The American Diabetes Association (ADA) states that “millions of people around the world live with diabetes or know someone living with diabetes. Regardless of the type of diabetes, it isn’t yet a curable disease.” According to County Health Rankings and Roadmaps, “the percentage of adults aged 20 and above with diagnosed diabetes in Campbell County is 11% with Kentucky’s percentage at 13%.”  According to the Northern Kentucky Health Department reports that 1 in 4 people in KY have pre-diabetes.  The ADA states that “lifestyle management is a fundamental aspect of diabetes care and includes diabetes self-management education (DSME), diabetes self-management support (DSMS), nutrition therapy, and physical activity.” 

On the second Thursday of each month, participants with diabetes and those diagnosed with pre-diabetes attend the Diabetes Support Group at the Campbell County Cooperative Extension Service to learn, practice and adopt new skills in order to help them cope with and better manage their diabetes. The Diabetes Support Group is hosted by Ronda Rex, Agent Family & Consumer Sciences Education from the Campbell County Cooperative Extension Service. Ronda not only host but collaborates and co-facilitates the Support Group with Julie Shapero, Northern Kentucky Health Department Registered Dietitian and Diabetes Educator. 

 The Support Group was moved to the Extension Office two years ago and since that time, the registration per month has grown from an average of 8 participants to an average of 22 participants. Ronda provides low-carbohydrate, portion controlled snacks and fruits and vegetables every month. She also teaches University of Kentucky (UK) curricula and demonstrates UK recipes for at least 3-5 of the program’s sessions each year. Throughout the Support Group sessions, Ronda focuses on the UK curriculum, Taking Ownership of Your Diabetes emphasizing the curriculum’s “Thinking Your Plate, My Plate (diabetic version) and Portion Sizes," Plate It Up Kentucky Proud and Nutrition Education Program recipes.  Ronda has recently incorporated the UK curriculum of Memory Banking and Life Story: How Your History Can Help for overall health and wellness. Julie facilitates by providing diabetes education as a Registered Dietitian and Diabetes Educator and answers any questions relating to foods/nutrition, diabetes numbers, statistics, and overall self-management care.  Julie also works with the participants providing them with any other community resources concerning their overall physical and mental health.  Ronda and Julie set up various speakers throughout the program each month. Topics include: diabetes basics (terms and numbers), food care, healthy weight loss, chair exercise, carb counting, dental health, eye care, foot care, heart health, communicating effectively with your doctor or health care team, overall diabetes’ management and community resources that are available. 

ADA states that “Diabetes self-management education and support has been shown to be cost-effective by reducing hospital admissions and re-admissions as well as estimated lifetime health care costs related to a lower risk for complications.”  In April 2018, a two-part comprehensive program (AADE Accredited Diabetes class), called Healthy Living with Diabetes, was facilitated and conducted by the Campbell County Cooperative Extension Service, Ronda Rex and the Northern Kentucky Health Department, Julie Shapero.  Nine participants attended and completed the program. Ronda Rex, Agent for Family & Consumer Sciences Education hosted, facilitated and conducted the program by providing the UK curriculum, Taking Ownership of Your Diabetes focusing on “Thinking Your Plate, My Plate (diabetic version) and Portion Sizes.” Ronda also provided lunch both days of the program by conducting demonstrations focusing on Plate It Up (PIU) Kentucky Proud recipes. One day, the participants prepared a PIU recipe, Broccoli Pizza, substituting various vegetables. Another day, the Nutrition Education Program meatloaf recipe was demonstrated and served. Julie Shapero, Northern Kentucky Health Department Registered Dietitian and Diabetes Educator and Paula Bergen, Registered Nurse and Diabetes Educator taught the comprehensive program focusing on diabetes basics, managing diabetes, healthy eating, developing an active lifestyle, taking medications and reducing health risks. 

Cooking Up Diabetes Self-Management 2018 Program 5-month follow-up evaluations showed that 100% of the 9 participants will have an eye exam every year, 88% will both take medicines as doctors ordered and check their feet every day and 63% will eat foods that help them keep blood sugar control. The evaluation also showed that because of the program, 100% of the participants fully understand low and high blood sugar levels, when to call a doctor or go to the emergency room about a diabetes problem. A 5-month follow-up evaluation revealed that of the 9 participants who attended all parts of the series and completed the program, 50% of those who turned in pre-and post A1C measures, improved their A1C values.  One hundred percent of the participants set a diabetes behavior goal with 78% turning in follow-up information of meeting their goal due to either being more physically active, better monitoring their blood glucose levels or making better choices to reduce their risks of diabetes progression. One hundred percent of the participants that turned in information on both pre-and post-behavior goals, met their goals.

One female participant, Sandy, said “I have been attending the Diabetes Support Group for 3 months and before I came, my A1C was 9. Then it went down to 8.2. This week, my A1C was 6.5. This group has definitely helped me to stay focused. Ronda and Julie are doing a great job and I look forward to coming.” (3/20/19)

A male participant, Paul, said “I retired after working for 23 years on 3^rd shift, ending up with diabetes and a brain tumor, with no time to learn. Since retiring, I have been trying to learn all I can about diabetes. For the past year, I have been coming to the Support Group and I have learned that my A1C was at 9.5 and I am proud to say that now it is 7.0” (3/20/19)

Tera, another DSG participant, testified that since Sept 2018 when she started the program, she has lost around 70 lbs.  The program has encouraged her to begin exercising and watch what she eats.  (5/9/19)

In 2018, Ronda asked Julie to collaborate with her and the Northern Kentucky Area Family & Consumer Sciences Agents to teach 56 people about diabetes basics and management at the Healthy Living from the Inside Out Program. This program was an area Homemaker (Kentucky Extension Homemakers) overall health and wellness program.   Ronda and Julie used the UK curriculum, Taking Ownership of Your Diabetes. Follow-up program evaluations indicated that 73% of the participants stated that as a result of the program, they have taken steps to either better manage their diabetes or lessen their risks for having diabetes.

Pam Sigler completed a public value piece using the information from  this success story highlighting the DSG in Campbell County and can be found at: extension.ca.uky.edu.     

http://www.countyhealthrankings.org/app/kentucky/2018/measure/outcomes/60/data

http://www.diabetes.org/diabetes-basics/

https://www.professional.diabetes.org/diabetes-self-management-education 

Julie Shapero, Med, RDN, LD, LDE, Diabetes Educator, Northern Kentucky Health Department