"Dining With Diabetes" Provides Improved Health Strategies

Diabetes robs sight, mobility, sensory feeling, health and life from hundreds of thousands of people. In fact, the disease has reached epidemic proportions, according to the Centers for Disease Control and Prevention. In Colorado alone, incidence of diabetes has risen more than 25 percent since 1990, and now affects 205,000 Coloradans.

Of middle-aged people, twice as many have diabetes as don't. The disease and its related complications is a top cause of death for Americans, with heart disease, the leading cause of diabetes-related deaths. People with diabetes are two to four times more at risk for a stroke.

Diabetes is the leading cause of new cases of blindness in adults, and the leading cause of end-stage renal disease. About 60-70 percent of people with diabetes have mild to severe forms of nervous system damage. However, the most striking thing about diabetes is that, unlike so many other debilitating illnesses, its impact on health often lies within the control of people with the disease--if they know how to adjust their lifestyle.

In Colorado, the northeastern corner of the state is among several areas with a high incidence of the disease, according to the Colorado Department of Public Health and Environment. As is typical of many rural areas, there aren't enough registered dietitians or diabetes educators to teach people with diabetes or their caretakers how to control the disease. This leaves people with a difficult choice--drive long distances for care, or try to educate themselves.

"Many effects of diabetes can be partially controlled through lifestyle," said Melissa Bardsley, Colorado State University Extension human nutrition specialist. "About half of the 205,000 people with the disease in Colorado don't know that they have it, so the first step is to raise awareness of the signs and symptoms of diabetes. The second step is to become educated about how to control blood sugar through diet, exercise and sometimes medication."

When a group of Extension agents in Colorado noted that they were getting more diabetes-related calls from the public, they and Bardsley established an educational partnership with the Colorado Diabetes Control Program, a branch of the Colorado Department of Public Health and Environment, which works with communities to lower the incidence of diabetes and reduce deaths caused by the disease. Extension presented an educational program, "Dining with Diabetes," a hands-on meal planning program designed to supplement information provided by registered dieticians and other professionals, not to replace education delivered by health professionals.

More than 100 residents in six counties four in eastern Colorado, two in the Front Range--attended a series of Dining with Diabetes classes taught by Extension agents and specialists. The program focused on increasing participant understanding of how nutrition, diet and exercise affect blood sugar levels. For example, participants learned what foods supply carbohydrates, how to use artificial sweetener when cooking and baking, and how to glean more information from food labels. Since people with diabetes also are more susceptible to heart attacks and strokes, the classes provided information about heart-healthy eating.

Loretta and Paul Smith, from Akron, decided to attend the classes when Paul's doctor told him he would have to go on insulin because his blood sugar levels were consistently high.

"Paul has had a big change in his tests since the classes," said Loretta. "His doctor was very pleased with the results of the class, too. With the information from the class [on how to control diet], we can work to keep his blood sugar level at an appropriate range."

The Smiths said that before the Dining with Diabetes classes, their only option was to drive 72 miles for diabetes education. "We wouldn't consider going that far out of town to a class, so I guess we would have tried to figure out ourselves what to do." With the classes, Loretta follows a meal plan to prepare food for both her and Paul that keeps blood sugar in line--more vegetables than meat and sugar. She uses lessons from the class, like mixing fruit with yogurt for dessert, which gives Paul a sweet treat that also provides calcium.

Barbara Larsen, Diabetes Control Program manager, said that Extension's involvement in rural diabetes education is an ideal fit with her program. Strapped by a lack of resources, Larsen and just one other person are charged with coordinating the Colorado Department of Public Health's diabetes education programs for patients and professionals.

"It's nice to have a partner who is already out there, connected with the community," said Larsen. "Without Extension to help bring science-based education to rural areas, many people with diabetes would be without information that allows them to control the disease and enjoy life with fewer complications."

--Dell Rae Moellenberg

For more information, contact your local Colorado State University Extension office.

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