Two nurses from Tennessee preach "reversal of diabetes"

Chains, saws and old logging equipment litter the field at the back of Wendy Norris's family farm, near the county seat of Altamont, Tennessee. Norris was once part of the local wood industry and the rusty tools are remnants of a time when health problems did not prevent it from cutting down hardwoods.

"I was nine months pregnant," says Norris. "My husband and I stayed a long time in the middle of nowhere, under a tent."

These outdoor adventures are just a memory now. A few years ago, when Norris was 40 years old, her feet began to go numb. She first badumed that it was because she was staying all day at work in a retirement home.

"But it was not," she recalls now. "It was this neuropathy, where my [blood] the sugar was high and I did not know it. Norris had developed type 2 diabetes.

Grundy County, Tennessee, has a long list of public health issues and type 2 diabetes tops the list. The county is incredibly picturesque; its life expectancy rate is one of the lowest in the region.

Norris was relatively active. She also enjoyed sodas, sweets and icy dinners. In the meantime, diabetes is running in his family. So when his diabetes the diagnosis fell, her doctor prescribed insulin injections and told her to watch what she ate.

"You sit there thinking:" What does that mean? "Said Norris.

Type 2 diabetes can be reversed with weight loss and exercise. but research shows that people need a lot of help to control their blood sugar simply by changing their diet and lifestyle, and that they rarely get enough support. It is easier for doctors and patients to rely primarily on drugs.

Norris says she's trying to revise her diet by herself was confusing and difficult. And when things did not change, the doctor increased his dose of insulin.

But then Norris lost his health insurance. Injectable insulin cost her hundreds of dollars a month – money that she just did not have.

Fortunately, some of the nurses in her community intervened to help, not with money, but with crucial support of a different nature.

At the nonprofit medical clinic Beersheba Springs, a nonprofit clinic founded in 2010 to provide free or low-cost health care in the area, Norris was initiated to an alternative approach to tame her type 2 diabetes – and the prospect of completely reversing his diagnosis.

Retired nurses on mission

In an old In the presbytery near the clinic, Karen Wickham puts lentil stew in the spotlight among a handful of participants in the evening's health education session. arrival.

She and her husband, Steve, are white-haired, semi-retired nurses who have dedicated their lives to what they call "the reversal of diabetes." They offer six-week seminars to type 2 patients like Norris, who also brought his father and daughter.

"It's our goal," Karen says. "Our goal in life is to try to help make a difference – first in our community."

Using slides, the Wickhams explain the difference between sucrose and glucose, as well as the science behind the fact that foods like potatoes cause blood sugar to rise, unlike sweet potatoes. They preach to eat as much fiber as the stomach and drop almost all types of sugary drinks.

Then they demonstrate ways to burn all those calories. One evening, Steve invents the "Beersheba Boogie" on the spot, inviting participants to raise their knees and fist.

All these people will have to find a way to become active at home because there is no gym nearby. There is also no adequate grocery store nearby, so healthy cooking can become a real chore. These community-wide barriers show why it can be difficult for people to stay healthy in rural areas of America. But the Wickhams work to overcome these obstacles.

Steve calls for applause as participants share their latest health statistics: "His blood sugar is going down! Give him a hand."

If it sounds like a wake up meeting, it's sort of. Steve and Karen Wickham feel compelled to do this work as part of their Christian faith as Seventh-day Adventists – members of a denomination known for its concern for health.

"I think God holds us responsible for living among these people and doing nothing," says Steve.

The Wickhams first moved to Grundy County to care for sick parents and eventually built the home of their dreams. They planted extensive orchards, vegetable gardens and small bays to satisfy their vegetarian diet – a common diet among Seventh-day Adventists.

But once settled in their mountain retreat, the Wickhams were disrupted by the Grundy County National Health Rankings: The 13,000-strong county ranks as the least healthy in Tennessee, on an annual basis. Grundy County has the shortest life expectancy of the state and a high diabetes rate (16% of adults), which can eventually lead to blindness, kidney failure and amputations.

"I had been taking care of diabetic patients for so long and I knew the progression," Karen says. "If you really want people to get better, you have to deal with lifestyle interventions."

Reviewing one's diet and activity level is the obvious solution, but these changes are difficult to start and even more difficult to maintain.

"Nobody, in fact, will bring all the lifestyle changes we recommend," says Steve. "But if you make the kind of choice that will lead you to a healthier lifestyle, then you will get better."

A more optimistic message

In addition to their lifestyle tips, the Wickhams always warn, advising people to talk to their doctor about their condition and treatment. They also acknowledge that their seminars are not yet "evidence-based" or supported by peer-reviewed scientific literature. This is one of the reasons why they could not get government grants to fund their program directly.

However, studies have shown that people whose blood sugar level is in the range of "prediabetes" could recover normal blood sugar levels by losing 5% of their body weight.

And weight loss and exercise have already shown a decline in hemoglobin A1c, which doctors use to monitor a patient's blood sugar over a period of two to three months.

In addition, a new study by Dr. Roy Taylor of the University of Newcastle in the United Kingdom seems promising for a real remission.

"There has been no information on the possibility of rolling back diabetes," Taylor said.

Most studies show that type 2 diabetes, in most patients, progresses in one direction. But Taylor says these studies also involve people who continue to gain weight, which is typical for people with diabetes.

"Doctors tell their patients," You have a chronic disease. We know that it will worsen progressively. "Then they turn around and their patients do not lose weight and do not exercise, but they gave them this totally depressing message," he said.

Taylor's research reveals that if a patient loses 30 pounds or more, diabetes can be reversed in its infancy. Taylor prescribes a strict liquid diet and limited exercise – in the beginning – so as not to stimulate appetite. People with type 2 diabetes must lose fat in the liver and pancreas.

In the end, Taylor hopes that better nutrition will become the preferred answer to hyperglycemia over the next decade.

"I think the main headwinds [against progress] These are just concepts – scientists and doctors who believe that this is an irreversible condition because of what we have seen, "he said.

Even the American Diabetes Association has changed in opinion. The pressure group adopts a new position on type 2 reversal: "If a patient wishes to seek the remission of type 2 diabetes, particularly within 6 years of diagnosis, weight management programs based on evidence is often successful. "

John Buse, Head of the Department of Endocrinology at the University of North Carolina's School of Medicine, helped draft the revised guidelines of the American Diabetes Association. "We know, literally since the 17th century, that food is the key to managing diabetes," he said.

But it is difficult to write a prescription to change your lifestyle.

"Doctors do not have the time to do it right, so we have often used this kind of method," he says. "Eat less carbohydrates and walk every day." This does not have any impact. "

The Wickhams are doing their part to enrich the scientific data, by monitoring the blood sugar levels of participants in their program. And even the short-term anecdotal evidence they've gathered resonates well beyond Grundy County, and they're traveling more and more recently.

The couple just sold their retirement home to be able to say yes to all the invitations they received, mainly through Seventh-day Adventist groups, in order to present their program to others. communities in the United States.

Wendy Norris added that the prospect of rolling back type 2 diabetes had already completely changed her vision of health.

"I felt like having to take three or four strokes a day the rest of my life," she says. "I already have one."

This story is part of the reporting partnership between NPR and Nashville Public Radio and Kaiser Health News.