A man leaned out his car window at 10th and Niagara streets Wednesday afternoon and shouted at Angela Myles.
"Why are you all walking?" the man wanted to know.
"For the march for diabetes," answered Myles.
The message was getting out.
Myles, a Sanborn resident, was one of more than 50 people who walked from Niagara Falls Memorial Medical Center to Niagara Falls State Park to mark World Diabetes Day. The event coincided with marches across the country to raise awareness of the disease.
Diabetes is a daily struggle for Myles and 240 million people across the world.
Dr. Anita Chaudhuri of Memorial's Diabetes and Endocrinology Center of Niagara sees the local impact of that struggle every day and worries about trends that show the number of diabetes patients will almost double in future years.
"I want to emphasize that diabetes has not only become an epidemic in our country, but it is a pandemic now," Chaudhuri said.
The number of diagnosed cases in New York State increased by 70 percent between 1997 and 2004, according to statistics provided by Memorial.
Then there are the people who don't know they're diabetic.
"For every two cases that are diagnosed, a third goes undiagnosed," Memorial President Joseph A. Ruffolo said.
Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that converts sugar, starches and other food into energy for daily life, according to the American Diabetes Association. Its cause remains a mystery, although genetics and environmental factors, such as obesity and lack of exercise, appear to play roles.
It can lead to a host of medical conditions.
Myles, 37, hardly thought about diabetes before she was diagnosed in 2003. She felt perfectly healthy when she went to her doctor for a regular checkup. A nurse practitioner noticed a dark spot on her neck -- a sign of insulin resistance.
"My dad was diabetic, but I still just didn't think about it," Myles said.
Since having been diagnosed, Myles has focused on eating right and walking regularly. She lost 65 pounds and was taken off her medication for diabetes. But she knows it's a fight she will have to continue.
"It's still a struggle for me. I can't say that I won," said Myles, who set up a health-related Web site through her employer, WIVB-TV, where the public can discuss health issues and ask questions. "It's a fight that we have to struggle every day to win."
Chaudhuri believes that the number of people diagnosed with diabetes is growing because of a lack of awareness of the disease. She said she finds that troubling because diabetes can affect every organ in the body, but can also be controlled by preventative measures.
"This is a problem which has to be addressed," Chaudhuri told the walkers. "This is a problem that can be controlled, because if you don't control diabetes, the diabetes controls you."