Preventing Diabetes and Heart Disease in Montana
By Shirley Schneiter
The incidence of diabetes in Montana, as well as in the rest of the country, continues to increase. The most recent data, from 2006, reports that 48,000 Montanans, 6.4% of the population, have diabetes. This is an increase from 2.8% in 1990. Approximately 176,000 Montanans between the ages of 18-64 years old have pre-diabetes.
Pre-diabetes is a condition in which a person’s blood glucose levels are higher than normal but not high enough to be classified as diabetes. Risk factors for pre-diabetes are similar to the risk factors for type 2 diabetes, which include being overweight and inactive, a family history of diabetes and a history of gestational diabetes.
In January of 2008, the Montana Department of Public Health and Human Services (DPHHS) funded four healthcare facilities in Montana to provide a prevention program for both type 2 diabetes and heart disease. These programs are using the successful model of the National Diabetes Prevention Program (DPP) that demonstrated a 58% reduction in the incidence of diabetes and improvement in cardiovascular risk factors such as elevated cholesterol and blood pressure. The Montana Cardiovascular Disease and Diabetes Prevention Program is currently available in eight sites across Montana, with the planned addition of four new sites in 2011. Community Medical Center in Missoula was chosen as one of the original four sites for the prevention program.
Eligibility for the program is based on specific risk factors for diabetes or heart disease, such as being overweight, pre-diabetes, high blood pressure or elevated cholesterol. Adults who meet the eligibility criteria, and are referred by their providers, may enroll in the program after meeting individually with a lifestyle coach.
The program consists of two phases. Initially the groups meet weekly for 16 weeks and then monthly for six months. The two major goals of the DPP, both nationally and in Montana, are to achieve a 7% weight loss and a minimum of 150 minutes per week of moderate intensity physical activity. During the weekly one-hour sessions participants learn about healthy eating, physical activity, problem-solving and coping skills. They also keep a daily food record including their intake of fat grams and physical activity minutes. The follow-up phase includes six monthly sessions focusing on maintaining weight loss and lifestyle changes.
Results of Montana’s own prevention programs have been similar to those seen in the National Diabetes Prevention Program. The first 820 participants to complete the initial 16 weeks of the program lost an average of 15 pounds. Forty-five percent of participants achieved the 7% weight loss and 66% achieved a minimum of 150 minutes a week of physical activity. This compares to 50% and 74% in the National DPP, respectively. Overall, participants also saw improvement in blood pressure, blood glucose levels and cholesterol numbers.
The lifestyle changes required to achieve these results are often small and quite achievable for most people, and the rewards are numerous. Sometimes it might be as easy as starting the day with a healthy breakfast, to help control what is eaten later in the day, and scheduling physical activity into your day as you would schedule other important activities. Most importantly, these types of small lifestyle changes are less difficult to maintain over time than making drastic changes in your daily life.
Ask your provider if you are at risk for developing type 2 diabetes and heart disease. If so, now is the best time to take steps towards improving your health.
Shirley Schneiter, a Registered Dietitian and Certified Diabetes Educator, is the coordinator of the Diabetes and Heart Disease Prevention Program at Community Medical Center.