Joan Davis of Newark began tending to other people’s needs at an early age. As a young girl, she learned to cook and clean so that her mother could work on the family’s dairy farm. In her teenage years, she provided home care and baby-sat for a friend who had been severely injured in an automobile accident.

During her sophomore year at Lakewood High School, Joan began dating Terry, a classmate who rode the school bus with her, and sometimes worked on her family’s farm. They were married after high school, and through the years, raised three children. After the children were grown, Joan worked as a housekeeper in Zanesville. Following retirement, she baby-sat for one of her five grandchildren on a daily basis. With her long-standing history of serving others, Joan found it difficult to have the roles reversed, relying on her physicians for help when she learned that she had diabetes in her mid-50s.

“The way that I found out that I had diabetes was strange,” Joan said. “I had been having bad headaches, and stayed in bed a lot. I thought I was suffering from migraines. Then one day,I bought new eyeglasses. Within a week or two, I could not see very well, so I went back to the store and told them that I thought they had given me the wrong prescription. They double checked and told me that my eyes had changed since my examination, and recommended that I see my physician. I visited Dr. (Talya) Greathouse, and she ordered tests at Licking Memorial Hospital to check for diabetes.”

After reviewing the results of Joan’s glucose tolerance test, Dr. Greathouse diagnosed Joan with type 2 diabetes, commonly called “adult-onset diabetes.” Joan was already familiar with the condition because her father had received the same diagnosis at the age of 71.

Dr. Greathouse prescribed oral medications for Joan and explained the role that a healthy diet and exercise have in managing her blood sugar levels. Dr. Greathouse also provided education on other diabetes management measures, such as proper foot care and the importance of regular eye exams.

“The dietary changes took a little getting used to at first,” Joan remembered, “but now I am used to them. I have cut way back on fried foods, and I do not eat a lot of bread. I used to make a lot of cakes, but we do not have a lot of desserts, anymore. If I do have cake – at a birthday party, for example – I take only one piece and scrape off the icing. My taste has changed, and the icing tastes way too sweet for me now. I have been eating more healthy foods since 1999, and now I do not miss the old foods that I used to eat.”

Joan found that providing day care for her grandson kept her active. “He is 2½ years old,” she said, “and he has never walked. He ran from the first day that he stood up. He is a typical boy – plays in the dirt and mud puddles. He definitely keeps me running.”When Joan is not running after grandchildren or taking care of other chores, she and Terry enjoy taking fresh-air walks for exercise. Their list of favorite walking routes includes some of the state’s most scenic locales: The Dawes Arboretum, Black Hand Gorge, Columbus Zoo, Old Man’s Cave, and the boardwalk at Buckeye Lake.

Despite Joan’s efforts to manage her diabetes, her blood sugar levels were not well controlled, and her periodic A1c blood tests fluctuated. The A1c hemoglobin blood test measures the average blood glucose level from the previous three months. Diabetes patients who have good blood sugar control with A1c levels below 7 percent have a lower risk of developing many diabetes-related complications, such as macular degeneration of the eyes and problems with the cardiovascular system, nervous system, liver, and renal system. Joan’s A1c levels were usually around 7 percent, but at the end of 2012, they spiked up to 8.5 percent.

Dr. Greathouse referred Joan to see Jaime T. Goodman, M.D., of Licking Memorial Endocrinology, for more intensified diabetes care. Dr. Goodman ordered blood tests and reviewed Joan’s recordings of her home blood glucose checks. On her third visit, Joan’s A1c level had spiked again, and Dr. Goodman recommended a high-tech continuous glucose monitoring (CGM) test to discover any anomalies that were occuring without being detected by Joan’s home glucose monitor.

Licking Memorial Endocrinology uses the Medtronic iProTM2 Professional Continuous Glucose Monitoring System for an accurate and detailed around-the-clock account of a patient’s blood sugar levels. The CGM test is useful for patients who have not been able to achieve good blood glucose control. With the CGM, a tiny electrode called a glucose sensor is inserted under the skin of the patient’s abdomen to measure the glucose level of the skin’s fluid. A small plastic-covered monitor is worn outside the body to receive and record the readings via radio frequency.

Joan was nervous about having the CGM inserted, but soon found that her fears were unnecessary. “It did not hurt going in,” she said. “It was very comfortable to wear. They put special bandages on the monitor so that water would not get under it, and I could shower. I was careful to pull my clothing out and over the monitor because I was a little worried that I might knock it loose. Otherwise, I forgot about it most of the time.”

Joan had the CGM inserted on a Wednesday and returned to Dr. Goodman’s office on the following Monday to have the sensor removed and the collected readings uploaded to a software program. The analysis revealed that Joan’s blood sugar levels were mostly stable throughout the day, but elevated after breakfast and slightly decreased overnight. Dr. Goodman adjusted Joan’s medications to address the blood sugar variations.

“Dr. Goodman instructed me to increase my metformin dosage to one and one-half tablets in the morning, with one more at night. She continued my glipizide dosage at one tablet in the morning and another one at bedtime. I am on a total of four medications for diabetes, and Dr. Goodman evaluates them at each visit to ensure that they are well balanced. I also carry a complete list of all my medications in my billfold in case of emergency.”

Joan had an A1c test approximately three months after her CGM test results were analyzed and Dr. Goodman had adjusted her medication. The A1c results showed that Joan’s average blood sugar levels had successfully lowered to 6.5 percent.

Joan said, “I continue to see Dr. Goodman several times a year. As an endocrinologist, she keeps on top of new treatments and really watches for any possible complications. She focuses on more than just the blood sugar levels – she regularly orders blood work to check my kidneys and liver, and checks my feet for sores.”

Joan may not be accustomed to having others take care of her needs, but she is willing to put herself in Dr. Goodman’s expert hands to help avoid a wide range of potential diabetes complications. Family activities are important to Joan and Terry, and she wants to maintain the energy required to attend as many of their grandchildren’s events as possible. “We enjoy their sports, school plays and school activities. We even attend as many events as we can for the grandchildren who live in Missouri. We love to travel.”

Dr. Goodman and I-Tsyr Shaw, M.D., are accepting new patients at Licking Memorial Endocrinology for treatment of diabetes, thyroid problems, or other glandular conditions. Appointments can be made by calling Dr. Goodman’s office at (220) 564-7950, or Dr. Shaw’s office at (220) 564-1740.