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By Blake Farmer, Nashville Public Radio
In a former church rectory in Grundy County, Tennessee, Karen Wickham unveiled her lentil stew as people showed up for an evening health education clbad.
Wickham and her husband, Steve, are semi-retired white-haired nurses who have spent the last years of their working lives helping people with type 2 diabetes to control and even reverse the situation by following a diet and diet. by doing exercise.
Wendy Norris is in the group and she brought her father and daughter. Since her diagnosis several years ago, her doctor prescribed insulin injections and told her to watch what she ate.
She remembered thinking about the time: "Well, what does that mean?"
The Wickhams have decided to answer this question in Grundy County, Tennessee, which ranks last on the residents' health scale. Grundy population of 13,000 has the shortest life expectancy in the state and a high rate of diabetes (16% of adults), which can lead to blindness, kidney failure, or amputations.
Norris said that trying to revise her diet by herself was confusing and difficult. And when things have not changed, the doctor has been increasing his insulin dose.
But then Norris lost his health insurance. Injectable insulin cost her hundreds of dollars a month, money she just did not have.
"I felt like stuck, forced to take three or four shots a day [for] the rest of my life, "she said. She enrolled in one of the Wickham's six-week seminars and found the number of takes she needed: "I've already reduced her to one."
With slides, the Wickhams explain the difference between sucrose and glucose, as well as the science behind the fact that some foods, like potatoes, increase blood sugar levels, unlike sweet potatoes. They preach to eat as much fiber as the stomach and drop almost all types of sugary drinks.
Steve and Karen Wickham explain the course materials to participants at their Type 2 Diabetes Seminar in Grundy County, Tennessee. The six-week seminar offers detailed instructions on the biology of diabetes, its diet and exercises – and provides personalized support.
And they demonstrate ways to burn all those calories. Steve even invented the "Beersheba Boogie" – after the town of Beersheba Springs in the Grundy area – asking participants to raise their knees and fist while walking on the spot.
Taking charge of radical changes
All workshop participants must find a way to be active at home or at a nearby rugged national park, as there is no gym in the county. There is no convenient grocery store nearby, so healthy cooking can become a 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.
During an education session, as participants shared their latest health statistics, Steve launched: "His blood sugar levels are going down!" Give him a hand.
If it sounds like a wake up meeting, it's sort of. Steve and Karen Wickham claim that their faith as Seventh-day Adventists imposes on them faith, a name known for health. They first settled in Grundy County to care for sick relatives and, once settled into their scenic mountain retreat, they were disturbed by the suffering they saw at home. their neighbors.
"I think God holds us responsible for living among these people and doing nothing," said Steve Wickham.
Many people think that type 2 diabetes is virtually incurable, although it has long been known that the disease can be reversed by weight loss and exercise. But research shows that people need a lot of help to change their lifestyle and rarely get it.
"I had been taking care of diabetic patients for so long and I knew the progression," Karen said. "If you really want people to get better, you have to deal with lifestyle interventions."
These changes can be difficult to start and even more difficult to maintain.
"Nobody, in fact, will make all the lifestyle changes we recommend," Steve said. "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 give a warning, advising people to see their doctor. They also acknowledge that their seminars are not yet "evidence-based" or supported by peer-reviewed scientific literature.
However, studies have shown that people with blood sugar in the "prediabetes" range can regain normal blood sugar levels by losing 5% of their body weight.
And it has already been shown that weight loss and exercise reduce hemoglobin A1c, a test used by doctors to control a patient's blood sugar over a two to three month period.
In addition, new research by Dr. Roy Taylor of the University of Newcastle in England is promising for a real remission.
"Doctors tell their patients," You have a chronic disease. We know that the situation will gradually worsen. 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 shows that by losing about 30 pounds, type 2 diabetes can be reversed in the early stages.
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 think this is an irreversible condition because of what we have seen, "he said.
Even the American Diabetes Association has changed in opinion. The advocacy group has a new position on inversion:
"If a patient wants to achieve remission of type 2 diabetes, especially within six years of diagnosis, evidence-based weight management programs are often successful."
Dr. John Buse, Chief of the Department of Endocrinology at the University of North Carolina's School of Medicine, helped draft the new position on the reversal.
"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 for a lifestyle change.
"Doctors do not have the time to do things right, so we have often used this kind of method," he said. "Eat less carbohydrates and walk every day" … it basically has no impact. "
The Wickhams are doing their part to enrich the scientific data, by monitoring the blood sugar levels of participants in their program. And the short-term anecdotal evidence they gathered resonates well beyond Grundy County. They are traveling more and more recently.
Steve Wickham, who is a nurse, takes blood at the mid-point of his wife Karen's six-week diabetes seminar. The hemoglobin A1c levels measured by the laboratory test help patients to check whether changes in their diet and exercise affect their blood glucose levels.
The couple has just sold their retirement home to be able to say "yes" to all the invitations they have received, mainly from Seventh-day Adventist groups, to present their program to other communities in the country.
This story is part of a reporting partnership that includes Nashville Public Radio, NPR and Kaiser Health News.
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