A
simple, inexpensive method for preventing type 2 diabetes that relies on
calling people and educating them on the sort of lifestyle changes they could
make to avoid developing the disease has proven effective in a study conducted
by researchers at the University of California, San Francisco (UCSF) and the
City of Berkeley Department of Public Health.
The
study involved 230 people in poor, urban neighborhoods in the San Francisco Bay
Area cities of Richmond, Oakland and Berkeley. Contacted by phone
about once a month, half of them received specific dietary guidance and other
lifestyle counseling. After six months, those who had received the counseling
had on average lost more weight, were consuming less fat, were eating more fruits and
vegetables and showed more improvements in lowering in their blood triglycerides,
a key risk measure for type 2 diabetes.
Described
this week in the American
Journal of Public Health, the new intervention is specifically designed
for urban, poor, and predominantly minority communities. It addresses the need
for diabetes prevention
interventions in these communities and highlights a simple fact that
doctors at UCSF and elsewhere have been repeating for years — that type 2
diabetes is preventable in the first place.
“Diabetes
is not something you are necessarily going to get just because it runs in your
family,” said Alka Kanaya, MD, an associate professor of medicine at UCSF and
one of two senior authors on the study. “It is very preventable, and lifestyle changes can
really impact the onset of diabetes.”
“You
can do something about it,” said Anita Stewart, PhD, a professor at the UCSF
Institute for Health & Aging and the Center for Aging in Diverse
Communities who is the other senior author on the paper.
How
Lifestyle Changes Can Prevent Diabetes
Diabetes
is a chronic and complex disease marked by high levels of sugar in the blood
that arise due to problems with the hormone insulin, which regulates blood
sugar levels. It is usually caused by an inability to produce insulin (type 1)
or an inability to respond correctly to insulin (type 2).
A major
health concern in the United States, diabetes of all types affect an estimated
8.3 percent of the U.S. population — some 25.8 million Americans — and cost
U.S. taxpayers more than $200 billion annually.
In
California alone, an estimated 4 million people (one out of every seven adults)
have type 2 diabetes and millions more are at risk of developing it. These
numbers are poised to explode in the next half century if more is not done to
prevent diabetes.
Previous
studies have shown that counseling and other lifestyle interventions are
effective at preventing type 2 diabetes, but those interventions have generally
been designed for clinical settings and include separate sessions with numerous
health professionals. This makes them expensive and difficult to scale to large
urban populations where diabetes interventions are needed the most.
Many of
this country’s urban poor face thin health insurance coverage, low literacy,
and low income, and a higher risk of developing type 2 diabetes.
These disparities were apparent in the UCSF study. About half of the study
population was composed of immigrants, and nearly a quarter had no health
insurance.
Almost
a third said they faced financial hardship, and 22 percent had less than a
high-school education.
By
focusing on a phone-based solution delivered by the Public Health department
staff, the UCSF researchers designed their new intervention specifically as a
low-cost community-based approach that would be relevant to poor, minority and
low-literacy populations.
Similar
telephone interventions have been used to reach out broadly to populations in
San Francisco and in other cities to spread lifestyle messages related to hypertension,
smoking, high cholesterol and other issues.
“This
adds to our public
health toolkit of ways to do outreach and prevent diabetes,” said
Kanaya.
More
information: The
article, “The Live Well, Be Well Study: A Community-Based, Translational
Lifestyle Program to Lower Diabetes Risk Factors in Ethnic Minority and
Lower–Socioeconomic Status Adults” by Alka M. Kanaya, Jasmine Santoyo-Olsson,
Steven Gregorich, Melanie Grossman, Tanya Moore and Anita L. Stewart appears in
the June 14, 2012 issue of the American Journal of Public Health.
Provided
by University
of California, San Francisco
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