For eight years, Jeanne Houtz, who has a family history of diabetes, ignored all the symptoms — visual problems, weird sensations in her feet and blisters that would not heal.
The San Diego woman was diagnosed with type 2 diabetes at age 40, but she refused to take her medications or to lose weight. Houtz never realized she was in danger until the bones in her right foot collapsed, causing wounds that eventually led to infection.
But attention to this insidious disease came too late, and it finally cost her a leg, which was amputated in 2005.
"I know I am the worst person on the planet, acting like this," said Houtz, now 56.
"My mom had it, everyone had it," she said. "When I was a young girl, I had an aunt who had it and she was told not to eat brownies. She would crave them and I thought, 'Why does she eat them?' I later realized it's an uncontrollable urge."
Houtz is one of 20.8 million Americans who have been diagnosed with diabetes, a disease that is now epidemic and is linked with the increased prevalence of obesity in the United States, according to the National Diabetes Education Program Progress Report 2007.
About 6.2 million Americans have the disease, but go undiagnosed.
The total number of people with diabetes in the United States is projected to rise from 17.7 million in 2000 to 30.3 million in 2030, placing the United States third in global prevalence, second only to India and China, according to the report.
About 66 percent of all adult Americans are overweight, a major risk factor for type 2 — or adult onset — diabetes. Left untreated or not managed well, the disease can lead to peripheral neuropathy, which can lead to foot deformities and eventually amputation.
Today, Houtz listens to her doctor, though at 5 feet, 9 inches tall, she still weighs 260 pounds. The bones in her second foot are now starting to deteriorate, putting her at risk again.
More than 60 percent of all amputations are caused by diabetes, according to the National Institutes for Health.
Ron Santo, an all-star baseball player for the Chicago Cubs and later the White Sox, concealed his type 1 diabetes in the 1960s. Later in his career he went public with the disease, but eventually lost both legs to amputation, one in 2001 and the other in 2002.
Each day, doctors perform 230 amputations in the United States, but some experts estimate that half of all such operations would have been preventable if minor infections were caught and treated in time.
That was not the case with Houtz.
After her diagnosis in 1992, Houtz said she felt "fine." But by 2000, she began to lose her sight, eventually undergoing four eye operations. Diabetes also ravages vision and can attack the kidneys.
Soon, her feet were affected.
"One day I looked down and my feet weren't straight — they were curving to the side," said Houtz. "This went on for a couple of years, then I felt knots at the bottom of my feet, and they started to become flat. One day, all of a sudden, the bones started cracking."
According to her doctor, Houtz was experiencing Charcot foot, a deterioration of the weight-bearing joints, most often caused by diabetic peripheral neuropathy. The condition develops over time and is seen most often in patients who have had the disease for years and poorly controlled it.