Most Americans believe they are in excellent health despite having a chronic disease or being at risk for developing diabetes according to a study by the American Diabetes Association. This misconception is the target of two local prevention and awareness programs that aim to empower diabetes patients with education and put control of the disease into their hands.
Dr. Jane Bolin, an associate professor at the Texas A&M University Health Science Center School of Rural Public Health and director of the Southwest Rural Health Research Center, said, “If individuals don’t take ownership of it, they become sort of passive and they forget about their appointments. Providers can only go so far really to remind them of their appointments.”
Treatment of diabetes requires a multi-treatment approach with medication, diet, and exercise, which can be overwhelming to recently diagnosed patients, especially those that do not have the skills needed to manage their symptoms. To limit the effect of diabetes on a patient’s quality of life, patients must be proactive in controlling the disease at home, in addition to the clinical aspect of treatment; however, doctors do not have time to educate and equip their patients with the tools they need to control symptoms outside of the office.
In 1996, Dr. Kate Lorig, a professor at Stanford University, and several colleagues developed a solution to the problem with a community-based program for self-management of chronic disease. The seven-week workshop is based upon the theory of self-efficacy, the confidence a patient has in mastering a new skill or affecting his or her health. The program has proved so successful, it is becoming a standard measure of treatment in chronic conditions such as arthritis, cancer, heart disease, obesity, and diabetes.
Dr. Marcia Ory, a professor at the HSC-School of Rural Public Health said, “The whole concept is to get somebody who maybe has a chronic illness to be teaching it and what you learn are life skills and management. These programs are not to take away from what happens in the clinical setting, but are really to supplement them and recognize that life goes on outside of that 15 minute appointment that might occur every six months.”
The workshop, Living Well in the Brazos Valley, is offered by the Brazos Valley Area Agency on Aging under a program called Living in Style and is free of charge. The BVAAA is one of three agencies in the state that received funding through the Center for Disease Control for the program. The workshop teaches participants how to problem solve and set goals; cook and eat healthy; increase physical activity; manage pain; evaluate information on the internet; talk to doctors, family, and friends about the disease; and deal with a number of emotions and feelings. The classes are two and a half hours long once a week and run for seven weeks.
Daphne Fulton, chronic disease self-management program manager at the HSC-School of Rural Public Health, said in spite of being an evidence-based program and one of the only programs in which she has seen visible results, the biggest problem she encounters with the program is a misconception about what chronic disease is.
“We’ve had trouble marketing it,” Fulton said. “If we tell people it’s a chronic disease, they say they don’t need it. We ask, ‘Do you take medication every day?’ The answer is ‘Yes,’well then you have a chronic disease.”
Because individuals suffering from chronic disease often experience the same types of problems, the Living Well program does not address each disease specifically. But, The Texas A&M System AgriLife Extension Service offers a diabetes specific program called Do Well, Be Well and a Cooking Well with Diabetes class.
The nine-lesson Do Well, Be Well class includes four nutrition sessions and five self-management sessions. Graduates of Do Well, Be Well are eligible to enroll in a Cooking Well with Diabetes class that teaches participants how to cook meals that are lower in carbohydrates, fat and sodium, and high in fiber. AgriLife Extension has been offering the class since 2005.
Program director Dr. Alma Fonseca said, “The class is not just for those with Type 2 diabetes, it is for caregivers, family members, and friends that help too.”
Reports on the results of the classes are published annually. AgriLife Extension is enrolling for Do Well, Be Well now. Classes begin March 26 and runs through April.
WHAT IS DIABETES?
Diabetes is a metabolism disorder that results from the body’s inability to produce or respond appropriately to insulin. There are three types of diabetes: Type 1, Type 2 (formerly known as adult diabetes), and gestational diabetes.
Gestational diabetes can occur during late pregnancy and usually disappears after birth of the baby. But, women that develop gestational diabetes are four to six times more likely to develop Type 2 diabetes within 5 to 10 years. It is unknown what causes this form of diabetes.
Type 1 diabetes is an autoimmune disease in which the immune system attacks the insulin producing cells in the pancreas. The onset of symptoms is rapid and a daily dose of insulin is required for survival with this form. Type 1 diabetes accounts for 5 to 10 percent of the diabetes diagnoses and typically affects children and young adults.
Type 2 diabetes occurs when the body fails to use insulin properly and slowly decreases the amount of insulin produced in response. The onset of symptoms is gradual and often causes a delay in diagnosis and treatment. Type 2 diabetes is the most common form of diabetes, comprising 90 to 95 percent of diabetes diagnoses.
RISK FACTORS
Diabetes is rarely a singular condition. Obesity and high cholesterol often accompany the disease. Those with a low activity level, poor diet, and a family history of diabetes are at risk of developing the disease. While those aged 45 and over are at greater risk of developing the disease, the number of diabetes cases in individuals aged 20 and younger is rising in direct correlation to obesity rates. Additionally, recent research is showing an increased risk for individuals of certain ethnicities -- African-American, Hispanic, American-Indian, Asian, and Pacific Islander origins.
The American Diabetes Organization offers an online risk assessment at www.diabetes.org.
SYMPTOMS
The symptoms of all forms of diabetes are the same:
• Frequent Urination
• Excessive Thirst
• Unexplained weight loss
• Extreme hunger
• Sudden vision changes
• Tingling in the hands or feet
• Fatigue
• Dry skin
• Sores that will not heal or are slow to heal
• More infections than usual
The symptoms of Type 1 diabetes are sudden while symptoms of Type 2 diabetes are gradual and are often confused with signs of aging. Early diagnosis and treatment can prevent some symptoms.
-Rebecca Watts, About Town Press
