Matsuoka first met Dr. Kaufman at a camp for diabetic children. “On the first day of camp I was waiting in line for dinner when I started to cry for no particular reason. Dr. Kaufman was busy giving other children their evening injections but she immediately dropped everything, took me aside, held me on her lap, and asked me what was wrong. Sure enough, my blood sugar was low. I knew she was very busy and had hundreds of other kids to look after, but she made me feel that she had all the time in the world for me if I needed it.”

Some doctors are like drill sergeants, says Matsuoka. They tell their patients what they can and cannot do. Not Dr. Kaufman, she says:

“Her philosophy was more ‘Okay, you want to do something. Let’s figure out a way for you to do it while keeping your blood sugars in the normal range.’ Dr. Kaufman helped me realize that diabetes is only as limiting as I allow it to be.”

“I think this is the greatest gift that any physician can give to their patients with a manageable chronic illness like diabetes.”

When Matsuoka has finished her studies, she wants to be a health care policy analyst and work on improving access to health care.

“Yes, to a certain extent, how well diabetic patients do is up to them and how well they control their diabetes. But if they can’t even afford blood-testing supplies, how can anyone expect them to stay well?”

“I lost my parents to diabetes,” says Ruby Wolf. “What I saw with my parents is not what I want for my community.”

Wolf is a member of the Zuni tribe that lives in the high desert of New Mexico. Traditionally Zuni people were lean and athletic. Runners often traveled long distances to reach farm fields or to carry messages between villages.

Lard and sugar, cars, sit-down habits, and other modern influences have brought a huge change to the Zuni. Many now fall victim to obesity and its companion, type 2 diabetes.

Some 1,400 Zuni are diabetic in a tribe of only 10,000. That’s three times the rate for the general population.

Wolf believes that education is key to turning this around—education about type 2 diabetes and about healthful Zuni traditions.

As director of a local nutrition clinic. Wolf works with other activists to re-introduce healthy practices into daily life. A majority of Zuni women once again breastfeed their infants. New playgrounds have been constructed. The community drinks low-fat milk instead of whole, and bottled water is now stocked in vending machines.

The Zuni gym is constantly busy with group workout sessions and individual users of the weights and stationary bikes. There’s also the Zuni Fitness Series. Runs, walks, and other fitness events take place each month starting in the spring and building up to a 25-mile reservation relay in August.

By offering a wide variety of events. Wolf says, “we’ve been able to motivate people who are not necessarily interested in competing at sports or running.”

There used to be a charge to take part in the Fitness Series, but that’s been dropped. Now participants are asked for something else: information. The registration form asks about body mass index, risk factors for diabetes, and other health information. Wolf explains that these data, along with follow-up data collected at future events, will be used to measure the community’s progress toward fitness.

Meanwhile Wolf’s nutrition clinic continues to educate about wellness through a Healthy Lifestyles project. The project puts out fitness information through radio, bulletin boards, articles, and other means, but especially through the fourteen staff people who make personal visits to community members. On these visits staff members are able to spend more time educating clients compared to health workers in a medical setting. Also, they are able to help entire families learn what to do to stay fit, so the burden of change is not on one person alone.

The Healthy Lifestyles project recently succeeded in getting a wellness curriculum included in the public schools at all grade levels. Another recent success is a grant to the schools for fruit and vegetable snacks, so children are less tempted by junk food.

Wolf says that what has really helped get the message across is providing educational materials in the Zunian language. Some people have told her, “I never knew that until I heard it in Zuni.”

What keeps Wolf inspired are those moments when people are having fun staying in shape. “Five hundred-plus walkers out at 7:30 in the morning,” she says. “What motivation!”

She’s also inspired by the need to undo the myth that to be Zuni means to get diabetes. “We say no, this is not what has to happen, this is not the belief we should have anymore,” she says. “We’re going back to tradition and if we do that we’ll have healthier lifestyles.”

His life is a dream come true. But Stackhouse has seen how diabetes can cut lives and dreams short.

Two of his older sisters, Delois and Jean, died from complications from diabetes. Now his mother, Minnie, and his father, George, have been diagnosed.

Stackhouse says, “People think diabetes is an old people’s disease and that it is not really a deadly disease. But because of my sisters, I have seen how it can kill people in their 40s.” He has started his own charity called the Triple Threat Foundation to fund research and raise awareness of diabetes. Stackhouse has filmed public service announcements for television and spoken about diabetes before Congress. “Managing diabetes, ” he has said, “is tougher than anything I do on the basketball court.”

Stackhouse grew up in small town in eastern North Carolina called Kinston. Because of his sisters, he thought insulin shots were normal. “I guess that’s because I grew up the disease. It was just something that people did, like pouring milk into cereal. My sister had to take shots. I didn’t think it was anything major,” he says.

And like many people, he thought that diabetes came from eating too much sugar. In fact, Stackhouse says, “sugar” is what people in Kinston often called diabetes. Bad diet may increase your chances of getting diabetes, but sugar doesn’t cause it.

It became clear to Stackhouse just how serious diabetes could be when his sister started to suffer complications. Delois had her left foot amputated. Jean suffered both kidney failure and hepatitis.

One of Stackhouse’s main goals is to raise awareness of diabetes in the African, Latino and Native American communities. The disease hits those groups especially hard. The statistics are shocking. Thirteen percent of all adult African Americans have diabetes, 10 percent of all adult Latinos, and, by some estimates, 15% of all adult American Indians and Alaska Natives.

Stackhouse thinks one place to start is to educate people about symptoms so they will get a diagnosis, early treatment, and advice about how to control the disease. “If people have blurry vision or find that that they have to go to the bathroom a lot, they should go get checked out,” he says.

Stackhouse does not have diabetes now, but he knows he is at risk because of his family history. He is careful about what he eats. As a pro basketball player, he is very active, to put it mildly. But once his playing days over, Stackhouse knows he is going to be have to careful. “I’m definitely not out of the woods with this disease.”

I was taking a sulfonylurea pill, and it would help, but then sometimes I would feel bad, and my doctor would tell me that my blood sugar level was staying too high too long. That’s when he gave me a prescription for Glucophage too. Now I am taking both of them. My doctor told me that my blood sugar is at a good level and staying there and that is good.

Also, since I’ve been taking Glucophage my weight hasn’t been going up and I like that. I may be along in years, but I am trying to keep my figure.

Diabetes is not going to stop me.

H. Provenzano
Brooklyn, New York

I have a good doctor who helped me understand what diabetes is and what I could do about it. He helped me change the kind of food I eat and plan an exercise program (I’m walking about four miles a week). Those changes helped, but not enough. Then he put me on Glucophage and it helped me control my type 2 diabetes.

It is not always easy staying on a diet plan, walking the four miles each week and remembering to take Glucophage, but my wife, and even my two daughters, have helped me stick with it. They are always reminding me about all the things I have to do to stay healthy. I don’t mind because I’m doing it for them.

Since I started controlling my diabetes, I feel good and know I can do my job, and that is what it is all about.

P. Gomez
Phoenix, Arizona