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  • Writer's pictureThe San Juan Daily Star

Know the signs of diabetes and take charge of your health

In Puerto Rico, two out of seven adults have diabetes. That’s half a million people, but what’s more worrisome is that an equal number of islanders could have the disease and don’t know it.

By Alejandra M. Jover Tovar

Special to The Star

In Puerto Rico, two out of seven adults have diabetes. That accounts for 500,000 people dealing with the disease, but what’s more worrisome is that an equal number of people could have it and don’t know it.

Nutritionist and dietitian Dennice Miner, who chairs the board of the Puerto Rican Diabetes Association, said the island diet doesn’t lend itself to maintaining a healthy lifestyle. People rarely eat salads or lean proteins, instead going for a fried, carbohydrate-heavy diet (think rice and beans at every meal) as the norm.

“With a high consumption of carbohydrates, soft drinks and desserts, the pancreas, tasked with the production of insulin, cannot handle that much sugar,” the expert said in an interview with the STAR.

Nov. 14 is World Diabetes Day.

“We work in November to raise awareness about prevention in Puerto Rico. Surprisingly, the island has the highest prevalence [of diabetes] in the United States. The most recent statistics are alarming because more than 500,000 people have diabetes; 15.8% of the population has it, but twice as many are in pre-diabetes,” Miner said. “The disease starts 10 years before you are diagnosed; type 2 diabetes is the most prevalent in adults in Puerto Rico.”

Diabetes is a chronic condition in which the pancreas stops producing or releasing the hormone insulin or is not functional.

“Insulin is needed in our body to convert glucose into energy, and glucose is the sugar we ingest in food,” Miner said. “Carbohydrates and fried foods, the main staple of the Puerto Rican diet, are metabolized and converted into sugar, and our pancreas has to release insulin. Insulin is the key that unlocks the cells for the sugar to enter and be used. If I don’t have the key, the sugar stays in the blood, and then you have diabetes.”

Pre-diabetes is also dangerous, and many people don’t present symptoms.

“One of the most affecting factors is being overweight and obese,” the nutritionist said. “People over 35 who are overweight and obese and have a family history are at risk of developing the condition.”

Those with pre-diabetes have high blood sugar and feel the need to urinate frequently. Also, constantly feeling thirsty or hungry, irritable and losing weight for no reason, having dry skin, or feeling tired or weak can be signs that something’s wrong.

What about people with hypoglycemia, those who experience sugar crashes? Are they at risk?

“There are patients whose pancreas releases more insulin than it should, and many patients who experience hypoglycemia eventually end up with diabetes because the body overreacts to food,” Miner said. “You need to keep a healthy schedule with snacks and not eat foods high in sugar. Hypoglycemia is already an insulin situation in the patient’s body, and there may be patients with hypoglycemia who may develop diabetes.”

People who suspect they have pre-diabetes should get tested immediately through blood work.

“The criteria for diagnosis of pre-diabetes, according to the American Diabetes Association, is fasting blood glucose of 100 to 125 milligrams per deciliter of blood, a three-month test of glycosylated hemoglobin (A1C) between 5.7% and 6.4%, or a two-hour oral glucose tolerance test with a value of 140 to 199 milligrams per deciliter,” Miner said.

Even though it’s a chronic disease, you can manage diabetes through medication and lifestyle changes.

“Chronic means that I have beta cells in the pancreas, and I have lost more than half of those cells,” the nutritionist said. “If you’re diagnosed but change habits, start a healthy diet, and use medication properly, there could be changes. Eventually, some people don’t even need medication. You cannot reverse diabetes, but by giving up soda and sweets, the pancreas can level out, and you can achieve control.”

Education is key to preventing more people from developing the disease. That’s why the Puerto Rican Diabetes Association will hold on Sunday, Nov. 20 the event “Encaminada” (On the Way) at the Cataño waterfront (formerly Bahía Viva). From 9 a.m. until 4 p.m., the event will feature lectures, health screenings, arts and crafts, children’s activities, a dog show and live music, among other attractions. There will also be information tables from the municipality.

Those who want to know more about diabetes and access an interactive map of doctors who can help manage the disease can visit

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1 Comment

Oct 12, 2023

This article provides crucial information on recognizing the signs of diabetes and taking control of one's health. It's essential for individuals to be aware of the symptoms and risk factors associated with diabetes to prevent complications down the road.

Moreover, I appreciate that the article touches upon the importance of palliative care in managing chronic conditions like diabetes. Palliative care is a valuable resource for enhancing the quality of life for those living with long-term health issues. It not only focuses on symptom management but also addresses the emotional and psychological aspects of dealing with a chronic illness.

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