Since the year 2000, diagnosed diabetes among adults has more than doubled in Kentucky. This disease affects over 530,000 Kentuckians. The Big Sandy region of Kentucky has a much higher rate of diabetes, as reported by Kentucky Public Health. The state average is 13.1 percent, or one in every eight adults. Surprisingly, 17.4 percent of adults in the Big Sandy region suffer from diabetes.
In the last year, Pikeville Medical Center (PMC) expanded its endocrinology services to better care for the people of the region.

PMC Endocrinologist, Maali Milhem, MD, and Mavis Lowe, APRN, treat patients at PMC with diabetes daily. Lowe has been treating and educating patients with diabetes at PMC for over 25 years.

Dr. Milhem came to the hospital last year to care for patients with diabetes and to expand the endocrinology services offered at PMC. She also treats patients with osteoporosis, thyroid problems and glandular issues.

Katie Ray, 26 of Hardy, has been a patient of Lowe’s for the past three years. She was diagnosed with Type 1 Diabetes at age eight.

Type 1 and type 2 diabetes are different diseases. While both types of diabetes are chronic diseases that affect the way the body regulates blood sugar, type 1 diabetics do not produce insulin. Their diabetes cannot ever be managed with diet and lifestyle changes the way type 2 can. A type 1 diabetic must take insulin every day for the rest of their life.

“It started on a weekend. My mom thought I had a stomach virus,” explained Ray. “After two days of vomiting and sleeping, she took me to my pediatrician, who tested my blood and immediately sent me to Lexington. At that time, my A1C level was close to 13.”

A1C is a blood test that measures the average blood glucose level over the past three months.

She spent a week in ICU before being released to go home. At home, things were different. She had insulin injections to take when she ate. Even eating was different and controlled. She had a schedule of when to eat and she had to learn what portions of carbohydrates to eat.

Insulin injections and scheduled eating were Ray’s new normal. Things remained this way until she was introduced to the insulin pump as a teenager.

“I first tried the insulin pump when I was a sophomore in high school. It was a lot to get used to, but it changed my life for the better,” Ray expressed. “The pump made me feel like a ‘normal’ person again. It was much easier to go out and not worry about carrying my insulin and needles around with me.”

Before Ray began seeing Lowe, she traveled to Huntington, W.Va. every six months to get bloodwork and refills on her insulin and pump supplies. Her A1C was around 10.

“Mavis has been, by far, the most helpful provider I have ever seen. My A1C is now 6.5 and that is the lowest it has ever been, thanks to her,” said Ray. “She is so compassionate and empathetic to my needs. Mavis stays up-to-date on the current insulin pumps available and what would be best for me.”

Lowe is proud of Ray’s dedication to keeping her diabetes controlled.

“Katie is a very motivated, self-disciplined young lady who is very successful in her diabetes management,” stated Lowe. “She is willing to do all recommended therapy and it shows in her visits. Her diabetes is very well controlled.”

In addition to treatment, PMC also offers Diabetes Management classes available through physician referral. These classes give patients upfront education to prevent complications by learning the right things to do.

The class is broken up into two sessions, three hours long with a day in between to practice meal planning. Upon return the second day, Diabetes Educators review any issues patients may have had on the practice day. There is also a one month follow-up to assess progress and help with any challenges patients may have had during the previous month.

“The primary benefit of diabetes management classes is the patient is better equipped with the knowledge they need to control their diabetes,” said Lowe. “It’s not just about taking medication. It teaches you to balance your nutrition and activity.”

Success is measured by lowered A1C, weight loss, blood sugar control, a better overall outlook on health and diabetes, and felling like you are in control of the disease.

“The best way to control diabetes is through diabetes education and lifestyle intervention,” Lowe advised. “Some cases of type 2 diabetes can be controlled in this way without medication.”
Ray has not had to endure any of the subsequent health problems that can result from diabetes. Part of her quarterly visits to Lowe keep close watch on her kidneys and heart. She also gets her annual eye exams, as diabetes can take a toll on one’s vision.

“Diabetes can cause lots of problems, but is controllable,” Lowe said.

She explained that diabetes thickens the blood causing it not to circulate through the body as well as it should. This can spark the beginning of issues in the kidneys, the heart and even the eyes. It is important for patients to control their blood pressure as well as their blood glucose. Thickened blood cannot get though the arteries as easily and the heart has to work hard to pump the blood through the body.

Ray knows that if she should experience any of the ill effects on the body from diabetes, she will get quality care from PMC and from Lowe.

“She is easy to talk to and explains any concerns I may have,” said Ray. “Mavis has a real passion for helping people with this terrible disease.”

Dr. Milhem and Mavis Lowe, APRN, are located on the 10th floor of the PMC Clinic. To make an appointment please call 606-218-2210.