Prevention is key to remaining outside the South’s ‘Diabetes Belt’

“Cheap, fast food is just way too plentiful. We’ve kind of lost a connection with trying to eat well. We’ve lost what is a normal amount of food to eat."

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New Hanover, Pender and Brusnwick counties may not be considered to be within the CDC's so-called 'diabetes belt,' but the number of people with the disease is still high.
New Hanover, Pender and Brusnwick counties may not be considered to be within the CDC’s so-called ‘diabetes belt,’ but the number of people with the disease is still high.

Donna Livingston has a sweet tooth. Cookies, soft drinks, sweet tea. She likes her sugar.

Livingston, age 59, had never thought about the consequences of her cravings until she retired in 2011 from her career as a high school math teacher at New Hanover High School in Wilmington.

Over the next few years, she noted a rise in her health insurance premiums. To bring them back down, her health insurance company said that she would need to have a health assessment—which included an A1C reading, the average of three months of blood sugar levels.

 Her A1C was 5.6, which is borderline normal. A blood sugar of 5.7 is considered pre-diabetes, and 6.5 is diabetes. But Livingston was overweight—160 pounds on her 5’4” frame. She had other worrisome health measures. So, the state lumped her in the pre-diabetic category.

“It kind of scared me that I was at risk for diabetes,” Livingston said, recalling that her maternal grandfather had the disease, but neither of her parents had it.

What Livingston learned about diabetes, she didn’t like.

“It can affect a lot of organs. You can get amputations because of it,” she said. “You can be on meds for the rest of your life.”

Livingston didn’t want to go down that path, so she consulted a nutritionist, and later saw an ad in the paper for a diabetes prevention course at the YMCA, and signed up.

 Focusing on Prevention

The YMCA course is part of a nation-wide CDC effort to curb the diabetes epidemic in the U.S. According to the American Diabetes Association, in 2012 nearly 10 percent of the population had diabetes, or 29.1 million people. Another 86 million Americans had pre-diabetes—an increase of 79 percent from 2010.

March was national diabetes awareness month, and last Tuesday was diabetes alert day, in which the ADA invites all potentially at-risk Americans to take its online assessment, which can be taken at any time: http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/?loc=alertday

 The CDC diabetes prevention program, which is active at YMCAs in 47 states, has enrolled more than 50,000 people. At the Wilmington YMCA, over 130 people enrolled in the first year-long program, which started in October, 2015.

“Our goal is really to help people get in front of (diabetes),” said Marjorie Lanier, the diabetes prevention program coordinator at the Wilmington YMCA. “(The program has) been replicated over and over again. There is a lot of evidence that people enrolled in program can cut their risk in half.”

The course is group-based, with no more than 15 people in any one group. They meet weekly for classes, and are also required to do 150 minutes of exercise per week.

“The power in that is that the groups are all in the same boat, working toward similar goals,” Lanier said. “That peer support is really powerful.”

The next courses begin in May, and more information is at the YMCA website: https://www.wilmingtonfamilyymca.org/programs/diabetes-prevention-program/

Livingston, who finished the program in February, agreed that sharing ideas with her classmates was one of the most useful parts of the program. Most importantly, she learned how to control portions and make better food choices, like cutting out fried food and limiting pasta.

“I’ve never been a diet person, but this is a program that you can live with. You’re eating regular food,” Livingston said.

She eats more salads, fruit and veggies, and if she has a sweet—like cherry dump cake (one of her favorites)—she’ll just have one piece, and then share it at church.

Eating like this, Livingston has stuck to a 1,200-calorie diet, and she ended up losing about 45 pounds, at one point weighing just 116 pounds. That far exceeded the program’s own five-to-seven percent weight loss goal for participants.

Livingston felt too thin, so she added nuts and some other healthy fats to her diet, and is now back up to her ideal weight of 125-130 pounds.

Local Diabetes Map

Many counties in the South comprise what the CDC considers the “diabetes belt.” Although New Hanover is not among the 29 North Carolina counties in that category—nor are Pender and Brunswick—the rate of diabetes in this area is significant.

According to the North Carolina Public Health Department, 12.1 percent of the population in Pender County is diabetic, 11 percent in Brunswick, and 8.4 percent in New Hanover County.

In nearby Columbus County, which is considered part of the diabetes belt, 16 percent of the population has diabetes.

Susan Mintz, a registered nurse and certified nurse educator at the New Hanover County Health Department, blames the incidence of diabetes primarily on a culture of poor food choices.

“Cheap, fast food is just way too plentiful. We’ve kind of lost a connection with trying to eat well. We’ve lost what is a normal amount of food to eat,” Mintz said. “We’re just not exercising. We’re spending too much time on computers. The population’s getting older.”

Mintz runs a call line out of the health department for newly diagnosed diabetes patients (910-798-6775), as well as a support group for people with diabetes and pre-diabetes, as well as their caretakers.

“Still in the South, it’s the female that cooks,” Mintz said. “We’re all brought up in a certain culture, eating certain foods.”

Weaning people from their beloved sweet tea and fried chicken can be tough, she added.

“As long as we can keep the education going, I think that can help. It’s one of those things where you can’t quit.”

The support group meets on the first Friday of every month from 10 a.m.-11 a.m. at the New Hanover County Senior Center on Shipyard Boulevard.