WILLMAR -- With intensive, one-on-one lifestyle coaching, the onset of diabetes can be delayed or prevented altogether, studies have found.
Whether this approach works equally well in a community-based group setting will be the subject of a pilot project that starts next week in Willmar.
Deb Lippert, a certified diabetes educator and program coordinator of the Rice Diabetes and Nutrition Center at Rice Memorial Hospital, hopes it will prove to be an effective, lower-cost way of reducing the burden of diabetes.
"This has been a goal of the diabetes center for the past three years," she said. "Every other program we've looked at has had some barriers, and cost is one of them."
Willmar is one of three Minnesota cities -- Rochester and West St. Paul are the others -- that were selected for the study through the Steps to a Healthier Minnesota initiative.
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The four-month, once-a-week program starts Tuesday at the Kandiyohi County Area Family YMCA.
The project, known as Individuals and Communities Acting Now to Prevent Diabetes, targets a population that often falls through the cracks: people with prediabetes.
An estimated 1 million Minnesotans have prediabetes. At least 2,000 people in the Willmar area and surrounding counties are believed to have the condition.
These individuals have blood glucose levels that are higher than normal but not high enough to qualify as diabetes. Many of them are at significant risk of developing type 2 diabetes, Lippert said.
The progression to diabetes doesn't have to be inevitable, however, she said.
One of the most widely cited studies, the Diabetes Prevention Program, found that with intensive individual counseling on nutrition and physical activity, the three-year risk of developing diabetes was reduced by 58 percent.
The key word is "intensive," Lippert said.
"It takes repetition for lifestyle change. It takes a period of time for people to change their behavior," she said. "There are some people who have enough internal motivation to do that, but the majority do not."
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Individual counseling can be expensive, however. Most outpatient clinics don't have the resources to provide it, and many health plans don't cover the cost.
Hence the purpose of the pilot project: to examine whether group counseling in a community setting can achieve the same results as the Diabetes Prevention Program.
The 16-week program that starts Tuesday at the YMCA uses specially trained facilitators who will address nutrition, physical activity and motivation.
"It gives them tools to make positive changes," said Kara Ellwood, health enhancement director at the YMCA. "They know what they need to do. They just need to be reminded and they need to be held accountable."
The goal for the participants is to reduce their weight by 7 percent and increase their activity to 150 minutes a week by the end of the program, Lippert said.
The participants will be assessed before the study to collect data such as blood glucose and cholesterol levels and use of medication. They'll be reassessed when the study ends, and the data then will be blinded and forwarded to the Minnesota Department of Health.
Fifteen people are being recruited initially. It's the goal of the YMCA to continue offering the program on a regular basis to reach as many people as possible, Ellwood said.
She and Lippert said the program holds considerable potential.
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If it's successful in delaying or preventing the onset of diabetes and the costs and complications associated with diabetes, it can be replicated elsewhere in Minnesota, they said. The same model could be used for other chronic conditions, such as high blood pressure, that can be positively influenced by changes in nutrition and physical activity.
The data also could help build a case for insurers to provide better coverage for these types of preventive programs, Lippert said.
"So it's very important that we do a good job with this program," she said.
She and Ellwood said there are still a handful of openings and time to register before the project is launched on Tuesday.
"We know that there's lots of people out there. We know this is a need in the community," Ellwood said. "It's just a matter of getting them to sign on the dotted line and say, 'I'm ready to change.'"
