As we have documented previously, diabetes is a rampant and preventable scourge in South Carolina, affecting the daily lives of half a million adults and dramatically increasing their mortality risk. Recent research suggests that type II diabetes – i.e., diabetes with adult-onset – is significantly less associated with genetics than with lifestyle. Although individuals who have family members with type II diabetes have an increased risk of the disease themselves, the evidence suggests much of that is due to common environmental factors.
This is good news: while genetics are a factor in diabetes, they are not determinative. Because lifestyle decisions play an outsized role, lifestyle changes can dramatically reduce the incidence of diabetes. For the many individuals and organizations in the Lowcountry working to slash diabetes rates in adults, the time to reach high risk populations is before they are diagnosed. The Centers for Disease Control (CDC) reports that more than a third of Americans have pre-diabetes, defined as an elevated resting blood sugar that suggests the eventual onset of full-blown diabetes. Individuals with pre-diabetes experience no symptoms but 40% of them will develop diabetes within five years. The CDC estimates that only
A Coalition of Action Against Diabetes
That is where a host of local organizations, including one coordinated effort, are attempting to interrupt the diabetes pipeline. They know that only 10% of those already diagnosed with diabetes can reverse the diagnosis, even with improved diet and exercise.
A diabetes coalition called Healthy Tri-County Diabetes Coalition is working to stitch together the various efforts community-wide and reach populations at risk of obesity, physical inactivity, high cholesterol, and high blood pressure, the four key indicators of diabetes risk. Ninety percent of those with type II diabetes are overweight or obese. These populations are associated with minority, low-income, and rural communities.
Health educator LaShandra Morgan, owner of Edible Antidote LLC, a company that offers healthy lifestyle training; and Kayla Visser, program coordinator for the AccessHealth Tri-County Network diabetes prevention program, serve as co-chairs of the coalition. They aim to increase awareness and utilization of the many resources available to those at risk and those already diagnosed.
The Lowcountry Graduate Center knows that the economic development of our region depends on a healthy workforce. Diabetes costs employers an estimated $245 billion nationwide and results in 5.5 added days of missed time per employee, according to Gallup and the American Diabetes Association (ADA). Diabetics incur more than double the medical bills of other employees, which gets passed on to employers in insurance premiums. Diabetic employees are also less productive than their counterparts, according to the ADA.
Take the Pre-Diabetes Test
That is the bad news. The good news is that the evidence-based, year-long National Diabetes Prevention Program offered locally has been shown to thwart the onset of diabetes. The program teaches nutrition, exercise, and stress management and has demonstrated that a 5-7% reduction in body weight and 150 minutes of weekly physical activity slashes the incidence of diabetes by 58%. Even for those who eventually cross into the diabetes diagnosis, the program delays the onset by four years.
Various are organizations, including Roper St. Francis Healthcare, MUSC, the Summerville Y, and a host of individuals and companies, offer diabetes prevention training, many of them for free or nominal charge. The state SC Center for Rural and Primary Health Care at the University of South Carolina School of Medicine has funded a program for which Morgan serves as project lead that is focused on rural populations in all three local counties. Trident United Way is bankrolling AccessHealth’s effort to serve as a hub of diabetes prevention in the area and to increase the number of programs throughout the region.
Anyone can get screened for pre-diabetes with a simple test offered by the CDC to determine if they are at risk of pre-diabetes. Raising awareness and convincing at-risk individuals to take the test and participate in the programs has been the major challenge facing diabetes educators. Morgan offers “sweet talk” focus groups that help participants get excited about learning how easy, inexpensive, and delicious healthy eating can be.
Employers Not Yet on Board with Diabetes Prevention
“We live in the South and cooking and food are how we show love,” said Morgan. “I understand that food has to taste good and that healthy food has a stigma of being plain. I like to give out cooking tips: instead of sautéing in oil use chicken broth so there are no trans fats or create different types of seasoning instead of salt. When food tastes good the problem is solved.
Visser says the lifestyle coaches provided as part of the Diabetes Prevention Program help make lifestyle changes easy. “The lifestyle coach is there for them throughout the week to talk them through every one of the small changes we propose they make. Many programs offer incentives to participate like cookbooks, pedometers, boxes of produce,” she said.
Diabetes Prevention Program offerings have not caught on at area employers, some of whom don’t recognize the long-term cost savings. It is likely that must change before real community-wide reductions in the prevalence of diabetes – and the damage it does to our area’s health and economy – is possible.