Transcription:
Diabetes Prevention Program

Melanie Cole (Host): Welcome to Bryan Health podcast. I'm Melanie Cole, and I invite you to listen as we discuss the diabetes prevention program at Bryan Health. Joining me is Mary Luebbert. She's a certified diabetes care educator with Bryan Health.

Mary, I'm so glad to have you with us and what a great topic we're discussing today. As we're talking about diabetes and prediabetes, what does that mean to have prediabetes and who is at risk?

Mary Luebbert: Well, any age range is at risk for prediabetes. When we go to the doctor's office and have those labs checked, our weight checked, those are indicators for our health. And we try to categorize or get people before they're at risk for a disease process such as diabetes. And we've learned over the years by checking their A1c or their fasting glucose, and if they're creeping up beyond the normal ranges, such as fasting blood sugar of 100 to 125 or an A1c of anything from 5.7 to 6.4, they're at risk. So we want to help them.

Melanie Cole (Host): So, what does the research say from the CDC about diabetes prevention? As we're talking about prediabetes today, which in my opinion, Mary, as an exercise physiologist, I look at that as a warning sign, your body's warning you ahead of time about this insidious condition of diabetes that's really an epidemic in the country. They're warning you ahead of time so you can take steps. What does the CDC say about this?

Mary Luebbert: Well, the CDC always wants to make people aware and educate them and understand what's going on in their life, just like a teacher does in school. You have steps to make your life better. And so the CDC in 2002 started three phases of research and they found out that by giving them group support and educating them in food, exercise and stress management, that they could prevent or delay the onset of diabetes. And we've got really good at it by the time they had 10 years of data and we knew that even at Medicare age, we could make a lifetime change and prevent or delay diabetes.

Melanie Cole (Host): Very true. So now, tell us about your prevention program at Bryan Health. Who can participate, how long do classes last? Give us an overview of this program and you can include how long you've been really running this kind of a program.

Mary Luebbert: Well here at Bryan, the staff has been very passionate for seven years and we've had an accredited program, which means that with the CDC we've met the goals of getting our participants to lose 5% to 7% weight loss in one year and the class lasts a year because the research says that people are interested, want to make changes, but to keep it off is the hard part. And so that's why we do it a year. And we've been taking insurance and making sure that everybody's welcome as long as they're 18 years or older and are willing to make those commitments because it does take 22 classes in a year to make a difference for their health.

Melanie Cole (Host): And now tell us about the success. What have you seen and how do people like it?

Mary Luebbert: People love the class. In the beginning, they're a little bit intimidated because we make them work. We know any time you're working for your health, it's going to take some determination and hard work on their part. And we help them, we guide them, but we do not do the work for them. This is not a program where we give them food or make them work with us six or seven hours a day. We guide them and tell them how they can be successful on their own. But the group in itself, each group is support system for each other. And that's wonderful to see, community getting together and helping their neighbors and understanding, "I've been there," "You're struggling," and give them the words of encouragement from coworkers or friends in the group versus us professionals.

Melanie Cole (Host): What an important aspect of a group like that, is that support from your peers, from the people. It works that well in cardiac rehab as well, because you're in there with people who are going through the same thing, so they can really relate. But I'd like you to tell us about your multidisciplinary team. Who's all involved in a program like this, Mary?

Mary Luebbert: Well, the CDC wanted it to be streamlined for the clients. And so they actually certify people with this curriculum and they can be anybody coming off the street with this certification. But at Bryan, we took the time and had registered dieticians and exercise physiologists and nurses be part of the peer group for teaching it because we wanted them to stay focused on their health. And we know that diabetes and heart disease go hand in hand, and so sometimes we would give them tools of education to keep them motivated so that they didn't give up. And that's where we set ourselves apart from most clinics is because we do to have a higher attendance. We do have people losing more weight than 5% to 7%, but it's because we keep them motivated. And it's hard. A year long program takes a lot of dedication. Twenty-two sessions doesn't sound like a lot, but it is when you have to carve it out for yourself and make it a priority.

Melanie Cole (Host): Well, it is. You're right. It's challenging, but it's rewarding all at the same time, because you really are being your own best health advocate in that case. I'd like you to tell us a little bit about what the group classes focus on. You say, these are sessions, you talk about it's a year length and that it's difficult. This is not an easy thing, but it's rewarding and it's fun and it's supported. But what does it mean? What are you talking about? Are we exercising? Are we discussing meals out and keeping journals? What is it you're doing with these people?

Mary Luebbert: Great questions, and we do all of the above, but sometimes we have to be honest. We customize it per the class that's involved. Sometimes they want to change recipes. And so we talk about these recipes and why we're getting these recipes and why we eat a certain way. And then as dieticians or health professionals will say, "Okay. You know, some of those cheesy TV cooking shows, the reason they taste so good is because there're too much fat or too many calories in them." And so we get them back grounded into what they need to do.

And so portion control is a big part of our discussions. Talking about, are you having a colorful plate and enough fruits and vegetables? When do you buy the good fruits and vegetables? In season? And what are those? You don't have to only eat vegetables. You don't have to eat expensive food. You can have frozen foods, but we want to share what we can do and keep it realistic because some of these people live on a budget. Some of these people aren't great cooks, so you have to customize it.

And that's the key is keeping people engaged so that they don't feel like failures and give up. It is about understanding that you don't have to be an athlete. You don't have to join a gym. You can do exercises at home. And so sometimes we will give them stretch bands and do some exercises in class. Sometimes we'll walk during class. We call it a walking meeting. And that's wonderful because then we talk about the trail system here in Lincoln, the bikes that you can rent in Lincoln. So we engage them in our own community and use tools that are available, but they didn't maybe know or didn't know how much it costs. So we break it down in usable parts for them to be engaged and happy and make it convenient for them.

Then the last part is stress management. And boy, that's where having the professionals on board makes a huge difference because we've just gone through a pandemic. I don't even know if it's over. Stress. Some of us like to eat when we're stressed. Some of us don't know what to eat when we're stressed. Some of us go out to eat when we're stressed. And those might be areas that can be trouble. Some of us give up and don't exercise. Some of us are working from home and there's more food available when you're eating at home and working from home.

Some of us are just depressed. They can't control the pandemic. They're lonely. Some of them have been going through divorce or aging. And so that support is so important and so vital. And so when they get together and they play pickleball together, they're back to a support network. If they're going out and eating at a fast food restaurant, then they know this is a safe place and these are the things that we can eat together or are in our budget or what we talk about is our parameters for safe eating to continue to lose weight.

So sometimes it's not one thing, and it's a lot of things that we enter in and they don't even realize that we're giving them information, but they're learning as they go. And then, it's not so bad that we took away their twelve-ounce steak and they only get four ounces. That's not so bad that they're having more vegetables on their plate when they could find that they could go to the farmer's market and eat at a reasonable price. But those are their choices and we never take anything away. We never give them special foods that they have to have. It's their choice and they feel accomplished. And that's the best part of this support system, is knowing that they can do it themselves.

Melanie Cole (Host): Beautifully said. What a comprehensive program. Is it covered by insurance, Mary?

Mary Luebbert: We do take all insurances and we've had great success. Over 80% of our insurance are covering it. But it's preventative, and so not all plans are preventative. But we work with the clients and they can do it individually and pay as they go or they can ask for their flex benefits to be used for it. So we make it as affordable as we can.

Melanie Cole (Host): Well, preventive medicine certainly is such an important aspect of health and wellness. As we wrap up, Mary, if someone's interested in the program, how do they learn more or get registered? And please offer your best advice for how families can help support the person going through this program and what you'd like people to know about preventing diabetes in the first place.

Mary Luebbert: Well, here at Bryan, we have internet access and we have a website and then we also have For Your Health monthly flyers that go out and we want you to apply or attend all informational sessions that are free, learn when you want to join and what you want to do. My name is Mary Luebbert at bryanhealth.org and you can always email me and I can send out the bare bones or give you a one-on-one tutorial. We enroll four times a year. Each quarter, we have a new class starting. And sometimes it's just all about finding about when is best for you. So we'll make it happen for you. We just have to know you're interested and ready to make change.

Melanie Cole (Host): What great information. Thank you so much, Mary, for joining us today. And I want to thank our Bryan Foundation partner, NRC Health. And you can get more information on the diabetes prevention program at Bryan Health by heading over to our website at bryanhealth.org for more information, and to get connected with one of our providers.

That concludes this episode of Bryan Health podcast. Please always remember to subscribe, rate and review this podcast and all the other Bryan Health podcasts. We have so many in our library, interesting ones, all of them. And you can learn so much about your health. I'm Melanie Cole. Thanks so much for listening.