November is American Diabetes Month and time to raise awareness about risk factors and concrete steps to help people live healthy with diabetes. More than 30 million people in the United States — that’s almost 10 percent of the population — are affected by diabetes according to the Center for Disease Control’s 2017 National Diabetes Statistics Report. Marcia G. Ory , PhD, MPH, co-director of the Center for Population Health and Aging at the Texas A&M School of Public Health laments that “there are millions of Americans with undiagnosed diabetes, or those who lack proper education about diabetes and how to manage it properly. More common among middle-aged and older adults, diabetes diagnoses among adults has also more than doubled in the last 20 years and is especially common in Texas and locally.” In the Brazos Valley, about 20 percent of adults reported they were told by their physicians that they had diabetes, according to the 2019 community health assessment conducted by the Texas A&M Center for Community Health Development.
While diabetes is a chronic health condition, type one and type two differ in how they process insulin. Type one is caused by genetic and autoimmune factors where the pancreas makes little to no insulin and treatment is insulin therapy for life. Type two is caused by an insulin resistance where the body’s cells don’t use insulin well.
“The majority of people who have diabetes, have type two diabetes. Type one diabetes is only found in approximately five percent of the people who have diabetes,” says Wendy Creighton, RN, BSN, with the Center for Population Health and Aging at the Texas A&M School of Public Health.
Risk factors for developing prediabetes and type two diabetes include (CDC, 2017):
- Being overweight
- Being 40 or older (however, those people developing it younger than 40 is growing)
- Having a family member with type II diabetes (parent or sibling)
- Being physically active less than three times a week
- Having ever had gestational diabetes
- Being a non-Caucasian population
Yet, despite these risk factors, type two diabetes can be reversed or delayed with management and lifestyle changes.
“Diabetes education is a lifelong process because diabetes is a lifelong disease; it causes changes to body systems over time,” Creighton says. “Diabetes self-care requires daily attention to nutrition, exercise, blood sugar monitoring, medication compliance, and stress reduction.”
If left untreated, chronic complications of diabetes can present themselves as periodontal disease, blindness, delayed wound healing, heart disease, nerve damage, poor circulation, and kidney disease.
In addition to regular monitoring by a physician, community education is important to inform people in the community about the disease and how to manage it.
“Due to time constraints, most clinicians are unable to adequately teach people during office visits,” Creighton says. “People need more in-depth knowledge about daily diabetes self-care behaviors to help decrease the complications that diabetes can have on the organ systems of the body.”
The diabetes self-management education and support program offered by the Texas A&M Center for Population Health and Aging — an American Diabetes Association-approved support program — provides knowledge and resources needed for diabetes maintenance.
In the course, participants cover topics including blood sugar monitoring, how food and exercise affect the body, managing diabetes when sick, nutrition, and stress management. Participants also receive a free glucometer and learn how to check their blood sugar.
Attendees who participate continue with follow-up visits over a course of a year where they focus on goal setting, lab testing, and developing strategies to help manage complications of diabetes.
“These programs are not content-driven; they’re process-driven. Problem-solving, goal-setting, action-planning — those are really the skills we try to teach so that participants can learn,” says Matthew Lee Smith, PhD, MPH, CHES, co-director of the Texas A&M Center for Population Health and Aging.
For more information about the diabetes self-management program and others that the Center for Population Health and Aging offers, visit www.cpha.tamhsc.edu/workshops. These will be useful tools as the holidays approach.
This commentary is brought to you by the Texas A&M Center for Population Health and Aging. CPHA strives to bring together stakeholders and partners from the community, clinical, and corporate sectors to address the needs of older adults. Working together, CPHA’s mission is to keep Texans “Active for Life®…Everyone! Every age! Every day!” For more information about CPHA, visit www.cpha.tamhsc.edu.
