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Wednesday, June 19, 2024

Overcoming Diabetes Challenges

Diabetes has been a formidable foe for many, many African-Americans. If you have ever been diagnosed with diabetes or prediabetes you know about the struggle to keep everything under control.

When it comes to winning the battle against “sugar,” it helps to start with understanding the condition and ensuring that you have devices in place to win every step of the way. Where does that wisdom come from? Stay tuned. There are quite a few resources here in DC to support you.

Scope of the Problem
The number of diabetics in the District has declined over the years. Once upon a time, in 2010, 10.9 percent of the city’s population was diabetic. The latest findings come from 2016, when the percentage hovered around 7.7. The further east you go in the city, the higher the rates become. Wards 7 and 8 present the most severe statistics. According to the District government, 13.4 percent of Ward 7 residents were diabetic in 2014, while Ward 8 had a whopping 19.7 percent, more than double the national rate.

Prediabetics, people told by their doctor or a medical professional that they are borderline diabetic, are at the crossroads where health decisions can make their status take a turn for the better or for the worse. It mostly depends on the actions they take after diagnosis.

According to DC Health Matters, the number of prediabetics in Wards 7 and 8 in 2011 was not the highest in the city. Ward 6 had the highest percentage of pre-diabetics at 9.1 percent, followed by Ward 5 at 9.0 percent. Wards 7 and 8 stood at 7.0 and 7.5 percent respectively.

When It Isn’t Food That Drives Your Blood Sugar Levels Up
We know that what you eat is the primary factor that influences glucose levels. However, food is not the only culprit. Social determinants of health are being studied more closely these days and with good reason.

Social and economic factors can markedly influence glycemic levels. When a person is experiencing stress from trauma, homelessness or in their personal life it can affect their decision-making in the area of self-care. Environmental or neighborhood factors can also deter a person from prioritizing their health. Simply stated: If you’re suffering from a tremendous amount of stress you may eat more or make poor food choices. If you don’t feel safe enough to walk outdoors, exercise may be the last thing on your list. These factors can lead to higher glucose levels and put a person at risk for uncontrolled diabetes.

Another often-ignored influence on blood sugar is sleep deprivation. Studies have repeatedly demonstrated that not getting enough sleep can contribute to higher hemoglobin A1C levels. Sleep disturbances such as restless leg syndrome, periodic limb movements, peripheral neuropathy or sleep apnea put a person at a higher risk for developing obesity. Obesity is linked with higher risk for developing diabetes.

Making a 180-Degree Turn
Although the numbers and statistics look grim, there is room to turn it all around. Diabetes is a reversible condition. DC Health (formerly known as the Department of Health) created the website DiabetesFreeDC.com to help give diabetics and prediabetics the tools they need to manage their condition. In collaboration with healthcare professionals, community health partners and diabetes experts, Diabetes Free DC offers navigation tools for patients and providers alike.

Chronic disease management and prevention has been a focus at DC Health. Shalewa Noel-Thomas, bureau chief for cancer and chronic disease prevention at DC Health, explains how the department is stepping up its efforts to get people on the path to wellness. “We are not focused on solely treating diabetes and chronic diseases but we’re focused on preventing chronic diseases and promoting wellness that people can better manage, including diabetes.”

Noel-Thomas adds that DC Health keeps the social determinants of health in mind as well when addressing diabetes. “We are working with providers and community-based partners and others to ensure that we increase awareness of the importance of the social determinants of health. When we talk about social determinants we are talking about issues such as employment, housing and education that really affect people’s environment.”

Individualized help is even more important. Robin Diggs Outlaw, division chief for chronic disease at DC Health and chronic disease director points out that environmental changes are critical for success. “The environment that residents live and work in really has to support healthy lifestyles. A lot of our work is not just focused on clinical management of diabetes but also environment changes that we can implement and how can we improve access to healthy foods, how we can ensure that there are adequate sidewalks and safe places for people to engage in physical activity.”

Amerihealth Offers Healthy Interventions
Are you an AmeriHealth Caritas DC member? AmeriHealth has developed a more personable, community approach to addressing diabetes. In addition to a free Weight Watchers program and gym memberships, it offers metabolic-syndrome wellness circles for people who suffer from diabetes, hypertension or high cholesterol. Keith Maccannon, director of marketing, community relations and outreach at AmeriHealth Caritas District of Columbia, explains how the circle works. “We have wellness circles with a community group called Shire. People who are living with one or more of these [chronic] conditions meet every other week for 12 weeks to learn about label reading, how to cook healthy, how to shop healthy, learn more about their condition. Most importantly they get to share with each other the strategies they use to get better. What makes the program so successful is that alumni come back as peer educators and they act as coaches.”

People suffering from uncontrolled diabetes need a more intense approach. AmeriHealth provides extra assistance in order to reduce their A1C levels. “If someone is identified as uncontrolled diabetic with an HbA1C of greater than 9, we actually put them on a food-as-medicine program. We send diabetic-friendly prepared meals to their doorstep each week. They can get 21 meals for three meals a day or 14 meals. And we typically put them on that program for 90 days to replace the meals they would normally eat. We wrap that with nutrition counseling with one of our certified nutritionists to help them understand how to prepare meals. No charge to the members.”

Personalized services like this train people to be more aware of what they eat and become more independent.

Other healthcare organizations such as Trusted Health Plan, United Medical Center and Unity Health offer similar diabetes management programs.
If you suffer from diabetes, there are resources for you. Be relentless in your pursuit of information, follow up with your healthcare provider often and, most of all, never give up.


Candace Y.A. Montague is the health reporter for Capital Community News. Follow her on Twitter @urbanbushwoman9.

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