
and how much of it.
For severe cases of diabetes, injections of insulin are needed to move the sugar out of the blood
and into the muscle and fat cells where it belongs.
For others, the new pills may be taken to help the pancreas secrete enough insulin.
In many others, it's simply a matter of diet.
[Kathy:] I was put on insulin, gradually increased 'til it came to the right amount,
and urine tests and once in a while blood tests.
I administer the injections myself.
[Narrator:] Self-discipline is a vital ingredient of treatment when it comes to diabetes.
Mrs. Levine is a good example of the ideal patient.
[Mrs. Levine:] As a diabetic, there are three things I have to be concerned about:
that I take my medicine daily, that I watch my diet very carefully,
and that I do my exercise daily.
[Narrator:] Every few months Mrs. Levine sees her doctor. He gives her a blood test,
checks her weight and reviews her diet chart.
Mrs. Levine finds it's much easier to handle the dietary requirements
then when her mother and father had diabetes.Everything then had to be weighed and measured.
[Mrs. Levine:] I do most of my shopping at the supermarket and I buy
very much what anybody else buys.
I buy a lot of fruit at the fruit department.
[Narrator:] Mr. Altock takes medicine and watches his diet but nostalgically.
[Mr. Altock:] You know I used to like noodles and pancakes and applesauce and all this stuff.
I could eat that for breakfast, you know, in the morning.
He cut that all out and uh, put me on a strict diet.
Vegetables, less bread.
I eat two slices of bread in the morning for breakfast, and then I eat a, I eat grapefruit
without the sugar, the way they come, no sugar.
I eat oatmeal, I put salt on there instead of sugar and then I use only skim milk because the doctor,
at that time of the examination, when they put me the them pills, no fat, no butter,
he cut me out of the butter, he cut me out of the fat.
[Narrator:] Mrs. Cook takes her medicine and stays on her diet most of the time.
[Mrs. Cook:] I need no injections, and I take two tablets a day and that's really all that...
all the inconvenience.
There are times that perhaps I don't have quite as much energy, but generally that's because
I haven't lived up to the rules.
[Narrator:] Mr. Mundt is one of the diabetics who needs neither insulin nor pills.
He keeps the balance entirely through diet and his strenuous work provides
most of his daily exercise.
[Mr. Mundt:] I repair radiators, and recoil the radiators.
This is a small radiator, but some of them are very, very big, the very big radiators, you know,
require some strenuous handling, lifting up, and all that.
[Narrator:] Mr. Mundt, like most diabetics, can hold a full-time job.
In fact, three out of four diabetics are not restricted in any daily activity.
The new medicines and greater knowledge of the disease have made all this possible.
Years have been added to the diabetic's life.
In fact, some diabetics are living much longer than a great many other people
who don't take such good care of themselves.
What about the million and a half persons who have diabetes and don't know it?
The diabetics unknown. Why don't these people know?
Many do not recognize or do not have the common symptoms of thirst, excessive urination,
incessant hunger.
Others don't want to face up to the fact.
Some find it out when they go their doctors for other complaints.
Far too few make the discovery in the best possible way, the annual medical checkup
that looks for any and all diseases.
Mrs. Cook, whom you will remember, almost died because she didn't know she had diabetes,
has become an eloquent spokesman for this.
[Mrs. Cook:] I hope the time is coming when people will go for, more people will go for their
annual checkup, and let the checkup include a, uh, testing for diabetes.
[Narrator:] Diabetics are also found through screening programs organized by voluntary health
associations with the help of the county medical societies, and by local public health departments.
Sometimes they are held in local hospitals. Such a place is the Middlesex Hospital
in New Brunswick, New Jersey, where Mrs. Susan Ridenaur went for her test.
Mrs. Ridenaur first became interested in diabetes through the American Diabetes Association.
She read a pamphlet and discovered that women of her age group were most likely
candidates for the disease.
There was a quite a group the morning she went to the hospital, and she stood in line to register.
In the laboratory the doctor took a sample of her blood.
The technician prepared it for the automatic machine that makes it possible to screen many
people quickly, by handling 12 samples at a time, or up to 1,000 a day.
It takes five minutes for the processing.
One test tube comes off the machine every 30 seconds.
Mrs. Ridenaur waited for her results.
[Background noise]
The test tube dropped off the rack. It was colorless.
This meant the Mrs. Ridenaur was a suspicious case.
She was referred to her doctor for a further checkup, and he in turn was notified of the results.
Mrs. Ridenaur's doctor told her that he would have to do more-definitive tests to find out
whether she actually had diabetes.
That this was merely an indication; however, it would be well to do these tests right away.
If people could only know how much more uncomfortable, not to mention the danger aspect,
it is to live with untreated diabetes, than it is to take care of it.
I'm sure there would not be a million and a half undetected diabetics in the country today.
If you need more convincing on this point,let's ask our diabetics what difference it has made
in the way they live.
[Mrs. Levine:] You know they say when you have an incurable disease, you live a longer
and healthier life, and it's very true because you're going to think of everything you do
before you do it.
[Kathy's mother:] Kathy is an honor student, a high honor student in the enriched course,
so in other words she's in the eighth grade but doing ninth grade work.
The one thing that was stressed was that you do not treat the diabetic any differently.
We do not treat Kathy any differently.
And of course Kathy is of the nature that she wouldn't allow herself
to be treated any differently anyway.
She has never felt sorry for herself, she has no reason to feel sorry for herself.
[Mr. Altock:] I do a whole lot of work around the house.
But what has to be done here in the house, I paint.
I shoveled snow this winter, course snow shovel is not... the doctor tells you if you're over 65
and I'm going on 72, you shouldn't shovel so much snow.
[Narrator:] Note that it is Mr. Altock's age and not his diabetes that is the restriction here.
Mrs. Jessick is more philosophical.
[Mrs. Jessick:] Well at first I was very unhappy, but then I realized it's a problem
you'll have to adjust yourself.
[Narrator:] Once the pattern has been established, diabetes is not hard to live with.
[Mrs. Jessick:] It's a lot of things in life I had to get used to, so I had to get used to that, too.
[Narrator:] And so these people and the other known diabetics throughout the country
are safe, happy, feel fine, and live long and useful lives.
Two generations ago diabetes was a threat to life itself, but not today.
The only real threat is not finding out in time by having annual checkups, or ignoring
the hereditary factor, and such common symptoms as excessive thirst, urination, hunger, boils
and the rest, and becoming by default a diabetic unknown.
[Interviewer on street:] Do you happen to have diabetes?
[Woman 5:] No, I don't believe so.[Interviewer:] Anybody in your family?
[Woman 5:] No. Well, my husband I think had it slightly, but he's deceased now.
[Interviewer:] What does he do for it?
[Woman 5:] Well, he doesn't do anything now, he's dead.
[Woman 6:] Well, I have a little, I did have it, I did have diabetes.
[Interviewer:] What did you do for it?
[Woman 6:] Well, I went to Meadowbrook Hospital and I had some insulation and I feel better now.
[Interviewer:] Does it incapacitate a person?
[Woman 6:] No...they take insulin shots everyday and can keep normal lives like the rest of us,
if they take care of themselves.
[Interviewer:] All right, thank you very much.
[A Panel Discussion Follows...]
[Director:] Action.
[Joan Wolle:] I'm Joan Wolle, State Director of Health Education in Maryland,
and also a representative of the Conference of State Health Educators.
I'm here to speak for you, the audience, and I hope I'll ask some of the questions
for which you'd like the answers.
Here to discuss some of the aspects of diabetes are three physicians who are specialists
in the field: Dr. Arthur Krosnick, Dr. Francis Lukens, and Dr. Kare Gundersen.
Let's review the usual symptoms of diabetes, Dr. Gundersen.
[Dr. Gunderson:] The symptoms are fatigue, weight loss, excessive thirst and urination, hunger,
cramps in the legs, boils that won't heal or wounds that won't heal.
[Joan Wolle:] Statistics show that diabetes is most likely to occur to those who have relatives
who have the disease.
Would you comment on this hereditary factor, Dr. Lukens?
[Dr. Lukens:] Diabetes is six to eight times as frequent in the family of a diabetic as it is
in the general population.
We know little about human heredity,but this at least gives us a practical guide
in the early detection of this condition.
[Joan Wolle:] If a person has diabetes in his family and he enjoys eating sweets,
should he stop eating sweets?
[Dr. Lukens:] The sweets only matter as part of the total food he eats.
He should keep his weight right on whatever diet will do this.
[Joan Wolle:] Dr. Krosnick, who is most likely to have diabetes?
[Dr. Krosnick:] Ms. Wolle, women have a higher chance of developing diabetes than men,
especially those who have had several pregnancies.
Overweight may be one of the causative factors in diabetes and we know that the most common age
is between 40 and 70 when diabetes first appears.
[Joan Wolle:] Isn't it true that an early sign of diabetes for some people
is actually loss of weight?
[Dr. Krosnick:] Yes, some diabetics have an enormous appetite and eat huge quantities of food
and lose weight in spite of this.
[Joan Wolle:] One thing that struck me about the film was that Mrs. Cook and Mr. Mundt didn't seem
to have any symptoms of the disease before it was diagnosed.
Does this often happen?
[Dr. Krosnick:] Well, mild diabetics may have no symptoms at all except fatigue.
This is most likely to be true of those patients who are detected by an annual checkup examination.
[Joan Wolle:] I guess this means that the only truly preventive measure that a person can take is to
have an annual physical checkup.
[Dr. Gunderson:] Yes, that's quite true.
It's a good idea to see the doctor once a year, maybe on one's birthday, and be checked out
completely with an examination of urine and blood,and of course then you could also
check for other diseases at the same time.
[Joan Wolle:] Dr. Lukens, isn't it true that quite a few county medical societies have sponsored
diabetes detection programs?
[Dr. Lukens:] Yes, the Philadelphia County Medical Society joined in testing 3,500 people last fall.
[Joan Wolle:] Dr. Krosnick, what are some of the testing methods?
[Dr. Krosnick:] Well, we use urine tests and blood examinations in New Jersey.
We find that urine tests are rapid and inexpensive,
but blood tests are much more accurate.
In some detection programs, automatic analysis and techniques of this type will provide an answer
in just a few moments.
Most of the people tested do not have diabetes, but those who are suspected are sent
to their family doctors for further tests.
[Joan Wolle:] You know sometimes the person who is told he has diabetes is very frightened.
[Dr. Gunderson:] Yes, that's true, being a diabetic myself I can understand this feeling.
However, once I was told about the disease and learned how to take care of it,
the fear disappeared.
I've taken insulin myself now for 22 years and would rather take a shot than shave,
since it takes less time and effort.
And of course, most diabetics don't have to take insulin.
They can get along quite well on pills or even on diet alone.
[Joan Wolle:] Dr. Lukens, isn't it true that diabetics should try to avoid cuts and other injuries?
[Dr. Lukens:] Most diabetics get over cuts very well.
The important exception is injury to the feet, particularly in elderly people.
[Joan Wolle:] Is there a cure for diabetes?
[Dr. Lukens:] No, there is no cure for diabetes, but it can be completely controlled.
Just as the near-sighted person can have normal vision with glasses without actually curing the eyes,
so the diabetic can lead a completely normal and useful life if he takes care of the condition.
[Joan Wolle:] Some people believe that diabetics don't have normal children.
Isn't this an old wives' tale?
[Dr. Gunderson:] Yes, diabetics have normal children, I have four very normal ones myself.
[Joan Wolle:] All this seems to add up to the important point that diabetes isn't too bad
a disease to have, that is, if you realize that you have it and you take care of it properly.
[Dr. Gunderson:] Diabetes hasn't interfered with my life to any appreciable extent.
I feel just as normal as the next person.
[Dr. Krosnick:] Everyone should know the symptoms of diabetes and should have
a test at least once a year.
No one can feel that he is exempt from this condition.
[Joan Wolle:] Now you know something about diabetes, the usual symptoms,
and how to find it early.
Do you know whether or not you have diabetes?
[Dr. Lukens:] Don't be like the nervous medical student who thinks he has each disease
he reads about, but be examined for diabetes at least yearly if you are fair, fat, forty,
or have familied with diabetes.
If you are not in this ought-to-be-tested group, this picture should make you join in
general detection programs and be a better-informed citizen able to help someone who missed seeing this film.
[The End]