By Lisa Girard
About 26 million Americans live with diabetes, a condition caused by the body’s failure to produce or properly use insulin. This number has been on the rise in recent years because of poor eating habits, an increasing number of Americans with obesity and more frequent diagnosis. In fact, according to a report from the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, one out of three children born in the United States in year 2000 will go on to develop diabetes at some point in their lives.
For the thousands of Monmouth County residents living with diabetes, there’s help available through the Diabetes Management Center at Riverview Medical Center in Red Bank. The center, which has been granted national recognition from the American Diabetes Association, is based on high-quality diabetes self-management education given by trained medical professionals to all participants.
“Diabetes is on the rise because of our lifestyles,” says Cindy Andl, a registered nurse (RN) and certified diabetes educator (CDE) with the Diabetes Management Center, which was founded in 1991. “Many people eat fatty or processed food, are overweight and don’t get enough exercise, and those people are at higher risk for diabetes.”
To participate in the Diabetes Management Program, you must have a prescription from a doctor. The program treats those with three types of diabetes: type 1, which is also referred to as juvenile diabetes because it often, though not always, develops during childhood or adolescence (5 to 10 percent of cases); type 2, the most common form, which can sometimes have no noticeable symptoms; and gestational diabetes, which occurs exclusively in expectant mothers, usually during later pregnancy. Symptoms of diabetes can include the following: fatigue; increased thirst; increased urination; dry skin; recurring infections; nausea; vomiting; and feeling listless and lethargic.
There are an additional 41 million Americans with pre-diabetes, which occurs when blood glucose levels are elevated above normal but are not high enough for a diagnosis of type 2 diabetes. The Diabetes Management Program also treats pre-diabetic patients, providing meal planning and suggested exercise routines that can help prevent diabetes or, at the least, delay its onset. “The problem is, there might not be any signs until the numbers are in the 200-300 range,” Andl says. “We need people going to the doctor on an annual basis, and if you are pre-diabetic, you need to make a lifestyle change. We have to get people to be their own health advocates.”
During the first visit to the Diabetes Management Program, the staff will conduct a thorough one-on-one assessment to determine the person’s individual needs and where the education process should begin.
“We explain what’s going on in the body so the patient knows why they’re being asked to change their diet, why they have to take medication and why they need to be sure to visit the dentist and eye doctor regularly,”
“We explain what’s going on in the body so the patient knows why they’re being asked to change their diet, why they have to take medication and why they need to be sure to visit the dentist and eye doctor regularly,” Andl says. “We teach them how and when to test their blood sugar levels, how to help lower their blood sugar levels, when to notify the doctor if the levels are too high, when to exercise, etc.”
The participant also receives his or her own personal meal plan – created by one of the center’s registered dieticians or certified diabetes educators – to control blood sugar and promote general health. “We don’t like to tell them they can’t eat what they want to,” says Mary Higgins, MS, the center’s registered dietician (RD) and a CDE. “We come up with numbers they can target, but there’s no one-size-fits-all diet.”
Following that first meeting, participants are asked to track their blood glucose level using a log sheet, which can help determine trigger points for their condition. After a month of tracking, they return to the Riverview to go over the log and see if any adjustments need to be made to their diet/health plan, as well as to discuss such issues as “how to handle sick days” and “how to manage diabetes while traveling.”
A second followup visit is then scheduled to make sure there are no further complications and to help with stress management and problem solving. Participants are free to attend further classes, which are scheduled for both day and evenings, that will reinforce this educational process with more detailed information such as how to prevent complications, what to look for in food labels, what to order in a restaurant and more.
Diabetes Management Program classes also address the following:
- Diabetes disease process and treatment options
- Nutritional management
- Incorporating physical activity into your lifestyle
- Utilizing medications (if applicable)
- Monitoring blood glucose and pattern management
- Preventing, detecting and treating acute complications
- Risk reduction, detection, and treatment for chronic complications
- Goal setting and problem solving
- Integrating psychosocial adjustment (coping skills)
“When people first come in, they are often confused and perplexed and they’re afraid to put anything in their mouths,” Higgins says. “They come out of that first meeting saying, ‘This isn’t as bad as I thought it would be. I can do this.’ But they have to make that decision to come and see us.”
“What I say is, ‘Don’t stick your head in the sand.’ It’s better to know what’s going on; fear of the unknown is much worse,” adds Andl. “The more they can take care of their body and their health, the better off they’re going to be in the long run.”
To service Ocean County patients, the Diabetes Management Program is also available at Ocean County Medical Center in Brick. For more information on either program, call (732) 530-2555 or visit the web site http://www.riverviewmedicalcenter.com/RMC/services/DiabetesManagementCenter.cfm
