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VA understands that life after service isn’t the same. You may be less physically active, have different eating habits, have started smoking, or you may have increased stress or other mental

health concerns. Unfortunately, these factors play a big role in your risk for developing diabetes. In fact, women Veterans are 2.5 times more likely to develop Type 2 diabetes than

non-Veterans—but prevention is possible! Diabetes is a chronic condition that occurs when your body's blood sugar, or glucose, levels are too high. There are three main types of

diabetes: * Type 2 occurs when your body does not produce enough insulin or is resistant to insulin. Type 2 diabetes usually occurs in adults and is commonly associated with obesity. It can

often be delayed or prevented with lifestyle changes. * Type 1 occurs when your body does not make insulin or makes very little, so you need to take insulin every day. Type 1 diabetes

usually occurs in children and is caused by an autoimmune destruction of the pancreatic cells that make insulin. It cannot be prevented, but it can be treated effectively, and it is much

less common than Type 2.  * Gestational diabetes can develop in pregnant women who have never had diabetes and it puts your baby at higher risk for health problems. Gestational diabetes

happens when your body cannot make enough insulin during your pregnancy. It usually goes away after birth, but it does increase your risk and your child’s risk for Type 2 later in life.

Those diagnosed with diabetes are also at higher risk for developing other serious health conditions, including heart disease and stroke, vision problems, nerve damage, foot problems, and

kidney disease. Diabetes affects nearly 25% of VA's patient population, and sometimes, it may be due to common lifestyle changes following service, such as being less physically active,

developing unhealthy eating habits, drinking alcohol or smoking, mental health challenges, and more. You may also be at higher risk for developing diabetes if you have certain risk factors

such as: * Being overweight * Being 45 years and older * Having a parent or sibling with Type 2 diabetes * Being less physically active * Having polycystic ovary syndrome (PCOS) * Having had

gestational diabetes or giving birth to a baby weighing over 9lbs Race and ethnicity may also play a role in your risk for diabetes. Women Veterans who are African American,

Hispanic/Latino, American Indian, Alaska Native, Pacific Islander, or Asian American are at higher risk. VA recommends women Veterans to keep up with your routine primary care visits so we

can catch diabetes as soon as possible during regular blood work. If you’re experiencing any of the following, speak with your VA health care provider about testing your blood sugar: *

Frequent urination * Increased thirst or hunger * Unexplained weight loss * Blurred vision * Numbness or tingling in hands or feet * Increased fatigue * Dry, darkened skin or skin tags. 

Your VA health care team can develop a treatment plan to help you delay or prevent Type 2 diabetes. This includes support for lifestyle changes around nutrition, exercise, substance use, and

more—which can also help prevent heart disease and stroke. Additionally, VA offers a wide range of services and resources to help you manage diabetes, including specialty care, blood

glucose monitoring supplies and medication, eye care, foot care, prosthetics, and more. We can also help you manage gestational diabetes during your pregnancy. Speak with your VA health care

team about your risk for diabetes. You can also call the Women Veterans Call Center at 1-855-VA-WOMEN to connect to care or visit the Women’s Health Diabetes page to learn more. NATIVE

AMERICAN HERITAGE MONTH November is Native American Heritage Month and this year’s theme is “Affirming Native Voices: Visibility, Leadership, Service.” The goal is to reflect on the

essential perspectives of the Natives of the Americas. Many Native Americans have made significant contributions to our nation, such as the Navajo code talkers during WWII, and U.S. Coast

Guard Veteran and Cherokee Activist Nellie Locus, who worked to preserve and teach history. Veterans who are using traditional medications from their cultural heritage should bring this up

with their VA provider. We want to be aware of what herbal remedies or traditional healing practices you use so that we can work with you and incorporate it into your treatment plan and be

mindful of what will best compliment treatments you are already using. You can always talk to us and know that we will be open to what you need, your values, and how we can help. It’s all

part of Whole Health; our belief in putting the Veteran at the center of their care. UPCOMING EVENTS VAPIHCS will hold a Thanksgiving Lunch on November 28, 2024, from 10 a.m. to 1 p.m. HST

at the Daniel K. Akaka VA Clinic at 91-1051 Franklin D. Roosevelt Ave in Kapolei. Veterans are welcome to come to this event and enjoy a hot meal with our staff. There is no need to bring a

dish, just come and enjoy! Point of contact is Schoen Safotu: 808-321-7505 or [email protected]. THOUGHTS FROM CHAPLAIN RICHIE CHARLES Back when sailing ships were reliant upon winds to

be driven across the ocean, little could cause more dread for sailors than for their ocean vessels to get stuck in the oceans’ doldrums. Doldrums refer to the belt around the earth near the

equator where air circulates in an upward direction, providing little horizontal airflow to propel sailing ships along. Sailors would find themselves stuck in the ocean’s doldrums for days

or even weeks, with a slowly depleting food and drinking water supply.  “Indecision” can be like doldrums. With no commitment made in a particular direction, indecision can leave us feeling

stuck, drifting in one stage of our growth experience with little to no progress. Making decisions helps chart our paths and craft our destinies. Yet, the sheer fact that choices have such

power can prevent some from ever exercising this amazing human ability to its fullest extent. Perhaps it’s the fear of regrets and making the wrong choice that keeps some in the doldrum of

indecision. Or the loss of control that comes from launching into the unknown. Or maybe we fear committing to a particular course of action, or maybe deep down, we’re unsure of what we want.

Regardless of what it might be, making decisions can help us courageously face the unknown, accepting what is, and is not within our control. Making decisions can help propel us to take on

new challenges and assume new responsibilities, thereby experiencing new growth. Making decisions can help in our self-discovery, since the very process of trying new things will confirm or

clarify what our likes and dislikes really are. So, let’s steer clear from prolonged indecision, and instead embrace and cultivate the power to make sound decisions in a timely manner. ONE

TEAM, ONE OHANA! ADAM M. ROBINSON, JR., MD, MBA, CPE  DIRECTOR, VA PACIFIC ISLANDS HEALTH CARE SYSTEM VADM, MC, USN, (RET) 36TH SURGEON GENERAL, USN Stay Informed Website:

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