Conway Woman's Example Part of Local Efforts to Improve Health

Maria Jarrow of Conway developed some unhealthy eating habits as she tried to cope with the loss of family members a few years ago. She became an emotional eater.
As her weight grew, she tried a number of diets with little success. “I could tell Oprah that I have done more diets than she has,” Maria said. “I knew what to do, but I was a yo-yo’r. I had developed an attitude that I was never going to lose weight.”
As Maria neared age 60, her family doctor told her she would soon have to take medication for her health.
She had an epiphany. “I decided I had to do something,” she said.
Maria joined a wellness support program for employees at Conway Regional and has begun to take back control of her life by following practical suggestions about shopping for healthy food without “going broke,” reading food labels for sugar and sodium content, following healthy recipes, meal planning and exercises that can be done while at work. The support program is led by a medical doctor, dietitians and nurses in the Conway Regional Diabetes Self-Management program. “They gave me a lot of common sense advice that I could follow,” she said. “The meal preparation was a huge thing because it helps me avoid temptation.”
Now Maria can be seen reading food labels in the grocery store and using her phone to check ingredients, doing exercises in the file room of the Mammography area where she works, and getting improved checkups at her doctor’s office.
Unfortunately, all efforts to improve health are not as successful as Maria’s.
In fact many people don’t know they are in trouble at all. The Centers for Disease Control and Prevention (CDC) project that more than one in three people in the United States have prediabetes, about 86 million people. Nine out of ten of those people do not know they have it.
The CDC offers a survey that measures risk level for prediabetes based on answers to questions about gender, age, a combination of weight and height, family history, blood pressure, gestational diabetes and activity level. It can be found at www.cdc.gov/diabetes/prevention/pdf/prediabetestest.pdf
A diagnosis of prediabetes means that your blood sugar level is higher than normal but not yet high enough to be diagnosed as type 2 diabetes. In the past, physicians have called it border line diabetes.
A family doctor can determine if a patient has prediabetes by conducting a fasting plasma glucose test, an oral glucose tolerance test and/or a Hemoglobin A1C test. The most definitive test is the A1C test which shows average blood sugar levels for the past three months. Results are:
Normal: 5.6% or less
Prediabetes: 5.7 to 6.4%
Diabetes: 6.5% or above

“A wellness lifestyle is the key to a long, happy life and it is up to each individual, not modern medical technology. Eighty percent of all chronic diseases are caused by lifestyle choices which include the quality and quantity of food, lack of physical activity and use of tobacco,” said William Furlow, MD, medical advisor to the Conway Regional Diabetes Self-Management Program.
Without positive lifestyle changes, people with prediabetes are very likely to progress to type 2 diabetes. For people with prediabetes, the long-term damage of diabetes — especially to the heart, blood vessels and kidneys — may already be starting, according to the Mayo Clinic.
“The earliest intervention provides the greatest opportunity to stop the diabetes process. Most people do not know that the average person with pre-diabetes may have already lost 40 percent of the function of their pancreas,” said Rhonda Tosh, a certified diabetes educator and lifestyle coach who coordinates the Conway Regional Diabetes Self-Management program. The pancreas is the gland that makes insulin.

Medicare Changes
In January of 2018 Medicare will begin covering prediabetes treatment provided by CDC recognized diabetes prevention programs as the nation rushes to slow the increase in diabetes cases, Tosh says. Medicare is the insurance standard bearer so other insurers are likely to follow.
“Thankfully, Medicare is recognizing that prevention of diabetes is going to be a better plan for our country than treating patients once they have already been diagnosed,” said Greg Kendrick, MD, Medical Director for the Conway Regional Diabetes Self-Management program.
He added, “Eating the typical American diet is a big risk factor for diabetes. The best tool we have is education of the population about healthy eating and exercise plans. If we can get people to understand how the choices they are making are affecting this disease state, we can prevent a large number of diabetes cases.”
In 2016 Conway Regional became the first diabetes management program to begin a two-year long certification process required by the CDC for official diabetes prevention program status.
The State Diabetes Advisory Council and the state Department of Chronic Disease have awarded the Conway Regional Diabetes Self-Management program the state’s Trendsetter Award for work to establish a diabetes prevention program. The Trendsetter award is the state’s award for chronic disease prevention and treatment.
Tosh credits the award to the work of a team of healthcare professionals at Conway Regional, including Janelle Williamson, a registered dietitian and certified diabetes educator; Brenda Turner, a registered nurse and certified diabetes educator; Ashley Cornett, a registered dietitian and diabetes educator; Kelly Batte, a registered dietitian and diabetes educator; and Drs. Furlow and Kendrick. “This recognition could not have been achieved without the diligent and inspirational care provided by our team,” said Tosh. “Conway Regional’s administration is highly supportive of addressing our community’s needs and is striving to improve the health our state.”
As part of the application, Tosh has been using data collected in part from a study of a patient group that is being treated for prediabetes. The ongoing data includes outcomes from the Conway Regional wellness program. Conway Regional’s certification, along with that of four other hospitals in Arkansas, is pending with the CDC. The two-year process is expected to be completed in January of 2018.
“The new part is the self-referral to the program,” said Tosh. “Currently insurance will only cover Type 1 and Type 1 diabetes, not prediabetes.”
The covered services will consist of education classes, structured meal planning, exercise, sleep hygiene, development of skills for coping with daily stress and other ongoing support programs similar to those that help Maria Jarrow.
She added, “The good news is that damage to the pancreas can be reversed. The goal of the diabetes prevention program is for participants to learn to eat healthier food and to be physically active 30 minutes each day. We have learned that if a person loses even 5 percent of their weight and becomes more physically active they decrease their risk of being diagnosed with diabetes by 58 percent.”