|June 6, 2013
Participants sought for Diabetes Prevention Program
By B.L. Azure
ST. IGNATIUS — Diabetes is a serious health problem in Indian Country including the Flathead Nation. It can cause debilitating problems with the heart, eyes, kidneys, feet and gums. It also can cause strokes and it often leads to premature death. However diabetes is controllable with proper management based on patient awareness and education, an active lifestyle, a healthy diet, medication and professional medical guidance.
In an effort to stem the escalation of the incidence of diabetes among the tribal people on the Flathead Indian Reservation the CSKT Tribal Health and Human Services Department and Providence St. Patrick Hospital of Missoula have entered into a joint diabetes education and lifestyle change partnership effort and they are seeking participants to enroll in the program.
The partnership will center on the Atlanta, Ga.-based Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program, a decades old diabetes education and prevention effort that has proven positive outcomes.
“We welcome this opportunity to work together with St. Pats on this project to improve the health education and services Tribal Health provides for our diabetic population,” said THHS Director Kevin Howlett, who noted that diabetes affects a great proportion of families on the Flathead Reservation and it is also a growing health concern nationwide.
According to the CDC millions of Americans including tens of thousands American Indians are at high risk for Type 2 diabetes. However, the results of a major clinic research project found that they can delay the onset of serious diabetic complications or potentially prevent the disease altogether with moderate diet changes and inclusion of a moderate exercise regimen. The research also found that the oral diabetes drug metformin (Glucophage) also reduces the risk but not as effectively as the aforementioned lifestyle changes.
A major research study in Massachusetts spawned the CDC’s Diabetes Prevention Program (DPP) that THHS and Providence St. Patrick Hospital plan to implement with tribal folks on the Flathead Reservation with pre-diabetes symptoms or at risk for diabetes.
“This research conveys a powerful message of hope to individuals at risk for Type 2 diabetes, a painful, life-threatening disease that has been increasing in this country along with obesity,” said former U.S. Department of Health and Human Services Secretary Tommy G. Thompson in 2002 after the results of the Diabetes Prevention Program began to spawn positive results. “By adopting a moderate, consistent diet and exercise program, many people with one or more risk factors for Type 2 diabetes can stop the disease before it becomes irreversible.”
The DPP compared three approaches — lifestyle modification, treatment with metformin, and standard medical advice — in 3,224 over weight people with impaired glucose tolerance (IGT), a condition with blood glucose levels higher than normal but not yet diabetic.
Approximately 20 million people in the U.S. have IGT, which raises the risk of developing Type 2 diabetes and cardiovascular disease. Once a person develops Type 2 diabetes, the risk of heart and blood vessel disease is even greater, about two to four times that of people without diabetes.
According to the research study diet and exercise that achieved a 5- to 7-percent weight loss reduced the incidence of diabetes by 58 percent in participants randomized to the study’s lifestyle intervention group. Participants — age 25 to 85 with an average age of 51 — in the group exercised at moderate intensity 30 minutes a day, five days a week, and lowered their intake of fat and calories. The volunteers randomly assigned treatment with metformin had a 31 percent lower incidence of Type 2 diabetes. Metformin lowers blood glucose mainly by decreasing the liver’s production of glucose.
Forty-five percent of the participants were from minority groups — including American Indians — that suffer disproportionately from Type 2 diabetes.
“Lifestyle intervention worked equally well in men and women and in all ethnic groups,” said Dr. David Nathan, chair of the research study at Boston’s Massachusetts General Hospital. “It was most effective in people age 60 and older, who lowered the risk of developing diabetes by 71 percent. Metformin was also effective in both sexes and in all ethnic groups but it was relatively ineffective in older volunteers and in those who were less over weight.”
More than 16 million people in America have diabetes with Type 2 accounting for 95 percent of all diabetes cases.
Diabetes results from having too much sugar in the blood due to a person’s inability to properly process it and transfer blood sugar to body cells and muscles where is used for energy — that begets the build up of blood sugar in a person’s physiology. Not good.
People susceptible to developing diabetes include: people over 30 years of age; overweight people; people with sedentary lifestyle; those with a history of diabetes in their family; women who registered high blood sugar during pregnancy; and/or, women that have given birth to a baby that weighed more than nine pounds at birth.
The warning signs of diabetes, include: feeling tired; blurry vision; increased thirst; frequent urination; sores that don’t heal; sore gums; and, unusual weight loss.
However not all pre-diabetics or diabetics exhibit the warning signs that is why it is good to know the susceptibility factors.
The CDC Diabetes Prevention Program will be implemented on the Flathead Reservation via grant funds from Providence St. Patrick Hospital and its diabetes specialists.
They are recruiting 25 folks 18 years of age or older who are at risk for diabetes or with pre-diabetes symptoms — high blood pressure; elevated triglycerides; high total cholesterol or high LDL (bad) cholesterol; low HDL (good) cholesterol; a history of gestational diabetes; and, women who have given birth to a baby weighing more than nine pounds — with a body-mass index of 24 or greater.
Applications will be taken throughout June with screening of participants tentatively scheduled for Tuesday, June 25 and classes are set to begin Tuesday, July 2, and each Tuesday after that — from 12-noon to 1 p.m.
Program participants will meet once a week for 16 weeks then once a month for the remaining seven months of the program at the Diabetes Program conference room in the St. Ignatius THHS Clinic.
Due to travel logistics the DPP staff wants to focus of folks from the Arlee, St. Ignatius and Ronan areas. Mileage will be paid but the bigger incentive is a healthy and long future. Oh yea, there will also be door prizes at each meeting.
For more information or to enroll for the screening process in the Diabetes Prevention Program, contact Sara Engberg at St. Patrick Hospital Diabetes Care and Prevention Center at 329-5781.
Space is limited so the sooner the contact the better the chances are for a better and longer future.