A rural pathway to prevent diabetes

By Sadie Fritzler and the Yuma Clinic

My doctor recently told me I am on a path to developing diabetes. I have “prediabetes” and really need to focus on diet and exercise. But I love meat and potatoes. I love tortillas. I even love my weekly Daylight Donut. Can I keep the things I love while also focusing on my prediabetes?

In the United States, 38% of people have prediabetes. The rate of prediabetes is higher in rural regions like Northeast Colorado than in urban regions.

There is a long-standing curriculum for people with prediabetes to prevent progression to full-blown diabetes called “Prevent T2”. While this program can work, it was not designed for people living in rural communities. The key predictor to success for prediabetes care is weight loss. The Prevent T2 program advises people with prediabetes to lose weight by reducing their daily calories. However, adherence to restricting daily calories is low. Culture, livelihood, and access to foods are huge factors when looking at diet options. In Northeast Colorado, we raise red-meat (cattle) often in our own back yards, we have a strong Hispanic influence on our diets, and many of us face limited availability and increased cost of fresh-produce. Adhering to a diet with lots of restrictions and limited access to other foods can be difficult.

The High Plains Research Network (HPRN) in collaboration with researchers at CU Anschutz Medical Campus are working on a project to prevent diabetes that allows for great diet choice and is designed for rural communities.

The Prevent T2+Choice program has been developed by HPRN’s community partners, local clinicians and clinic leaders, dietitians, and several people with prediabetes. This team helped shape the curriculum to reflect Northeast Colorado and rural communities. Diet options included reduced calories, reduced carbohydrates, and time restricted eating.

Dr. Jack Westfall, Yuma High School graduate, and recent part-time addition to the Yuma Hospital medical staff stated, “Prediabetes is really common, but the old standard prevention program was not really responsive to rural communities like Yuma. The work of the HPRN to make this diabetes prevention program accessible and meaningful to folks in Yuma is impressive. I am very excited to help folks get into this program.”

Participants in the Prevent T2+Choice program meet virtually one hour a week for 16-weeks. They will also have 1-on-1 appointments with local nutritionists, get several medical tests done (A1c, Continuous Glucose Monitoring, Activity Monitor), receive their own digital scale, and get a small financial compensation. The Yuma Clinic and HPRN partners look forward to local people with prediabetes letting us know what works.

The opportunity to participate in a program that can help prevent diabetes while providing very important feedback is incredible! If you are curious about this program or would like to participate, please contact Teri or Carmen at the Yuma clinic, or email the team at [email protected].

About the author: Sadie Fritzler is the Practice Facilitator and Research Coordinator for the High Plains Research Network, located in northeast Colorado.