Lewes resident Sharon Downs knows she has been making excuses about losing weight for years. She told herself she would get healthy but then would go back to eating the wrong foods and skipping workouts.
When her doctor diagnosed Downs with prediabetes, she realized she had to stop the excuses and seek real help. She found a program through the Rehoboth YMCA, one of only 17 sites nationwide participating in a nationwide pilot program to reduce prediabetes and prevent diabetes.
An estimated 79 million Americans have prediabetes, a condition in which blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes. Prediabetes raises a person's risk of type 2 diabetes, heart disease and stroke.
The high rate of diabetes nationwide has drawn the attention of the YMCA. By connecting residents with prediabetes to coaches, fitness trainers and support, national YMCA officials hope to prevent or delay the onset of diabetes anong participants. Using a grant from the Centers for Medicare and Medicaid Services, the national YMCA organization selected centers nationwide, including Delaware's YMCA; Rehoboth rolled out the program last summer.
For Downs, the program has made the difference.
Downs was part of the first group to go through the Rehoboth program. A small class of 12 people allowed the 58-year-old to feel like a part of a community.
“It's a discussion, not lectures,” Downs said. “It really is support. It creates a bond in the group while the coach helps guide us to the next level.”
Downs, a member of the YMCA, was going to the gym when she found out about the group by visiting an information table in the lobby.
She started meeting weekly with her group, working on her exercise routine and changing her food choices. Over the course of the first 16 weeks of intensive lifestyle changes, she met her goal. She lost 7 percent of her body weight –14 pounds.
“I'm the kind of person who needed the support to get me through it,” Downs said. “I have a 13-year-old and need to stay as well as possible.”
It was her daughter, her concern for her own health and the rising cost of healthcare that drove Downs to commit to the diabetes prevention program.
According to the Centers for Disease Control and Prevention, 26 million Americans are living with diabetes, but 7 million Americans do not know they have diabetes. Diabetes costs $174 billion annually.
The best part of Downs's experience came just last week when she met with her doctor to discuss her new blood work and test numbers.
“I just found out I am no longer in the range for diabetes,” Downs said with an excited smile. “I am now dedicated to being healthy. I'm in my third year at the Y, and it's changed my life.”
Food vs. medication
In a 2010 study, the CDC and National Institutes of Health wanted to see if medication or lifestyle changes had a larger effect on reversing prediabetes. The study found 58 percent of people in the lifestyle changes group were able to reverse prediabetes. This number increased to 71 percent for people over 65. By comparison, only 38 percent of those using medication reversed their numbers.
The study led to the formation of the CDC's National Diabetes Prevention Program. This year, the lifestyle classes will be expanded to all the Y locations in Delaware, as well as through many community organizations.
Stacy Fulton, a personal trainer and lifestyle coach, helps participants at the Rehoboth YMCA improve their food choices, increase physical activity and learn coping skills to maintain weight loss and healthy lifestyle changes.
“It's a personalized program so each person starts at a different level,” Fulton said. “We take people where they are and build a path forward.”
Fulton teaches the class about food and exercise by presenting information. Then group members exchange personal stories and figure out their own schedule for meals and workouts.
Two new classes will start in Rehoboth in March. The Tuesday class will begin at 6:30 p.m., March 5. The Wednesday class will begin at 10:30 a.m. March 13. Both classes are filling up quickly, so residents should contact the YMCA soon to sign up.
“The classes are really interactive,” Fulton said.
Participants weigh in each week, keep track of food and exercise using journals, and discover how stress and everyday life can trigger behaviors like overeating.
“This program is so valuable because I see people take control of something in their lives,” Fulton said.
For Downs, hearing from other group members helped her realize how long she had been making excuses for her weight and eating habits.
“It's a lifestyle change,” Downs said. “We put everything on the table so the coaches can help us get there.”
The hardest part for Downs was letting go of those excuses.
“I had to really take a good look in the mirror,” Downs said. “I had to realize the games we play with ourselves and own up to them.”
Now in the maintenance part of the program, Downs continues to exercise at the Rehoboth YMCA. She watches what she eats and says she has a better relationship with food.
“The whole time I was losing weight, I didn't feel deprived,” Downs said. “It really opened my eyes to a different way of looking at food and making healthier choices.”
Medicare will pay for program
Tricia Jefferson, director of healthy living for YMCA of Delaware, said the biggest change in the prevention program this year is that Medicare will now pay for the classes.
“If this program is successful, it could save millions in future healthcare costs and create an infrastructure for how community-based organizations deliver health services to the Medicare population with prediabetes,” Jefferson said. “Those who qualify through Medicare do not have to live in Delaware but they do have to participate in the YMCA of Delaware's program.”
In Rehoboth, Downs paid a lower rate because she was already a member of the YMCA. Residents do not have to be members to join a class, which are held weekly for 16 weeks, then meet monthly for the remainder of the year.
In some cases, insurance providers will pay for the classes because they are preventative actions. In other cases, financial assistance is offered through the YMCA.
For nonmembers the cost is $249, which can be broken down into four payments of $62.25 for the yearlong program. A free family membership is offered to nonmembers for up to four months, Jefferson said. For members the cost is $199 or four payments of $49.75.
“Part of our trial here is to see if the program can reduce the cost of diabetes care in the state,” Fulton said. “We can control our ability to prevent diabetes.”
For more information or to sign up for the program, call Tricia Jefferson of the YMCA of Delaware at 302-571- 6998 or email firstname.lastname@example.org.
Take the prediabetes test
• Are you a woman who gave birth to a baby weighing more than 9 pounds?
• Do you have a sister or brother with diabetes?
• Do you have a parent with diabetes?
• Are you overweight?
• Are you younger than 65 and get little to no exercise everyday?
• Are you between 45 and 64 years old?
If you mostly answered 'yes,' talk to a healthcare provider about prediabetes.
Making a change for your health
If you have prediabetes, making changes can prevent or delay type 2 diabetes:
• Lose 5 percent to 7 percent of your body weight, which would be 10 to 14 pounds for a 200-pound person
• Get at least 150 minutes each week of physical activity, such as brisk walking.
Hemoglobin A1c is now used as a diagnostic test for prediabetes. The test, also called glycated hemoglobin, measures levels of blood sugar over a period of 90 to 120 days, said Tina Trout, Beebe Medical Center's certified diabetes educator and coordinator of the hospital's diabetes management program.
Red blood cells travel through the body and collect glucose. This glucose can be measured using a simple test, now available at many physician's offices.
Trout said patients with prediabetes often carry extra weight across the belly, have a family member with diabetes and are not physically active. Women diagnosed with gestational diabetes during pregnancy are also at higher risk for prediabetes and diabetes, Trout said.
Beebe hosts free blood glucose screenings every Wednesday from 1 to 3 p.m. The screenings are held in Lab Express at the hospital, and at the Beebe Health Campuses on Route 24 in Rehoboth and in Milton. For more information on prediabetes and services available through Beebe, call 302-645-3300.
Diabetes is the seventh leading cause of death in the United States. People with diabetes are more likely to suffer from complications such as heart attacks, strokes, high blood pressure, kidney failure, blindness and amputations of feet and legs.