New blow for Rice: Moderate senator voices concern

WASHINGTON (AP) ? A moderate Republican senator, vital to any White House hopes of getting U.N. Ambassador Susan Rice confirmed as secretary of state, said Wednesday she couldn't back any nomination until more questions are answered about the deadly Sept. 11 attack in Libya and Rice's State Department role during the 1998 U.S. Embassy bombing in Kenya.

In a fresh suggestion of eroding GOP support for Rice, Sen. Susan Collins of Maine emerged from a 90-minute, closed-door meeting with the ambassador voicing new criticism of her initial account about Libya. Collins also questioned what Rice, the assistant secretary of state for African Affairs in the Clinton administration, knew about requests for enhanced embassy security before the Nairobi truck bombing.

Pressed on how she would vote if President Barack Obama names Rice to succeed Secretary of State Hillary Rodham Clinton, Collins said, "I would need to have additional information before I could support her nomination."

At the White House, Obama called Rice "extraordinary" and said he couldn't be prouder of the job she has done as U.N. ambassador. Cabinet members joined Obama in applauding Rice, who attended the meeting. Obama has not named a replacement for Clinton, who has said she intends to step down soon.

The misgivings from Collins, the top Republican on the Homeland Security Committee, came one day after three other GOP senators said they would try to block Rice's nomination. Sens. John McCain of Arizona, Lindsey Graham of South Carolina and Kelly Ayotte of New Hampshire said they were more troubled than ever by Rice's answers on Libya even though the ambassador conceded that her much-maligned first explanation was wrong.

In an unusual move, Rice and acting CIA Director Michael Morell have held two days of private meetings with Republican senators in hopes of assuaging their concerns. Privately, Senate Republicans said they had hoped the conversations would quiet the criticism as they want to avoid the spectacle of a postelection challenge to a female African-American nominee.

Instead, the sessions have cast further doubt on her chances for the top State Department job and increased the likelihood of a protracted fight if Obama does choose her. Although Democrats will have 55 votes in the next Congress, the president would need the support of five Republicans to avoid a filibuster of the nomination.

Collins said she was troubled by Rice's "political role" in downplaying the Libya attack as a spontaneous demonstration over an anti-Muslim video rather than a terrorist attack by al-Qaida affiliates in a series of Sunday talk show appearances on Sept. 16 ? five days after the attack and weeks before the election.

U.S. Ambassador Chris Stevens and three other Americans were killed in the raid on the U.S. diplomatic mission.

Rice has said she was relying on talking points provided by U.S. intelligence.

Introducing another issue certain to be fodder for any confirmation battle, Collins said she pressed Rice about security at the U.S. Embassy in Nairobi in 1998 when a truck bomb was set off outside the facility, killing more than 200 Kenyans and 12 Americans.

"What troubles me so much is the Benghazi attack in many ways echoes the attacks on those embassies in 1998 when Susan Rice was head of the African region for our State Department," Collins told reporters after the meeting. "In both cases, the ambassador begged for additional security."

Collins said Rice told her she was not involved directly in turning down the request for improved security. The Maine senator said that in light of Rice's position, she had to be aware of the general threats and U.S. Ambassador Prudence Bushnell's requests for security upgrades in Kenya.

Review boards headed by former Joint Chiefs of Staff chairman, Adm. William J. Crowe after the Aug. 7, 1998, bombings of the U.S. embassies in Kenya and Tanzania did not find reasonable cause that any U.S. employee breached his duty in connecting with the bombings. Rice was not blamed.

However, Crowe said the boards believed there was a "collective failure" by several administrations and Congress over a decade to invest adequately to shore up vulnerable U.S. diplomatic missions around the world.

Rice has emerged as the front-runner for the top job at State though Senate Foreign Relations Committee Chairman John Kerry, D-Mass., passed over for the job in 2008, is considered a strong alternative.

In a clear message to the White House, Collins said Kerry would have no problem winning Senate confirmation.

"I think John Kerry be an excellent appointment and would be easily confirmed by his colleagues," Collins said.

Sen. Bob Corker of Tennessee, who is in line to become the top Republican on the Foreign Relations Committee, was more circumspect about Rice's chances after his own meeting with the ambassador.

The GOP senator suggested that Obama "take a deep breath and nominate the person he really believes is the very best person for secretary of state, regardless of relationships."

Corker, who traveled to Libya in early October, was highly critical of the administration and the intelligence community, saying that "the whole issue of Benghazi has been a tawdry affair."

Democrats have rallied to defend Rice, casting the Republican criticism as political scapegoating.

"You know it's a shame to create a sideshow that seems, I think, very clearly to be very political out of something that really has no bearing on what happened in Benghazi," White House spokesman Jay Carney said Wednesday.

Rep. Adam Schiff, D-Calif., a member of the House Intelligence Committee, called the criticism a "transparent attempt" to deny Obama a potential Cabinet choice.

The issue remained at the forefront as the Senate, in debating a defense policy bill, approved an amendment by McCain that would lead to an increase of up to 1,000 Marine Corps personnel to provide security at U.S. diplomatic missions around the world.

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Associated Press writer Matthew Lee contributed to this report.

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Donna Cassata can be followed on Twitter at http://twitter.com/DonnaCassataAP

Source: http://news.yahoo.com/blow-rice-moderate-senator-voices-concern-213444777.html

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Diabetes is a manageable disease

After a family backpacking trip a couple weeks later, he weighed 66.

"It came on pretty quickly," said Gildon, now 28, reflecting on what led up to his eventual diagnosis: diabetes.

He's among the 26 million people in the United States with diabetes, according to the American Diabetes Association, which acknowledges November as American Diabetes Month.

The recently published Diabetes Report Card 2012 from the Center for Disease Control (CDC) listed Oklahoma as having had the highest increase in adult diabetes from 1995 to 2010, with nearly one in 10 Oklahomans having the disease.

Diabetes is a group of diseases characterized by high blood glucose, or blood sugar, the CDC's report explained. With diabetes, the body either doesn't produce enough insulin or is unable to use its own insulin effectively.

Glucose builds up in the blood and causes a condition that, if not controlled, can lead to serious health complications and even death, the report said.

At the time he was diagnosed, Gildon wasn't familiar with diabetes.

On the way home from that aforementioned backpacking trip, Gildon kept asking his parents to make pit stops every 20 or 30 minutes. He was also thirsty.

Eventually, he started feeling bad. After the family made it home, their physician said Gildon might have flu, then wrote him a prescription.

That evening, he became sicker still, and couldn't keep water or Sprite down. That's when his mother took him to the emergency room.

A normal glucose level is in the 80-100 range, Gildon said. That night in the hospital, his hit 999.

Signs and symptoms of diabetes can be subtle and increase over time, said Dr. Laura J. Chalmers with the Harold Hamm Oklahoma Diabetes Center at the University of Oklahoma, 4444 E. 41 St.

Those signs include being more thirsty, urinating more often, waking at night to drink and go to the bathroom, and weight loss, Chalmers said. The appetite may also be increased, and some people will have nausea and vomiting.

Gildon was diagnosed with juvenile diabetes, or type 1 diabetes (T1D), one of the three most common forms of diabetes, according to the CDC. Another, type 2 diabetes (T2D), makes up for about 95 percent of diagnosed diabetes in adults; the third, gestational diabetes, develops and is diagnosed as a result of pregnancy in 2 to 10 percent of pregnant women.

With T1D, the body is unable to produce insulin, a hormone secreted by pancreas to regulate blood sugar, Chalmers explained. Treatment for T1D is insulin.

In T2D, there is insulin resistance, she continued. Treatment for T2D involves weight loss, dietary changes and medications that help the body secrete insulin and overcome the insulin resistance. In some situations, patients with T2D require insulin.

Onset of T1D is typically before age 20 but presentable from approximately 6 months of age into adulthood, Chalmers said.

Annette Jones was 24 and pregnant with her youngest daughter when she was diagnosed with gestational diabetes.

"When women get gestational, it usually goes away after delivery," said Jones, alluding to the 2 percent of women who remain diabetic after pregnancy.

Jones has had diabetes for 27 years, more than half her life. Like Gildon, she wasn't too familiar with diabetes, other than having family members who were diabetic - but she was too young to understand what that meant.

"I knew there was not a cure and that you had to take shots," she said.

Lori Maisch was 45 when she was diagnosed with T1D. She had lost 25 pounds from May to September that year - "all the yard work I had been doing," she thought.

Constantly thirsty and going to the bathroom every 15 minutes, even at night, Maisch finally attracted the attention of someone in a doctor's office: her neighbor, who noticed her "sweet odor."

"It's the same scent I smell on patients that have diabetes," Maisch recalled her neighbor saying. "That prompted me to make an appointment with my primary care physician, be tested and diagnosed."

More than one diabetes

Misconceptions abound regarding diabetes, Chalmers said.

For example, T1D is treated with insulin and carbohydrate counting, she explained. Patients with T1D should have a healthy diet but are allowed to have cake, ice cream and other sweets within reason - as long as they take their insulin to cover the carbohydrates in the food they consume.

Maisch used to be one of those folks with preconceived notions about diabetes, she said. Since her diagnosis, people assume she has T2D because she's an adult.

"Then they say, 'I thought that only happened to children,' " she said. "Some will say, 'Oh, if you eat right and exercise more, you can control it.' No, that's type 2 - I am insulin-dependent."

Or she might have people tell her she can't have certain foods, like birthday cake, refusing to cut her a slice because "you can't have it," Maisch said. "I just need to adjust my insulin to eat it."

Most people don't know that there is more than one kind of diabetes, Jones said. Others she's met don't think that it's a big deal because diabetics take insulin.

"They don't realize the deadly consequences that occur with this disease," she said. "I have actually had people say to me, 'You have diabetes? You're not even fat.' I could go on and on."

Sometimes, people with diabetes might have a change in mood, experiencing "highs and lows," as Maisch said.

"If I am having either, I can come across irritable or out of it," she said. "I don't mean to but can't help it sometimes. I've found a lot of people don't understand that part of the disease."

Having diabetes can be expensive, too. Even with insurance, the two insulin shots Maisch needs each month are $100 each. Plus, she has test strips and syringes to buy. In all, it's about $400 out of her own pocket each month.

"I used to be more impulsive," Maisch said, "but now am more mindful regarding my meals and making sure I have my T1 pouch - blood glucose monitor, test strips, glucose tablets, insulin, syringe - every time I leave the house."

It takes planning

Another challenge is always having to be more prepared than the average person.

Like if a buddy of his asks him to go on a spur-of-the-moment bike ride, Gildon has to know what his blood sugar is, possibly take extra food with him in case he takes too much insulin or exercises too heavily.

If he goes on a long trip, he has to think ahead in case his insulin pump breaks - what would he do then? Gildon has to have a back-up plan.

When he'd go on a Boy Scout camping trip, Gildon and his dad crafted a case out of PVC pipe for his insulin so he could keep it in his sleeping bag on freezing nights - and insulin doesn't freeze.

One of the main challenges for Jones was changing her eating habits, like cutting back on carbs.

"Simplicity is gone," she said. "I can't go anywhere - store, work, park, ride my bike - without a plan, a snack or juice, something to treat low blood sugar."

Jones has to have her blood monitor with her at all times, and she checks her blood at least four, sometimes eight times a day.

Like Gildon, she wears a pump 24-7. "It is still better than six to seven shots a day," Jones said - but added, "I don't feel free."

Such adjustments aside, a normal, active life is achievable for most diabetics.

Jones wanted to have another baby after her second daughter, but the doctor said it was "probably best" she didn't.

"This was 27 years ago, so that mentality has changed now," said Jones, who has three beautiful daughters.

"God worked everything out," she said. "Maybe not the way I had planned it, but just perfect anyway."

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Stop diabetes before it starts

American Diabetes Month takes place each November in order to raise awareness of this disease.

According to the American Diabetes Association (ADA), it is estimated that nearly 26 million children and adults in the United States have diabetes. Another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes.

To stop this disease before it starts:

Get moving. Physical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes. The ADA recommends a half-hour of mild aerobic activity five times per week.

Eat more whole grains. White bread, white rice and potatoes have a high glycemic index, which can cause spikes in blood sugar and insulin levels. Whole grain foods help with diabetes prevention because they slow down carb absorption.

Limit your sugar intake. Be sure to read nutritional labels and steer clear of anything that lists sugar, sucrose, corn syrup or other sweeteners, such as evaporated cane juice or molasses, as one of the first ingredients.

Stop smoking. According to a Harvard School of Public Health study, smokers are about 50 percent more likely to develop diabetes than nonsmokers. New research shows that inhaling secondhand smoke may also lead to an increased risk of diabetes.

Get more sleep. Not getting enough sleep increases hunger, which leads to weight gain and, therefore, raises your risk of getting diabetes.

Check your glucose levels. The ADA recommends blood glucose screening for everyone age 45 and older. Generally, this testing is repeated every three years. But if you have known risk factors (like high blood pressure or obesity), discuss them with your doctor.

For more, visit the ADA's website tulsaworld.com/diabetes

And to learn more about Hillcrest's Center for Diabetes Management, visit tulsaworld.com/hillcrestdiabetes

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Support for diabetes

After being diagnosed with type 1 diabetes and not having a support system in place, Lori Maisch went into action.

She looked at the American Diabetes Association, JDRF (formerly the Juvenile Diabetes Research Foundation) and local support groups.

"I found that there were great meetings for type 2 (diabetes), for children with type 1, but none specifically for adults with type 1," Maisch said.

So she formed a group called T1Tulsa for adults older than 18 living with type 1 diabetes. They meet once a month. Sometimes they have speakers; sometimes they just visit and learn from one another.

"It is a special meeting for me, as it is the one time month I can look around the room, say anything, and everyone gets it," she said.

If you're interested in T1Tulsa, email Maisch for meeting details, T1Tulsa@yahoo.com.

Original Print Headline: Diabetes a race that can be won

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Jason Ashley Wright 918-581-8483
jason.wright@tulsaworld.com

Source: http://www.tulsaworld.com/site/articlepath.aspx?articleid=20121129_17_D1_CUTLIN563065

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