About the series One in an ongoing series appearing Sundays and Wednesdays through October on the causes, complications and costs of type 2 diabetes, its impact on Western Pennsylvania and what might be done to stop the epidemic. Coming Sunday: The serious complications of diabetes. Online chat Read the transcript of a chat with Dr. Silva Arlsanian.

When students understand a topic, they make better decisions. And so it goes with diabetes.

Mary Jo Dudley set out years ago to make diabetes understandable. As a registered nurse and certified diabetes educator, she started her sideline business, Ideabetes, in 1989 to create tools to help people understand a disease that's epidemic in America, with one in four people having it or at significant risk of developing it.

Mrs. Dudley's glucose wands, for example, are clear plastic tubes full of liquid and sequins. But one tube is watery, reflecting normal blood sugar, and the other is syrupy, representing blood with high levels of glucose or sugar.

As her wands prove, when blood is syrupy with sugar, the heart has more problems pumping it, especially into capillaries in the eyes, legs or kidneys, as proven by the lethargic sequins.

"Glucose attaches to the red blood cells and makes them tacky," Mrs. Dudley said. "Picture in your mind cells swimming in Karo syrup."

So when patients ask why they must keep their blood sugar under control or take aspirin, the answer is simple: It thins the blood and prevents clot formation.

Ideabetes also offers a "sugar foot" to show how to care for feet; a pillow that represents a red blood cell with balls of glucose that attach to it to explain the hemoglobin AIC test revealing blood-sugar levels; and an apron with internal organs attached to explain diabetes' effect on the body. Other products include a pancreas pillow, an insulin sphere and blood-sugar bingo.

They help explain the puzzling disease's impact on the body and the importance of medication, exercise, healthy diet and blood-sugar monitoring in preventing complications such as heart disease, strokes, blindness, renal failure, circulation problems leading to amputation, nerve damage, thyroid disorders and gum disease, among others.

Insulin is your friend and sugar is your enemy, she said.

"If people understand what you want them to understand, and why you want them to do it, they will be far more able to achieve their goals," Mrs. Dudley said.

Raised on a farm in West Sunbury, Butler County, Mrs. Dudley graduated from Presbyterian University Hospital School of Nursing in Pittsburgh, then received a bachelor of science degree in nursing at University of Pennsylvania.

"Most nurses are teachers," she said, realizing early in her career that people need more than cold, hard facts to understand diabetes.

Mrs. Dudley, who now lives in Dover, N.H., taught her first class on diabetes in the waiting room of her husband, Dr. William Dudley, an endocrinologist and certified diabetes educator. Her first student, a certified public accountant, had high blood sugar levels, but no other symptoms, and questioned why he needed treatment.

"I came home that night," she said. "I failed. I didn't reach him."

So she began pondering ways to teach people, and an idea arose. She filled one clear baby bottle with Karo syrup and another with water, adding red food coloring and Styrofoam balls to each. The one with water represented healthy blood and showed how easily the balls flowed through it. The one full of syrup represented the blood of uncontrolled diabetes.

"I passed them around, and he went absolutely white," she said of the CPA. " 'What do you want me to do?' he said."

For two years, she searched for tubes to make glucose wands and found them through a toy company. In 1992, she came up with the name, Ideabetes. Knowing little about marketing, she attended national conferences of diabetes educators and peddled her products. "I knew I had a good, inexpensive way to get basic concepts across," she said.

A woman who made an apron showing the body's internal organs contacted Mrs. Dudley to make and market the product. Mrs. Dudley arranged for women at her church to make the aprons along with pancreas pillows. They recently produced the 500th apron.

Studies in the '90s confirmed that normal blood-glucose levels prevented complications for people with type 1, and later, type 2. "Name one thing in the body that blood doesn't touch," Mrs. Dudley said.

Type 1, occurring in children and young adults, is thought to be an autoimmune disorder that destroys or impairs beta cells that produce insulin in the pancreas. So people with type 1 must take insulin injections their entire life to control the disease. Her pancreas pillows display that concept. One has 200 buttons, representing the beta cells that produce insulin. The other, representing the pancreas of one with type 1, has no buttons.

Type 2, formerly known as adult-onset, occurs when the body can no longer properly use the insulin it produces. Mrs. Dudley explains why:

A cell is a lock and insulin is the key that opens the cell to allow glucose to enter and be used as energy. But with insulin resistance, the lock and key get rusty and do not work efficiently, if at all. Removing the rust requires one to quit smoking, lower blood pressure and cholesterol, and bring blood-sugar levels under control.

"You are your own caretaker," Mrs. Dudley said. "That's why you need to see a diabetes educator. It would be great have an educator in every physician's office."

Especially ones with glucose wands and pancreas pillows.