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If diabetes were a virus, it would qualify as a pandemic. Currently, 10.5 percent of the U.S. population—34.2 million Americans—have diabetes. An estimated 1.5 million Americans are diagnosed with diabetes every year. What’s more, roughly 88 million Americans age 18 and older have prediabetes. That makes up 34.5 percent of the adult U.S. population, according to the Centers for Disease Control and Prevention.
“Diabetes is a complicated disease process that can impact each patient’s circulatory, nervous, and immune systems differently,” explains Hon Hanh Nguyen, DO, VHC Physician Group-Primary Care Arlington. “That is why diabetes education is key to helping patients understand and manage their disease. “For my diabetes and prediabetes patients, I have a good, honest conversation about the disease process and their lifestyle. Is the patient a working parent? Does their job require a lot of travel? Has the patient struggled with weight their whole life? This helps me make recommendations for changes in their lifestyle and develop the most effective course of treatment.”
“Referring patients to VHC’s diabetes nutrition and education program is a good way to jumpstart a new chapter in their lives,” says Dr. Nguyen. “Patients learn what foods are healthy, more nutritious, or are mostly empty calories. The result is, they come back to me with a better understanding of diabetes and how to tailor their own lifestyle to treat their disease.”
Getting a handle on diabetes before it starts
When tests showed that Jerry Hurwitz’s blood sugar was only a tenth of a point away from being classified as diabetes, his physician recommended that he attend VHC’s Diabetes Prevention Program (DPP).
“Most DPP participants have prediabetes, meaning their blood sugar is elevated but not yet at diabetic levels,” says Lisa Muras, registered dietitian and certified diabetes educator. “Starting at age 45, the risk of being diagnosed with diabetes increases. Insulin resistance begins to increase because the body doesn’t process glucose or sugar as effectively.” Other risk factors include extra weight, a sedentary lifestyle, and a family history of the disease.
Hurwitz, 71, started with weekly live classes and then moved to virtual ones. Both formats included weigh-ins, which, Hurwitz said, was an incentive to stay on track. “That gave me discipline,” he says. “Every week we covered different topics—psychological aspects of managing weight, controlling sugar intake, how to shop at a grocery store.” He also learned he didn’t have to do strenuous exercise. “I just had to move for 150 minutes per week, which I could do by regularly walking in my neighborhood.”
Persuading people to break long-established habits can be tough. “One way we motivate people is to focus on small, realistic changes,” Muras says. “Peer support is really key—having other people in the same situation as you provide useful tips.”
Hurwitz learned that his biggest problem was eating too many carbs and high-fat foods like ice cream. “When I cut back on those foods, the weight started falling off. Portion control is a big factor too,” he says. Hurwitz has lost 50 pounds, lowered his blood pressure, and brought his blood sugar to within the normal range. “It’s made a big difference,” he says. “I have more energy.”
Learning to self-manage diabetes
“I had been diabetic for years. I would try different diets and be enthusiastic for a while, but then I would go astray,” recalls Richard Cambridge. “I knew I was not living a lifestyle of moderation, but I did not realize what diabetes was doing to my body.”
“When Dr. Nguyen became my physician, she was very direct,” Cambridge says. “My numbers had shot up and she knew I needed to go one step further and recommended seeing a dietitian.”
Initially, Cambridge had an individual consultation with Lisa Muras, RD, CDE, VHC Outpatient Diabetes and Nutrition Program. “She was very encouraging and professional, and explained that taking a four-week diabetes class could help me self-manage my disease better, not only in terms of what to eat and the role of exercise, but being vigilant about checking my vision and feet,” says Cambridge.
Lisa also suggested Cambridge wear a continuous glucose monitor to check his blood sugar levels, instead of having to prick his finger several times a day. “The monitor makes it easy for me to see how what I eat affects my blood sugar. If I go to lunch and eat dessert, I will see a spike in glucose levels. After wearing the monitor for a few months, I have a record of how my blood sugar works. As a result, I know what foods I should eat.”
Cambridge found the diabetes class interesting and valued the group interaction with people who were at different stages of the disease. Today, he’s eating healthier, has lost weight, walks two hours a day—and has lowered his A1c significantly. “I attribute my success to the people who taught the class. I can’t cure my diabetes, but I can learn to live with it. I can ameliorate and stop those negative effects.”
You don’t have to face diabetes alone
VHC’s diabetes education programs can give you information you can use and provide practical solutions for managing your diabetes.
Taught by certified Lifestyle Coaches, DPP is a yearlong program based on recommendations from the Centers for Disease Control and is covered by Medicare. “The longevity of the program, which meets weekly for the first four months and then less frequently over the course of a year, helps motivate people who are slow to make changes,” says Muras. “They have the support of our lifestyle coaches and their peers.”
In addition to DPP, VHC’s Outpatient Diabetes and Nutrition Program offers individual counseling appointments, a four-week group class for diabetes management, a support group for those with Type 1 diabetes, and one-on-one counseling for women with gestational diabetes during pregnancy.
For many patients with diabetes, the biggest roadblock is feeling overwhelmed at the initial diagnosis, in terms of the amount of information that is presented about the disease and the complex treatment regimen they will undergo.
“After my patients attend diabetes education programs, I see a difference in their confidence level,” says Dr. Nguyen. “They feel less overwhelmed, more confident and understand what they need to do with lifestyle changes. That’s a win!”
From prevention to diagnosis to treatment, Virginia Hospital Center provides comprehensive diabetes care. Click here to find a Virginia Hospital Center physician.