The median household income and per capita income for Allen County is below the state average, $40,598 and $46,535 (respectively), which is below the national average ($63,179).  Income influences health, and we know that diabetes care is expensive.  According to a recent county assessment, Allen County residents are concerned about access to quality, affordable health care providers, chronic disease, and affordability of health care insurance.  Thirty-nine (39%) percent of Allen County adults are obese, 77% are overweight and 13% have been diagnosed with diabetes.  The incidence of diabetes matches the state at 13%, an increase of 50% since 2000, but is significantly higher than the national average, which was 9.4% in 2015, according to the American Diabetes Association. Those with diabetes lose an average of 10-15 years of potential life and can develop serious complications such as cardiovascular disease, blindness, kidney failure, and non-traumatic lower extremity amputations. 

Due to limited resources available in the county, community members and local healthcare providers frequently look to the local Cooperative Extension Service for information for individuals managing diet-related chronic diseases. The Allen County Family and Consumer Sciences Extension Agent partnered with the Allen County Health Department, as well as The Medical Center at Scottsville to present National Dining with Diabetes.  Nutrition is the cornerstone of diabetes management and prevention and Dining with Diabetes helps Kentuckians manage their own or that of a loved one’s diabetes through nutrition education. 

The program included four sessions that addressed Living Well with Diabetes, Carbs and Sweeteners, Fats and Sodium, and Vitamins, Minerals, and Fiber.   Overall themes included being an active member of your healthcare team, physical activity, and using the Plate Method for carbohydrate counting. Twelve participants attended each of the four sessions, and five additional participants joined throughout the program. Participants were recruited through newspaper articles, flyers in multiple locations around town, Allen County Cooperative Extension Service FCS Newsletter, as well as at the commodities food distribution. Individuals who have diabetes or prediabetes, or family members of those individuals were encouraged to attend. 

Participants prepared three healthy recipes per class session and sampled the foods they prepared. Participants described healthy cooking techniques, observed models representing blood with high cholesterol and glucose levels, and identified healthy and unhealthy plates based on sodium and fat content.  Immediately following the conclusion of the program, 71% of participants reported they prepared healthier home-cooked meals and 86% reported they intentionally chose smaller portions to help manage their diabetes or the diabetes of a loved one as a result of the program. Half of the participants reported exercising continuously for at least 30 minutes at least 3 times per week. Finally, 71% of participants reported at the conclusion of the program that they felt more confident in their ability to keep their diabetes under control or help a loved one keep their diabetes under control.

In addition, three-month follow-up data was collected from 8 participants. Of those who reported, 86% felt more confident in their ability to manage their diabetes or help a loved one. Past participants showed positive behavior change with 75% consistently exercising at least three times a week for 30 minutes, 100% of participants preparing more home-cooked meals, and 86% intentionally choosing smaller serving sizes. One participant stated, “I made the White Chocolate Orange Pudding recipe for my church potluck dinner this week, and everyone loved it!” In general, participants stated that Dining with Diabetes helped them, “try new recipes, pay attention to ingredients, and take more interest in my health.” Due to popularity and high demand for the class, the FCS Agent intends to offer the program again in the future, offer leadership roles to program “graduates”, and potentially start a Diabetes Support Group. 

Resources

USA Today – US Household median income  https://www.usatoday.com/story/money/2019/09/10/median-household-income-stagnant-last-year-poverty-fell/2271025001/

Kentucky Health Facts http://www.kentuckyhealthfacts.org/data/location/show.aspx?cat=1%2c2%2c3%2c8&loc=2

Allen County Assessment https://extension.ca.uky.edu/files/allen_extension_community_assessment_2019.pdf