Naval Medical Center Portsmouth staff held their fifth annual Diabetes Boot Camp, Nov. 13, inside the Endocrinology Clinic and along the main hallway of the Charette Health Care Center.

The boot camp is a one-stop shop for patients with diabetes to complete their annual appointments and health checks at one time. Services offered included foot checks, immunizations, glucometer troubleshooting, neuropathy checks, laboratory work, retinal exams, A1C tests - which check a patient's average blood sugar over the past three months - and one-on-one diabetes education.

"We're trying to target people who have fallen behind in their diabetic testing and control," said Cmdr. Michael Galitz, an endocrinologist and NMCP's Internal Medicine department head, who was a key organizer of Diabetes Boot Camp. "Population Health helps us identify known diabetics who haven't had labs done in over a year, or A1Cs that are out of standards, or haven't had eye exams or other testing done that should be done every year. We try to get them caught up as much as we can in the things they need to do, and when they finish, everybody who comes today gets to sit down with a certified diabetes educator. That educator will pull it all together and teach them about why this is important."

The boot camp also offered educational displays and classes on smoking cessation, insulin pumps - which are an alternative to daily insulin injections - dental health, foot health and care, meal planning and diet management, and blood glucose management. A highlight of the camp was a Zumba class to emphasize the importance of a daily exercise routine for diabetics.

From the outside looking in, it can be difficult to tell whether or not someone is living with diabetes. What goes on behind the curtain, however, is a completely different story. The life of a diabetic revolves around regulating his or her blood sugar. High blood sugar can have negative effects on circulation and, over time, lead to complications such as diabetic retinopathy, which causes blindness; neuropathy, the loss of feeling in the feet and hands; high blood pressure; heart disease; and kidney failure.

Diabetes is a metabolic disease that involves the production and metabolism of insulin, which regulates the amount of sugar in the blood. Though the disease generally falls into one of two categories, the key indicator of diabetes is high blood sugar levels over a prolonged time period.

Type One, or insulin-dependent diabetes, occurs when the pancreas completely quits producing insulin or produces it in negligible amounts. Type Two, or non-insulin dependent diabetes, occurs when the pancreas either doesn't produce enough insulin or the body does not use the insulin effectively.

Regardless of which type a patient has, without sufficient insulin metabolism, the patient's blood sugar reaches levels that, over time, may endanger his or her health and life.

"When you have high blood sugar, the sugar attaches to different proteins and causes changes that produce toxins or free radicals that can attack various organs. High blood sugar is also linked to cholesterol problems, and can increase blockages in the arteries, so there's a definite link to diabetes and heart disease and other vascular problems," Galitz said. "These complications are much easier to treat if they're caught early. The risk of complication is less if your blood sugar is under control, but when you do have complications, we can usually do something to affect them early. If we find it late in the process, it's more difficult to treat."

Diabetics must ensure their blood sugar levels remain within an acceptable level, which means checking their levels several times a day. All diabetics have to plan their meals and their exercise carefully, so as not to cause drastic changes in their blood sugar. During meal planning, they track carbohydrates in the food they eat.

"It's something I think about every day, before I put anything in my mouth," said Sam Howard, a retired Navy captain who was diagnosed with Type Two diabetes in 2013, shortly after his retirement. "The positive aspect of it is that it forces me to think through healthy choices. My family and I eat a lot more fiber, and we're more conscious of our protein intake. We're more highly aware of the impact that our food choices can make in our bodies and in our lives. My wife and I share meal planning and preparation responsibilities, and our meal choices tend to be on the higher protein side and more carbohydrate managed."

"My diagnosis has actually increased my exercise," said Emmett Williams, a retired Navy fire controlman who was diagnosed with Type Two diabetes in June. "I used to walk a lot, now I started jogging, weight lifting, just trying to get back in the swing of things when I was in the military. I think if you take this boot camp for what it is and get the information you need, it will work well for you. Some of the ladies here were directing me to all these different resources, and it was great. I would never even have known any of this information was available had I not attended."

"This has been a success every year," Galitz said of the boot camp. "The people who come are always very happy with how things work, and we plan to continue doing this into the future."

For more news from Naval Medical Center Portsmouth, visit http://www.navy.mil/local/NMCP/.