During his initial briefing, a YMCA staff member told Mason about the Diabetes Prevention Program — a yearlong educational course that aims to help adults who have been diagnosed with prediabetes or are at risk for Type 2 diabetes make lifestyle changes that can help them avoid or delay onset of the disease.
“I said, ‘I would like to join that,’” says Mason, a 62-year-old retired government contractor. “I joined it, and it’s working well for me. I keep my [blood glucose] numbers under control and keep my diet and weight under control. It’s working.”
The Diabetes Prevention Program is an initiative of the Centers for Disease Control and Prevention, which reports that 1 in 3 American adults have prediabetes and most — about 90 percent — don’t even know it. Prediabetes, as explained by the CDC, is when the blood glucose (sugar) level is higher than normal, but not high enough to be diagnosed as diabetes.
Prediabetes: Am I at risk?
You may be at risk for Type 2 diabetes if you
• Are 45 years of age or older.
• Are overweight.
• Have a family history of Type 2 diabetes.
• Have high blood pressure.
• Are physically active fewer than three times per week.
• Ever had diabetes while pregnant (gestational diabetes) or gave birth to a baby that weighed more than 9 pounds.
Having prediabetes puts people at higher risk for Type 2 diabetes, previously called adult-onset diabetes. The American Diabetes Association reports that 29 million Americans — more than 9 percent of the population — have diabetes, and that nearly all of them have Type 2 diabetes. Due to the well-documented childhood obesity epidemic, physicians are increasingly seeing Type 2 diabetes in children as well.
To localize these numbers, consider that 9 percent of the population of the city of Richmond is about 19,000 people; 9 percent of the greater Richmond area's population is about 113,400 people.
What is Type 2 diabetes?
Diabetes is a problem that causes blood glucose (sugar) levels to rise higher than normal, called hyperglycemia. Type 2 diabetes is the most common form. With Type 2 diabetes, the body does not use insulin properly, which is known as insulin resistance. At first, the pancreas makes extra insulin, but over time it isn't able to keep up and can't make enough insulin to keep blood glucose at normal levels.
Source: American Diabetes Association
YMCA of Greater Richmond, which operates 17 branches throughout the metropolitan area, has been offering the Diabetes Prevention Program since 2013. It’s one of more than 625 organizations across the country, including about 165 YMCAs, that are certified to offer the program.
“We know that diabetes and prediabetes are a huge factor for America and Virginia,” says Jana Smith, associate director of community health for YMCA of Greater Richmond. “In Virginia, 2.2 million adults have prediabetes, and 9 out of 10 don’t know it.
“It’s not something right now that is part of a common conversation with doctors in the regular annual checkup. We’re trying to raise awareness. If you determine you are at risk, number one, talk with your doctor to help manage your risk, and number 2, work with the Y to reduce your risk for the onset of Type 2 diabetes.”
YMCA of Greater Richmond offers the Diabetes Prevention Program at all of its locations. The course is open to adults, ages 18 and older. Classes start at various times throughout the year and are held during the day, in the evenings and on weekends, depending on need and interest. The Y also offers the course at community centers, churches and other locations.
“We offer them all the time,” Smith says. “It really depends on where the need is and when there’s a need. Once we identify enough people to start a class, we get on it."
The YMCA also is collaborating with local businesses and hospitals that might be interested in providing the program to their employees.
“Some employers are paying for it,” Smith says, referring the program’s $429 fee. “They recognize the need is so important. They want to make their workforce and community healthier and also see it reflected in their financials and health benefits that they’re providing. Some of the employers are paying the full cost for their employees to participate.
“We have relationships with most of the hospitals. Whether it’s a physician referring a patient to us or they’re paying for their employees, we’re working with the hospitals. We have a great partnership with the Virginia State Health Department, which is really helping us connect with the local health districts, particularly the Crater District — Petersburg, Emporia, Hopewell — and getting some programs going down there.”
Demographically, Smith says, most of the Richmond-area participants fall into the 40-and-over age bracket. Because prediabetes and Type 2 diabetes are “more prevalent in the African-American community, we do see some of that trend in our classes as well.”
Reaching older adults is also a priority. Smith has been working with the Better Housing Coalition, Senior Connections and other organizations to identify older adults who could benefit from the program.
“Once someone turns 65, they’re at greater risk for Type 2 diabetes, so we’re making a concentrated effort to reduce that risk,” she says.
The primary goals of the Diabetes Prevention Program are for participants to lose weight and get more active, actions that have been shown to decrease the risk of developing Type 2 diabetes. According to the YMCA’s fact sheet, the specific goals are reducing body weight by 7 percent and increasing physical activity to 150 minutes per week.
The one-hour, small-group classes meet every week for 16 weeks and then monthly for eight months. The course is taught by a certified lifestyle coach and the emphasis is on making healthy lifestyle changes. Participants track their progress by recording their meals and physical activity using food and exercise logs and being weighed at each meeting. Data gathered from participants are passed on to the YMCA's national headquarters and the CDC.
Classes typically number about eight students, but no more than 15, and participants can sign up in person at their local YMCA or online. Financial aid is available. Smith says YMCA of Greater Richmond uses a sliding scale and has a generous financial assistance policy for those who might not otherwise be able to attend.
“Sometimes we don’t even say it's $429,” she says, referring to the program fee. “Bring in your financial statement, and we’ll tell you what your program rate is.”
By participating, students can earn a YMCA membership, which can make getting 150 minutes of exercise per week a lot easier. For example, since joining the Y, Mason says he’s gone from exercising 30 minutes, five days a week, to more than an hour, five days a week. He’s also lost 15 pounds and has kept his blood sugar levels down.
“We want to provide the incentive for them and remove that barrier, because when winter comes we don’t want them to have that barrier,” Smith says. “It’s really pretty simple to earn a membership by just attending class and being engaged.”
Diabetes causes more deaths per year than breast cancer and AIDS combined.
Source: American Diabetes Association
Mason calls the classes “excellent” and says his instructors are “very supportive, always very concerned and there to give you a helping hand.”
“As far as the Y itself, it’s a very loving, family-type place where people get really concerned about you and your health. They really push for you to succeed, and I would encourage anyone that’s had a problem with prediabetes to do that program. There’s so much to gain and nothing to lose,” says Mason.
YMCA of Greater Richmond also offers the YMCA Diabetes Control Program. The program goals are similar to those in the Diabetes Prevention Program, but it’s aimed at those who have been diagnosed with Type 2 diabetes.
Prediabetes fast facts:
What is prediabetes?
Having prediabetes means the blood glucose (sugar) level is higher than normal, but not high enough to be diagnosed as diabetes. Nearly 90 percent of adults who have prediabetes don’t know they have it.
How many people have prediabetes?
In 2012, 86 million Americans age 20 and older had prediabetes, up from 79 million in 2010.
What’s the big deal?
Those with prediabetes who don’t lose weight or increase their physical activity could develop Type 2 diabetes within five years. Type 2 diabetes is a serious condition that can lead to health issues such as
• Heart attack.
• Kidney failure.
• Loss of toes, feet or legs.
How can I prevent Type 2 diabetes?
Having prediabetes does not mean a person will develop Type 2 diabetes. For some with prediabetes, early treatment can return blood glucose levels to the normal range. Research shows the risk for Type 2 diabetes can be lowered by 58 percent by
• Losing 7 percent of body weight (or 15 pounds for a 200-pound individual).
• Exercising moderately (such as brisk walking) 30 minutes a day, five days a week.
Losing even 10 to 15 pounds can make a huge difference.
More information on the Diabetes Prevention Program can be found at www.ymca.net/diabetes-prevention and www.ymcarichmond.org.