Group medical visits key with managing diabetes

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Old Towne Medical Center – Health Services Center (file photo)

Healthier lifestyles, including regular exercise and better eating habits are all goals most diabetes patients are striving for.

Kendra Robinson, a certified diabetes educator at Old Towne, believes these goals, plus learning from each other in a group setting is essential in managing the disease.

At Old Towne Medical Center, group medical visits are an option for patients with Type 2 diabetes — a program that has been successful for the past eight years.

Robinson follows 400 diabetes patients, and said those who do group visits—which include four to five patients—have better outcomes than those who are seen individually by doctors.

“These patients tend to follow through more than patients we are seeing one on one,” Robinson said.

During group visits, doctors and nurses give patients information about medications and nutrition, but the patients learn how to manage the disease from each other, Robinson added.

“Ultimately, diabetes is a disease that is self-managed,” Robinson said. “Lifestyle modification is the number one treatment.”

Type 2 diabetes, distinct from type 1 diabetes—which is caused by genetic mutations or viruses—often develops from lifestyle factors, namely obesity.

March 28th marked the American Diabetes Association (ADA)’s nation-wide Alert Day, in which it invites all Americans to take a diabetes risk test on its web site: http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/?loc=alertday

According to the ADA, the biggest risk factor for diabetes is becoming overweight by overeating.

PantherMedia 906049
PantherMedia 906049

Not surprisingly, dietary changes are the biggest obstacle diabetics need to overcome, Robinson added. “Access to healthy food is a challenge. Changing age-old eating habits is very difficult.”

With that in mind, Old Towne also offers cooking classes and grocery store tours for diabetes patients.

During the classes, they make healthy meals, and then send everyone home with a bag of groceries and healthy recipes. They also go to the grocery stores where patients are most likely to shop.

“We teach them how to get the most bang for buck; read a food label; use a coupon,” Robinson said.

“It’s a big hit because at the end of the tour, everyone gets a little gift card to buy some things they learned about on the tour that they never tried before.”

This spring Old Towne plans to launch an “eat out” program, which will target older men who are either widowed or single and tend to eat out a lot.

The idea is to go to the restaurants where they regularly eat and help them select healthy food items.

Old Towne also has a medications assistance program that provides diabetes medications for free, Robinson said, and the Sentara Williamsburg Regional Medical Center provides discounted rates for diabetes-related testing.

This financial help is significant because diabetes can be an expensive disease to manage.  At Old Towne 76 percent of patients are uninsured—a number that is rising, according to Janis C.L. MacQueston, Old Towne Director of Development.

The patient population also tends to be fairly transient. Of the 400 diabetes patients that Robinson follows, between 250 and 300 come regularly, meaning every three to six months.

“For those who stick around for a while, control is pretty good,” Robinson said.

But the attrition rate is high, and they constantly get new patients—especially young adults who were obese in childhood and carried that into adulthood, she continued.

According to the Virginia Atlas of Community Health, six percent of the population over age 19 in Williamsburg has type 2 diabetes, and 10 percent are in James City County.

Many patients test for diabetes—at one of Old Towne’s free walk-in clinics—when they already have tell-tale signs of the disease, like blurry vision or frequent sweating, Robinson said.

“We check their blood sugar, and it’s off the charts,” she added.

Another program in Williamsburg at the Peninsula YMCA called the Diabetes Prevention Program tries to help people before they even get to that point.  It enrolls people with prediabetes, which can morph into diabetes, usually within five years, if left untreated.

The program is nationwide, has been implemented in 252 YMCAs throughout the U.S., and follows CDC guidelines, said Michael Bennett, the regional director of operations and chronic diseases at the Peninsula YMCA.

Bennett said they’ve enrolled 32 people locally.

“So far we’ve had really good stories,” he said. “The facilitator gives them tools, and the participants help each other out. They become a support system for each other.”

The goal is for people to lose five to seven percent of their body weight, and engage in 150 minutes of physical activity each week.

Michael Maguire, age 71, did the same prevention program at the Victory Family YMCA in Yorktown. He was pre-diabetic before doing the course.

“Unfortunately, I inherited the family susceptibility to diabetes, and I was headed to full-fledged type 2 [diabetes],” Maguire said.

He weighed a little over 200 pounds at the beginning of the course, which he started in December, 2015. A year later, he was down to 182—and his A1C was below the pre-diabetic range.

Achieving these numbers has meant eating fewer sweets and carbs. Once he found himself in the middle of a heavy meal, actually opting for a salad instead.

“For most people, it took forty to fifty years to develop the lifestyle of diabetes. You can’t undo that in forty or fifty days, but you can in forty to fifty weeks,” he said, adding that the program is slow-paced and very supportive.

The Williamsburg Health Foundation gave the YMCA a $45,000 grant to sign up 75 new people by the end of the year, Bennett said.

“We’re trying to encourage people to nip it in the bud,”  he said. 

For more information on the YMCA program, people can call 757-342-5338, or visit the YMCA web site: http://www.peninsulaymca.org/diabetes/.


Correction: This story has been updated to reflect the current statistics of the number of people living in Williamsburg and James City County with type 2 diabetes.