By Lorna Collier

Diabetes. You let it sink in, try to remember the few things you've ever heard about the disease, picture shots and no sugar forever.

A doctor or nurse visits your hospital room for maybe 90 minutes to tell you such things as how to take blood sugar tests, what foods to eat when, what not to eat when, when to exercise, how to take your medication.

And then, says Dr. Mark Schneider, a Rockford internist, "you go wing it."

The problem with this, Schneider says, is that when you were told about your condition, you were still reeling from the diagnosis and you probably didn't absorb much of what was said.

Also, other questions weren't answered -- questions you didn't think to ask, because the situations hadn't yet occurred.

What commonly happens next, says Mark's wife, Sandi Schneider, is that after a couple of months on your own, you're "back in trouble again, and you don't know who to turn to."

Sandi Schneider, a diabetic, nurse and diabetes educator, represented the consumer on an advisory committee that helped set up an alternative to routine diabetes care: the Illinois Diabetes Care Center at Saint Anthony Medical Center in Rockford.

The center, which is unique to the Rockford area, offers intensive educational programs for diabetics, including hands-on lessons in nutrition and exercise.

"What we're trying to accomplish is to expand on [traditional instruction]," Mark Schneider says. "In addition to basic knowledge, there will be some practical application."

For example, Schneider says, a new diabetic might be told initially that, as part of an exercise program, he should walk. He might be given instructions on how to monitor his pulse.

"And that's it. That's as far as it goes," Schneider says. "They may or may not be doing it right."

At the Illinois Diabetes Care Center, clients will do the exercise, so they can learn first-hand how it should be performed.

Also, the programs will be restricted to groups of 10, so there can be interaction and support among group members. Group and psychological counseling will be offered.

"The psychological aspect to a great degree is usually ignored" in typical diabetes patient care, Schneider says. The new care center aims to change this by focusing on the complex emotions new patients may encounter. "There's anger, hostility, a sense of 'why me?', a lot of rebellion and denial. There can be conflict with other family members. It can be very difficult for teenagers."

The center offers two-day programs for non-insulin dependent diabetics and four-day programs for those who are insulin dependent. Cost is $250 for the two-day program and $350 for the four-day. Each class participant is allowed to bring one significant other, and small children are encouraged to bring both parents.

The center was developed during a year of study by an advisory committee made up mostly of Saint Anthony staffers, as well as the Schneiders and Dr. Robert Brazia, another Rockford internist.

Center staff members prepared for their jobs by attending a course at the International Diabetes Center in Minneapolis -- a course in which they, for set time periods, had to act as if they were diabetics, including taking blood-sugar tests and injecting themselves with mock insulin (actually, a harmless saline solution).

Pat Priola, a diabetes educator who served on the advisory committee, says she had to "be a diabetic" for 48 hours. "I found out what people have to deal with," she says. "To be honest, even I cheated the last day."

Another center staff member, Jill Baker, didn't have to simulate life as a diabetic: the 29-year-old nurse-educator has been a diabetic since age 9.

Baker got involved with diabetes education because she understands "what patients are going through. I felt I could be a good role model. And I knew patients really didn't get a good education."

When Baker was diagnosed in a small, rural hospital in southern Illinois, she wasn't told anything about her disease.

"I knew I wasn't supposed to have sugar, but I didn't understand it was a permanent thing," she recalls. "When I came home from the hospital, there was a plate of cookies on the table. I said, 'Can I have some?'"

Now, though, Baker says life on a diabetes diet isn't as difficult as it once was, due to all the sugar-free, dietetic products on the market. "There's sugar-free jello, sugar-free pudding pops...Most of my friends who aren't diabetic buy all that stuff anyway becaue they don't want all that sugar."

Baker also says it's a myth that diabetics must buy special diabetic foods; instead, they are urged to eat the high-carbohydrate, low-fat diets that are being recommended today for people in general.

"We like to emphasize the positive aspect," says dietician Nan Olson. "They can probably be eating healthier than the general population."

As part of the center's programs, Olson will tell patients to buy a cafeteria meal, then critique their purchases to see how they fit in with the patient's diet.

Many people don't realize, Olson says, how large portions are or that sugar can be hidden in such things as catsup.

Olson also teaches patients how to live in the real world: how to order fast food or restaurant meals and still maintain their diets. One tip, for instance, is to order sauces and dressings on the side.

The center is open to both newly diagnosed and long-term diabetics -- "to anyone with an interest in getting better control," says Priola.

Adds Dr. Schneider: "We want people to be able to live well with their disease."

For more information about the Illinois Diabetes Care Center, call 815-395-5444.

Sidebar: Diabetes Facts

* About six million people in the United States have diabetes. Experts estimate another four to five million have it, but don't know it.

* In the cities of Rockford and Loves Park, approximately 6,500 people have diabetes. About 725 new cases will be diagnosed this year.

* Each year, about 150,000 people with diabetes die. Life expectancy is one-third less for a diabetic than a non-diabetic of the same age.

* Diabetic eye disease ins the number one cause of new blindness in people between th eages of 20 and 74.

* Diabetics are two to four times more likely to have heart disease and two to six times more likely to have a stroke than non-diabetics.

* Ten percent of all diabetics develop some kind of kidney disease.

* About 45 percent of all non-traumatic leg and foot amputations are caused by diabetes.

* Direct and indirect costs for diabetes total $14 billion annually, accounting for 3.6 percent of total U.S. health care costs.

Source: Saint Anthony Medical Center, American Diabetes Association

Sidebar: Two diseases in one

* There are two types of diabetes, with differing causes, symptoms and treatments. They are commonly referred to as Type I and Type II.

Type I (Insulin-dependent)

* Usually strikes young children or adults

* Requires daily insulin injections

* Cause suspected to be a virus, which destroys insulin production

* Sudden onset, often mistaken for flu

* Symptoms: frequent urination, accompanied by unusual thirst; extreme hunger; rapid weight loss with easy tiring; irritability; nausea and vomiting

*Complications include eye and kidney disease

* Considered most severe type, affecting 1 million Americans

Type II (Non-insulin-dependent)

* Usually develops in people older than 40 who are overweight

* Runs in families

* Can be controlled with proper diet and exercise, though oral medication or insulin may be needed

* Body produces insulin, but it is not utilized properly

* Symptoms: blurred vision or any change in eyesight; tingling or numbness in legs, feet or fingers; frequent skin infections or itchy skin; slow healing of cuts and bruises; drowsiness

* Complications include heart attack, stroke, gangrene of the legs

* Most common type, affecting about 10 million Americans

 Sources: American Diabetes Association, Inc.; Dr. Mark Schneider, Rockford internist

 Copyright 1987, Rockford Register Star (article appeared in Oct. 29, 1987 issue)