WHILE THE WORLD’S ATTENTION has been focused on the COVID-19 pandemic, the global diabetes epidemic has continued unabated and on an upward trajectory, paralleling the worldwide rise in obesity. In fact, according to the Centers for Disease Control and Prevention (CDC), in the United States alone, 34 million people currently have diabetes and 88 million have the condition known as prediabetes.
To appreciate how steeply the rate of diabetes has climbed in our nation over the decades, consider that in 1958, there were only 1.6 million diagnosed cases in total. Today, we add nearly that many new cases (1.5 million) every single year—and that rate is expected to double by the year 2030.
What’s more, the COVID pandemic seems to have made matters worse. Jeannie Wagner, MS, RDN, LD, CDCES, BD-ADM, Clinical Coordinator for Diabetes Education Services at Mercy Health – St. Vincent Medical Center, notes that there appears to have been an uptick in the rate of diabetes in our community since COVID arrived. “However,” she says, “we’re not sure whether this increase is due to people putting on some extra pounds and being more sedentary, which has been identified as a risk factor for diabetes in and of itself, or if people were putting off doctor visits so we weren’t able to catch as many cases of prediabetes before they progressed to diabetes.”
To help counteract the upward trend of diabetes in our community, Mercy Health Diabetes Education Services is working to empower patients with the knowledge, support, and resources they need to either prevent diabetes or successfully manage the disease and its complications if it has already developed. Most importantly, this comprehensive, evidence-based program, which is recognized and certified by the American Diabetes Association, puts the patient at the center of care and in control of their own decisions and goal setting.
Wagner explains that patients need a physician referral to take advantage of this programming. Once enrolled, they’re scheduled for an initial assessment to discuss their medical history, their lifestyle habits, the medications they’re taking, their family history, and any other information relevant to their diagnosis or risk factors. They can then set the goals they want to work toward and begin attending the classes offered, which are presented by two full-time nurses and a full-time dietitian who are Certified Diabetes Care and Education Specialists (CDCES). “We also have an outreach nurse we refer to who can visit patients who are at high risk of hospital readmission or have already been admitted frequently, to ensure they have the education and resources they need. In addition, we can reach out to pharmacists within our organization to help patients with medication management,” Wagner comments.
Because prediabetes—defined as a blood sugar level between 100 mg/dl and 125 mg/dl and a hemoglobin A1C (a three-month average blood sugar) between 5.7% and 6.4% (diabetes is diagnosed at a blood sugar level above 126 mg/dl and an A1C of 6.5%)—can be turned around and its progression toward diabetes halted, Wagner strongly emphasizes the importance of getting routine medical exams as well as being aware of one’s risk factors for developing diabetes.
“Knowing your family history can be especially helpful in assessing diabetes risk. With type 2 diabetes, there’s a direct link to family history, but it’s triggered by lifestyle and other factors. If you have a family history of diabetes, you’re overweight or obese, or if you’re sedentary, you should see your doctor for screening on an annual basis. Others at increased risk of diabetes include African Americans, Hispanics, Native Americans, Asians, people with fatty liver disease linked to obesity, and women who’ve had gestational diabetes, didn’t lose weight gained during pregnancy, or had a baby weighing nine pounds or greater,” says Wagner.
When it comes to diabetes, prevention is a far superior option to treatment after onset. If caught in the prediabetes phase, developing cases can usually be reversed through lifestyle changes such as adopting a healthy diet and getting regular activity. In fact, losing just five to seven percent of one’s body weight (10 to 14 pounds for someone who weighs 200 pounds) can be sufficient to prevent prediabetes from progressing to diabetes.
The picture becomes more complicated once actual diabetes develops. Cases caught very early on, when they’re mostly an issue of insulin resistance, can usually be controlled and put into remission through healthy eating and physical activity. Cases diagnosed later often cannot be reversed, though they can usually be managed through careful blood sugar monitoring, medications or insulin, and a continued healthy lifestyle.
According to the CDC, common symptoms of diabetes include excessive thirst, frequent urination, unexplained weight loss, excessive hunger, blurry vision, numbness or tingling in the hands or feet, fatigue, very dry skin, sores that heal slowly, and having more infections than usual. However, it’s not uncommon for people with prediabetes or even early diabetes to experience no symptoms whatsoever. “We’ve seen patients with an A1C of 8% or 9% who have no symptoms whatsoever, and others who are right at 6.5% and have had symptoms. You can’t rely on symptoms to indicate you have elevated blood sugar. That’s why it’s so important to be attuned to your risk factors,” Wagner states.
We’re not yet at the point where diabetes can be cured, though, as mentioned above, if detected and managed early enough, it can go into a form of remission. Wagner prefers the term “remission” to “cure” because with type 2 diabetes lifestyle is always a factor. If healthy lifestyle habits are maintained, it may be possible to keep diabetes in remission. But if unhealthy habits creep back in resulting in weight gain, the diabetes will quickly return.
That’s where Mercy Health Diabetes Education Services comes in. The team works with patients to incorporate elements such as healthy eating, exercise, blood sugar monitoring, and medication use into their daily lives and helps them problem-solve when they encounter challenges in any of these areas.
“Our goal is not just to provide education but to empower our patients to manage their diabetes. We want our patients to know they are at the center of their care and we are their coaches and here to support and advocate for them. They should feel comfortable communicating with their physicians and other providers about the various treatment options available to them,” says Wagner.
The diabetes education program is located at Mercy Health – St. Vincent Medical Center, 2222 Cherry St., MOB2, Suite M 900. 419-251-4505. Education sessions are provided both in person and virtually. When group sessions are available, the staff has outreach sites at Mercy Health – St. Anne Hospital and Mercy Health – Perrysburg Hospital.
