The Health Care Collaborative (HCC) of Rural Missouri is taking a novel approach to diabetes management by integrating behavioral health therapy to assist diabetics in making lasting lifestyle changes. In a recent HCC podcast, John Bradley, patient care coordinator and R.N., shared comprehensive information about diabetes, the physical effects of the disease, and the importance of routine and preventative measures. His work in diabetes management at HCC is integral as this disease continues to adversely affect millions of Americans, including many individuals in the Lafayette County area.

Diabetes in America

Currently over 34 million Americans, one in every ten people, are living with diabetes. According to the American Diabetes Association, over 10% of Americans have diabetes with 1.5 million new diagnoses each year. Among these cases, 187,000 are children. There are an additional 88 million American adults, one in three people, living with prediabetes, a precursor to type 2 diabetes.

Sedentary lifestyle, obesity, and family history are among the instigators of diabetes. Making healthy lifestyle choices such as getting 30 minutes of physical activity per week and eating well-balanced meals can decrease chances of developing or worsening diabetes. Understanding diabetes, its risk factors, and its symptoms is pertinent to recognizing and managing the disease. However, 7.3 million Americans have undiagnosed diabetes which can lead to severe health conditions in addition to complications from the disease.

HCC’s Approach to Diabetes Management

Diabetes is not always recognized right away as negative symptoms sometimes appear gradually. HCC understands the importance of making small, lasting lifestyle changes to prevent diabetes, especially for those at higher risk. HCC’s Diabetes Prevention Program (DPP) integrates behavioral therapists to help individuals understand and control unhealthy habits. Bradley leads the program as well as attends for his own benefit after determining his risk factor for diabetes. “It begins with trying to figure out what the barriers are in order to make the necessary changes for optimal health,” Bradley said.

DPP provides diabetes management and support with the understanding that each person will have different needs on their journey to a healthier lifestyle. In place of prescribing a pill on the onset of treatment, HCC aids prediabetic clients with proper behavior modification and educates them on proper nutrition in a peer group setting where they receive feedback and communal support from individuals on the same journey.

The program lasts one year with weekly peer support groups, nutrition education, cooking demonstrations, and weight check-ins. DPP allows participants to be accountable for their progress in a supportive environment. The peer group setting allows for patients to discuss their experiences navigating diabetes as well as offer advice and support. Education about the disease from clinicians and peers helps eliminate fears and hesitancy surrounding treatment caused by misinformation.

What is the Difference Between Type 1 and Type 2 Diabetes?

While there are several types of diabetes, type 1 and type 2 are the most prominent. Type 1 diabetes causes the pancreas to produce little to none of its own insulin. This condition often presents in young children and there is no cure. Type 1 diabetes requires insulin therapy and proper diet and exercise to maintain healthy blood sugar levels.

Type 2 diabetes happens over time as the result of the body not producing enough insulin. When the body is not making a healthy amount of insulin, cells in the body become insulin resistant and the pancreas makes more insulin, resulting in high blood sugar levels. While there are exceptions, more than 90% of type 2 diabetes occurs in overweight and obese people.

“With type 2, if you let it go, even if you are on medication and you don’t take care of yourself, you will become type 1. You’ll be on insulin for the rest of your life,” Bradley said.

Diabetes can also lead to heart disease, stroke, amputations, vision loss, weight loss, and kidney failure. Regular check-ups are necessary to maintain healthy glucose levels or to combat high glucose levels before it turns into a diabetes diagnosis.

 What is Glucose?

The body uses sugar as glucose. “Glucose is like the gas,” Bradley said. “It’s the fuel that runs our bodies. Every organ uses glucose to run, our bodies won’t run properly without that.” According to Bradley, insulin is a hormone released by the pancreas that helps take the glucose that’s circulating in the bloodstream and pushes it into cells where it is utilized.

High glucose levels have a direct effect on the circulatory system. “High sugars in your blood over time thickens those arteries and veins and even narrows them,” Bradley said. High blood sugar inhibits proper blood flow through the heart and around the body.

“That narrowing of the arteries … think about it like a tree without leaves,” he said. “You’ve got your trunk and it goes off into smaller branches, and the smallest branches are the ones that produce the leaves. If you have a narrowing or a clogging of those small arteries, those leaves will never grow. They die off. That’s the same thing that happens in your body. It just doesn’t get the blood flow. It doesn’t get the oxygen, and it doesn’t get the nutrients.”

This clogging or block can lead to heart attacks, stroke, kidney failure, teeth and gum issues, and blindness. It leads to less oxygen in your blood, fewer nutrients in your system and the decreased immune system function.

What is Hypoglycemia vs. Hyperglycemia and Prediabetes?

Hypoglycemia is a condition where blood sugar levels are lower than normal. Low blood sugar can cause blurred vision, confusion, shakiness, anxiety, fatigue, headache, and irritability. Hypoglycemia can be treated with foods that can metabolize quickly as glucose in the body.

Hyperglycemia is the lack of insulin in the body because of high blood sugar and is a characteristic of diabetes. Having a high blood sugar level and being insulin resistant can lead to diabetes.

What is Prediabetes and How Do I Know If I’m Prediabetic?

Prediabetes is a condition where there is a high blood sugar level in the system but not high enough for a diabetes diagnosis. It can cause blurry vision, dry mouth, thirst, increased urination, itchy skin, increased urinary tract infections, and slow-healing wounds. Prediabetes requires a blood test for a proper diagnosis.

“Even if you’re not diabetic, the first thing anybody needs to do is get a hemoglobin A1C test,” Bradley said. “It’s a simple blood test that shows you where your blood sugar levels are over a three-month period.” A healthy glucose reading for a non-diabetic person is an A1C percentage below 5.6. The pre-diabetic A1C range is between 5.7 and 6.4. A diabetic A1C range is a percentage of 6.5 and above.

Reach Out for Support

If you, or someone you know is interested in HCC’s diabetic prevention program, contact John Bradley at 660-251-3838 or visit HCC’s Live Well Community Health Centers also offer retinal scans that detect early damage to the eyes, as well as the 340B Drug Pricing Program that provides substantial cost savings on prescriptions for Live Well Community Health Center patients.