Reversing the Path towards Diabetes

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PINEHURST – Education and motivation helped two area residents, along with dozens of their classmates, lose a combined total of 500 pounds last year—all without the need for surgery, fad diets, medicines or money. In fact, because of their personal efforts in free classes offered by Community Health Services at FirstHealth of the Carolinas, they were able to reduce and even avoid the risks of diabetes. They also reduced the amount of medicines they need and improved their overall health in ways important to them.

“I was surprised and a little worried when I went to a FirstHealth wellness screening and found I had prediabetes,” says Gay Childers, 67, of Rockingham. “Diabetes is very serious, and I knew it can affect all parts of the body. It’s also costly if you need medicines for it.”

Prediabetes is a health condition when blood sugar levels are higher than they should be, but not high enough to be called diabetes.

Childers was right to be concerned. Without making lifestyle changes, people with prediabetes are more likely to develop type 2 diabetes within five years, according to medical experts.

So in March of last year, Childers enrolled in classes held by FirstHealth that help people learn about prediabetes and how to reverse it. Health educators in the class, which meets over an entire year, teach important lifestyle changes that research shows can improve blood sugar and overall health. Topics include exercise, diet and stress management—and specific options to put this knowledge into action.

“Before I started these classes, I used to walk only once a week,” says Childers. “Now I walk at least 30 minutes four times a week, or more. I’ve lost 23.4 pounds, and my doctor was able to cut my cholesterol medicine in half! That’s all very important to me, and I feel like I’ve done really well.”

Childers also credits what she learned in class to helping her change how and what she eats, cooking more at home and reading food labels for calories, serving sizes and other information.

FirstHealth began making prevention of prediabetes a priority in 2016, when a review of area populations showed that rates of diabetes and death due to diabetes was high – even higher than the state average.

“With that data, our natural focus was to ask how we could help people not become diabetic in the first place,” says Roxanne Elliott, policy director with FirstHealth Community Health Services, a department that focuses on putting health resources like prediabetes classes in various towns and communities in the counties in the region.

In evaluating options to solve the prediabetes problem, the community health team landed on a proven program, the Prevent T2 (type 2 diabetes) program developed by the US Centers for Disease Control (CDC). FirstHealth, in partnership with local health departments, was able to leverage funds from the N.C. Office of Minority Health as part of the Minority Diabetes Prevention Project, and the Kate B. Reynolds Charitable Trust. With these funds and with the expertise of educators, FirstHealth began offering Prevent T2 classes in Harnett, Hoke, Montgomery, Moore and Richmond counties.

The classes, which are free, are quite extensive, starting with 16 weeks of weekly classes. Instructors have master’s degrees in public health and special training specific to this program. Meetings for the yearlong program taper off to one per month for the last six months.

“With this level of interaction, we’re able to help each participant create a personalized plan based on their preferences and goals,” says Samantha Allen, health educator for FirstHealth Community Health Services and one of the Prevent T2 instructors. “And the classes create a support system and an opportunity to share ideas with each other.”

Now in its second year, participation has been outstanding, Allen says.

“We set a minimum goal that half the class members continue in the program for six months or longer. In our first year, more than 90 percent stayed with it.”

But individual goals are the most exciting, she says. Many have improvements like Childers’ reduction in cholesterol medicine, or in A1C levels (a blood test that is an indicator of diabetes).

“We’re excited if someone loses a dress size or an inch around the waist, or if they just report how much better they feel,” says Allen. “Those wins are great motivators and proof that you can make changes that give you more control over your health.”

Another success, Sheila Evans, 57, agrees. Her physician referred her into the program when testing showed she had prediabetes. With the information she learned in the class, she has lost an impressive 60 pounds. “I’m amazed by how good I feel now. And my doctor reported at my last check-up that my A1C was ‘perfect.’”

Evans, a Hoke County librarian of 29 years, was also surprised by how helpful the interactive classes are.

“We learned by playing games, taking walks together and even having covered dish meals, where we researched and shared healthy treats,” she says.

To help with goals, the class also includes giveaways like measuring cups, food and body scales, and even automobile fuel cards to make it easier for participants for attend.

One illustration of how the class supports lifestyle change, versus a short-term change, is students’ success despite temporary setbacks or a family history of similar issues.

Evans, for example, has back pain from two unrelated health conditions, which could make exercise difficult. But she found a chair exercise class that still lets her get her blood pumping, she says. Other tools she learned about in class, like the MyFitnessPal app online, gives her information to continue making better food choices or simply track her progress after the class ended.

Childers, too, had health challenges – foot surgery and bronchitis – since she began the program. But what she had learned in class allowed her to keep the weight off until she was able to resume exercise.

“Many people think you are destined to have diabetes because of family history,” says Chelsea Whitfield, another FirstHealth Prevent T2 health educator. “But this program and our students show you can control many of the risk factors, and reverse the path to diabetes.”

To learn more about the prediabetes classes and to find a class near you, visit www.firsthealth.org/PreventT2.

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