I'll admit that chronic disease management is a topic I tend to neglect. Vaccines, superbugs and exotic diseases are sparkly and controversial, but I've been focused on wildlife parasites and global diseases when examples of the effects of chronic disease seem to be everywhere I turn.
Chronic disease is a growing problem that correlates with our lengthening life span, and diabetes has become a hugely common disease worldwide associated with lifelong illness, mortality and other diseases such as obesity and cardiovascular disease.
According to the American Diabetes Association, 8 percent of Americans suffer from diabetes, an alarming number that reinforces the idea that the modern American lifestyle is not a healthy one. Add in a family history of diabetes and late diagnosis or inadequate management of the disease, and diabetes becomes a serious public health problem. In Georgia, the incidence of diabetes has expanded from 4.4 per 1000 in 1999 to 10.7 in 2008, a 143 percent increase.
The issue may be further compounded in rural areas, which are typically poorer, where access to proper resources like nutritious food and health education services may be lacking.
So when I began to visit Hartwell, I expected to hear about diabetes as a common health concern. I was right. And while the prevalence of diabetes itself is worrisome, I learned that many diabetic patients in Hart County don't, or can't, comply with the directions their doctors give them to manage their diabetes.
Noncompliance stems from a number of causes: Unemployment in Hart County is near 13 percent, and people eat what they can afford. The same goes for medications. Still others just aren't willing to change their lifestyles, or aren't aware of what they're eating. Some find the effort of checking glucose levels and monitoring food intake to be too much, and just don't do it.
But in Hartwell and surrounding areas, a local health care system has attempted to give diabetic residents a chance to get the education they so badly need to deal with the disease properly.
Ty Cobb Healthcare System, which serves both Hart and Franklin counties, offers an outpatient diabetes education center as a part of its health and wellness services. Patients can meet with a dietician, receive one-on-one, individualized consultations and attend group sessions on various topics related to diabetes.
Rene Starrett, the clinical wellness coordinator for Ty Cobb, sees patients regularly upon referral from local primary care physicians. Most of her patients are Type 2 diabetics who experienced adult onset, and are usually over 50. She offers them a comprehensive overview of diabetes and helps them understand what changes they will need to make in their lifestyles, how to take their medications and how to monitor effectively. Many of the patients Starrett sees can get more in-depth, instructive knowledge from her than a physician who can tell patients to eat well, but not what eating well means.
Part of Starrett's approach to diabetes education is that support is just as important as knowledge when it comes to diabetes, a disease that requires intense personal management and surveillance. "A support system is very important," said Starrett. "Diabetes is very much about the patient."
I saw evidence of this at one of the free group sessions focused on monitoring strategies. Most of the attendees were older women, and I was surprised by the number of pre-diabetics who came for information. They came from several nearby towns, since these groups are the only free available group resource for pre-diabetics and diabetics.
Starrett acted as a member of each patient's support team, offering empowerment and advice for long-term health goals. For those suffering from diabetes, action in the now is most important, but it's easy to get discouraged or overwhelmed.
Starrett acted as a member of each patient's support team, offering empowerment and advice for long-term health goals. For those suffering from diabetes, action in the now is most important, but it's easy to get discouraged or overwhelmed.
What quickly became apparent was that this group is a way for those experiencing the same issues to help each other cope, share what they'd learned and encourage healthy behaviors in others. One woman expressed that fear of pain kept her from checking her blood sugar, which elicited a huge response and an influx of advice. Others expressed the difficulties of watching diet and understanding what causes changes in blood sugar, whether it's stress or eating an extra piece of bread at dinner.
Regardless of the concern, someone always had an answer. These support groups show that diabetes, and chronic diseases, aren't just about managing the physical aspects of illness. They are just as much about having the mental resources and support to lead a healthy, productive life.
