Snacking on crackers and a fondness for pasta expanded Rae Doboga's waistline to the point that she weighed 200 pounds. Little did she know that her blood sugar levels were rising dangerously at the same time.

The wake-up call came in March when a hospital visit for chest pains led to a diagnosis of Type 2 diabetes, the most common form of the disease.

At 76, the Lisbon Falls resident thought she had "dodged the bullet" that struck her parents and siblings. But the 25 pounds the 5-foot-5-inch woman gained from stress-eating after her husband's 1993 heart bypass may have been the tipping point.

To control the chronic disease, Doboga is now trying to lose excess weight « the most common denominator among diabetics. In fact, the rise in obesity in Maine and around the country has coincided with a diabetes epidemic in such a startling way that a new term has been coined « "diabesity."

Part of the reason for the increase in diabetes detection is the tightening of diagnostic criteria for the potentially fatal disease in 1997. But health care professionals say overall, the country is getting heavier and more sluggish and that many more people have diabetes than have been diagnosed.

In Maine, about 83,000 people have been diagnosed with Type 2 diabetes, and just as many do not know they are sick, according to the state's Diabetes Prevention and Control Program.

The number of diabetics in Maine more than doubled from 1994 to 2004. And, anecdotally, overweight children are increasingly accounting for more of the caseload, even though Type 2 used to only show up in adults.

Age, race and family history are among the risk factors for the chronic disease, but obesity is believed by some health experts to be the biggest predictor and certainly the chief one for children.

"You don't see a lot of thin kids or kids of average body proportion with Type 2 diabetes," said Dr. Don Burgess, president of the Maine chapter of the American Academy of Pediatrics.

With Type 2 diabetes, the body does not make enough insulin, the hormone that transports blood sugar into the cells so it can be used as energy. Sometimes the cells ignore the insulin.

Either way, sugar, or glucose, begins to build up in the blood. Over many years, high levels of glucose act as a toxin in the blood stream, damaging the blood vessels leading to the eyes, potentially causing vision loss; and the nerves, which is why more than half of the lower-limb amputations each year occur among diabetics.

In addition, there could be loss of kidney function and heart problems. In fact, the chances a diabetic will have a heart attack within the next five years is believed to be higher than those of a nondiabetic who has already suffered a heart attack.

A study published in the American Journal of Preventive Medicine this year demonstrates just how big a role weight plays in the prevalence of diabetes.

In 2003, diabetes was detected in two of every 1,000 average-weight people who were diagnosed. That same year, 18.3 of every 1,000 obese people were diagnosed, as were 5.5 of every 1,000 overweight people.

Being overweight complicates matters because cells are too filled with fat to make room for glucose from the bloodstream, said Dr. Irwin Broadsky, an endocrinologist at the Maine Center for Diabetes in Scarborough.

"The cells are saying, 'Yes, we've got enough. There's no need for more,'•" Broadsky said.

With age, race and genetics out of people's control, the only thing left to manage is their weight or diet. This also could help people who've developed pre-diabetes, a condition in which glucose levels are above-average but not high enough to count as diabetes.

"We focus on behavioral changes that could include portion control, appropriate food choices as well as increasing activity," said Kathy Beers, a nurse and manager of diabetes education at Mercy Hospital in Portland.

Beers said some people she sees feel like failures if they're not losing many pounds. In reality, they may be losing fat mass and gaining muscle mass, so they might not see a difference on the scale, Beers said.

Another thing to remember is that weight loss doesn't have to be dramatic for glucose levels to start falling.

"We see 30 percent improvement in people with only four, five pounds of weight loss, even in people who are fairly obese," Broadsky said. "When you talk about lifestyle modification, I'm not talking about something that is unreachable."

With enough exercise and healthy eating, a diabetic can normalize glucose levels and be considered to be in remission. Others, though, may need medication and insulin shots.

Doboga wants to avoid medication by losing 30 pounds over time. Already an avid walker, Doboga plans to hone in on her diet and is taking diabetes classes at Parkview Adventist Medical Center in Brunswick.

She has begun to add more protein to her diet, so she feels full longer and will not want to snack as much. Also, she is dropping her favorite starchy foods. Her husband, whose health has improved, is gamely adjusting to her new diet.

"I've eaten my way through his illness," Doboga said. "Now it's time for me to get a handle on myself."

Staff Writer Josie Huang can be contacted at 791-6364 or at: jhuang@pressherald.com