Dining with Diabetes

Diabetes is an expensive and potentially debilitating disease. In Virginia, it leads to 11,700 hospitalizations each year, at a cost of nearly $173 million. According to the American Diabetes Association, people with diabetes have medical expenditures that are approximately 2.3 times higher, on average, than those without diabetes.

The good news is that diabetes responds favorably to lifestyle changes. People with diabetes who make changes to their lifestyle can delay the onset or minimize the impact of serious health complications such as heart disease, blindness, kidney failure, and lower-extremity amputations. In order to make those changes, however, they need to understand how their daily decisions and activities can impact their health – in the short and the long term.

Virginia Cooperative Extension’s Dining with Diabetes program is designed to teach good self-management skills for people with diabetes, and to help them make positive changes toward a healthier lifestyle.

"For many participants, the classes caused 'the light to come on' in how they approached their disease," Milbourne says.

In 2006, Eleanor Schlenker, professor and Extension specialist in human nutrition, foods and exercise, was invited to attend a Dining with Diabetes training session for Extension agents in West Virginia, where the program was developed with funding provided by the Centers for Disease Control and Prevention.

After receiving the training, Schlenker became interested in replicating the program in Virginia. “I had seen the statistics that Type 2 diabetes was a growing health concern in the United States, and in Virginia in particular,” says Schlenker, “As a registered dietitian, I was interested in the potential impacts that diet and exercise could have on improving the health of people with diabetes. I saw that there was an opportunity for Extension to provide education to help Virginians manage their diabetes better.”

At the same time, Nancy Pribble, of the Virginia Diabetes Prevention and Control Project (VDPCP), a part of the Virginia Department of Health, was looking for ways to reach more Virginians with diabetes education.

“I knew, from assessments we had conducted, that there was a need for people to learn self-management skills to control their diabetes,” says Pribble. “Most Virginians with diabetes are referred to a dietitian or another self-management program, but only about half of them ever receive any formal diabetes education.” She goes on to say, “I also knew that in practical terms, we needed to look for statewide partners to have the greatest reach with an educational program.”

Pribble was familiar with the West Virginia program and thought Extension could also be a partner in Virginia. “We looked at which statewide nutrition programs are available and thought of Extension since they have nutrition experts that focus on meal planning and food preparation,” says Pribble.

In the fall of 2006, the VDPCP, the local office of the Virginia Department of Health, and Extension conducted a pilot-test of Dining with Diabetes in Dickenson County. Phyllis Deel, family and consumer sciences Extension agent, coordinated the effort locally. All parties involved declared the program a success, and Schlenker and Pribble went back to the Department of Health with a request for funding to broaden the program to five locations across Virginia in 2007.

Dining with Diabetes participants enroll in a five-session program that is conducted over four months. At the beginning, participants fill out a questionnaire that tells instructors how knowledgeable they are about their disease, how well they manage things like diet and exercise, and how well they understand the need for testing. Health professionals also screen each participant’s blood pressure and A1C hemoglobin level, an important indicator of how well they are managing their blood sugar.

At each session, certified diabetes educators or registered dietitians present a lecture on topics such as:

self-monitoring and self-care,
choosing between healthy and unhealthy fats,
monitoring carbohydrate intake and meal planning, and
knowing the importance of micronutrients such as vitamins and calcium.

Extension agents follow the lectures with education on healthy recipes and foods suitable for a good diabetes diet. They also lead an exercise session at the beginning of each meeting, that includes stretching or relaxation techniques that participants can do while seated.

At the end of the course, the health professionals again measure each participant’s A1C level and blood pressure. The A1C value tells how well blood sugar has been controlled for the previous few months. In 2007, 55 percent of participants from across Virginia showed a positive reduction in their A1C values from the beginning to the end of the program.

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Class members enjoy the food-sampling portion of each session, when they taste food prepared from recipes designed for a good diabetes diet.

Family and consumer sciences Extension agent Annette Jewell reviews program materials with a class participant.

Related Information:

Solutions - Living with Diabetes

Diabetes at the Centers for Disease Control and Prevention