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This podcast is presented by the Centers for Disease Control and Prevention. CDC – safer, healthier people.

Hi Babies. This is Mother Love, and I’m here to tell you that diabetes and its complications do not have to be your destiny. I am here to let you know, as a person who manages this insidious, equal opportunity, ugly disease every single day, because I too have type 2 diabetes. I want you to understand how fabulous you are — that you do not have to lose your eye sight, you don’t have to go on kidney dialysis, you do not have to lose your lower limbs, suffer a heart attack, nor a stroke, when you can take and make healthy choices, healthy options. You can go to the grocery store right there in your community and make healthier choices, just like I’ve done. Get up, walk, move, swim, exercise, jog, stand up off that couch, get yourself up, move during the commercials; just get your body moving. Make healthier choices right there in your neighborhood, right there in your grocery store. Instead of getting fat back, use some vegetable oil. Make healthier choices like I’ve had to do. I’m never going to tell you, my babies, that this is easy. I’m going to let you know it can be done.

[Dan Rutz] That’s celebrity talk show host and humorist Mother Love with a very inspiring and motivational message for people who want to prevent or control diabetes. Hello, I’m Dan Rutz, and welcome to this podcast on diabetes prevention. Today, we have two people from the CDC’s Division of Diabetes Translation: Sabrina Harper, Acting Director of the National Diabetes Education Program and Magon Saunders, Public Health Advisor at the CDC and former Diabetes Coordinator for the Georgia Diabetes Prevention and Control Program. Thank you both for joining us.

[Sabrina Harper] Thank you, Dan; we’re very happy to be here. Magon and I both not only have a professional interest in diabetes prevention, but we also have a personal interest. My father died from the complications related to diabetes. When I was 13, he had a stroke and as a result of the stroke, he was never able to use his left hand and he walked with the help of a brace and a cane. Shortly after I graduated from college at the age of 21, he died from end-stage renal disease, which is kidney failure. My father was only 54-years-old at the time of his death. He never got to see me walk down the aisle to get married, nor was he able to see his four grandchildren.

[Magon Saunders] Yes, thanks Sabrina. Diabetes has not only been a professional interest of mine, but it has now become very personal. I recently had a friend, African American, of course, who was diagnosed with diabetes after ten years of being a gestational diabetic patient. She of course, after having gestational diabetes, developed a lot of - gained a lot of weight, was very physically inactive and found that she had full blown diabetes. The following week this friend was actually rushed into emergency surgery for diabetic retinopathy. And what it sort of brought home to me is how insidious this disease is, how softly or quietly it works, and how it overcomes people without there even being aware of the fact that they have the disease. So now, not only is there a professional interest of mine in diabetes, but it has now become pretty personal.

[Dan Rutz] Well ladies, there is definitely a tragic element to this disease and diabetes and its complications are in the news a lot these days. What is it about diabetes that makes it that serious? Sabrina?

[Sabrina Harper] Diabetes costs the United States 174 billion dollars annually, that is billion with a “b.” Over 20 million people in this country have diabetes. Diabetes disproportionately affects minorities. A little over 3 million African Americans aged 20 years and older have diabetes. One third of the people who have diabetes are not aware that they have this disease. However, it is possible, in many cases, to prevent or at least delay type 2 diabetes in people at risk.

[Dan Rutz] Magon, we hear sometimes about the prevention of diabetes. Is it really possible to prevent diabetes?

[Magon Saunders] Dan, I’m so glad you asked that question. Through extensive research, not only in this country but across the world, we have now recognized that diabetes is indeed preventable. I’d like to talk about a study called the Diabetes Prevention Program Study. In this study, over 3,000 participants with pre-diabetes, which means that they have elevated blood sugars but the numbers are not high enough to be diagnosed as diabetes, were involved in an extensive lifestyle intervention program that looked at diets, looked at their exercise, and worked with them to do behavior modification. The participants in this group were asked to lose about 7 to 10 percent of their body weight, to reduce their fat intake, to reduce their caloric intake. And what we found out through an extensive research was that the people in this study group had about a 58 percent reduction in their risk for diabetes. So we definitely know that because of this invention that diabetes in indeed preventable.

[Dan Rutz] Well that’s very encouraging. Sabrina let me ask you about what the National Diabetes Education Program is doing to promote prevention of the most common type of diabetes that we’re talking about here.

[Sabrina Harper] After the DPP Study, NDEP knew it had to translate this science into materials that could be used at a community level. Thus, the Small Steps. Big Rewards Prevent Type 2 Diabetes Campaign was launched. Included are messages for high risk groups, such as you have the power to prevent diabetes. Focus groups told us they wanted to know more about how to make the behavior changes to prevent diabetes. To meet this need, NDEP developed the curriculum, Power to Prevent Diabetes: A Family Lifestyle Approach to Diabetes Prevention.

[Dan Rutz] Sabrina, what encourages you that something like ,i>Power to Prevent can actually work for African-Americans?

[Sabrina Harper] The DPP showed us that type 2 diabetes can be prevented or at least delayed in those at high-risk through weight loss, making healthy food choices, and physical activity. Let me add, physical activity does not only include walking, running, swimming, but also dancing. Moving to the beat of any music you like can be done without going outside or needing special clothes or equipment. 645 people or about 22 percent of DPP participants were African-Americans. In Power to Prevent, NDEP used the principles that worked in the DPP study to develop a user-friendly curriculum. We also pilot tested the Power to Prevent with members of the African-American community.

[Dan Rutz] Sounds like this can actually be fun. Tell me a little bit more about the Power to Prevent curriculum.

[Sabrina Harper] Power to Prevent was developed to help African-Americans learn how to prevent diabetes and develop the skills needed to make lifestyle changes. Power to Prevent helps people practice healthier habits that can prevent diabetes. The skills learned in Power to Prevent can also help those who have diabetes control the disease. The goals of the Power to Prevent curriculum are to encourage African-American families to become more physically active and eat healthier foods as a way of controlling or preventing diabetes. And provides program leaders with a step-by-step easy to read resource that best reaches their target audience.

[Dan Rutz] Magon, it seems to me that this curriculum could be helpful for everybody, not just African-Americans.

[Magon Saunders] What we found when we pilot-tested this curriculum that we actually had a mixed race audience, and we had very favorable comments from them. What we did also get as a message back to the NDEP from the focus groups, was that we needed to develop “how to” materials. We needed to tell people how to lose weight, how to eat healthfully. And so it’s important that this is utilized by all population(s) and this actually has universal appeal.

[Dan Rutz] Tell us a little bit more please about the tips and tools in Power to Prevent.

[Magon Saunders] In the Power to Prevent tools - curriculum, which I was fortunate to use while I was the Program Director in Georgia, we actually did some pilot-testing, as I said earlier, in mixed-race groups. And what we found is that the tools that were there, for me, was the best thing to work with as a dietician. We actually have a fat and calorie or an activity tracker which allows people to be food detectives or fat detectives. They can actually ascertain how much fat or how much calories is in their food before they eat it. The curriculum also allows people to have a log of their physical activity and keep a log of what they eat. Now as a dietician, that becomes very important to us because what we found is that people will think twice about what they eat if they actually write this down and have to share this with somebody else. So this was a great thing for me as a practitioner to have actually have these tools available from the NDEP. In addition, the tools also allow groups to be more responsible, it increases accountability, and one of the great things about the tool is that it also helps with portion control for people. Now as a society, we have gone to super sizing everything, but it’s so important because what it does for us is actually show people what an actual portion is and then you’re able to make adjustments as you eat more than that or increase your physical activity. Now as Sabrina mentioned, one of the great things about the curriculum is the emphasis on increase in physical activity and that, as she said, does not mean going to the gym, but walking the dog, even if you don’t have a dog, exercising in-between commercials --- we don’t care what you do, but finding that way in groups and at home to be more physically active is the key to what this curriculum does for us. And so it’s a great tool for me as a practitioner, but I’ve worked in communities where there are lay people working in diabetes that just love this because of valuable tools it offers.

[Dan Rutz] It really looks very user friendly and easy for people to adjust to their life styles. Sabrina, how can people get a copy of Power to Prevent?

[Sabrina Harper] Anyone can order a free copy of Power to Prevent by visiting www.YourDiabetsInfo.org or by calling the National Diabetes Education Program at 1-888-693- NDEP or 1-888-693-6337.

[Dan Rutz] And the operative word here is free, isn’t it?

[Sabrina Harper] Yes it is. All NDEP materials are free either by download, by filling out our publications catalog fax sheet, or by going on our Web site.

[Dan Rutz] Ladies, you have taught us a lot today about diabetes prevention. What else can you tell us in closing?

[Sabrina Harper] If you have a family history of diabetes, and most minorities do, diabetes does not have to be your destiny. Diabetes can be prevented or at least delayed. You need to take your health seriously and find out more information about diabetes prevention. For more information, once again, visit www.YourDiabetesInfo.org or call 1-888-693-6337.

[Magon Saunders] Dan, I wanted to just add some passing comments for the audience. One of my mantra actually is I call it from Abraham Lincoln and it says, “Good things come to those who wait but only what’s left behind by those who hustle.” I’ve added my own piece to that, and I said lets hustle to stop diabetes. It’s important that this message gets out to all African-Americans out there. If you are like my friend who never had health insurance or you have that risk for diabetes, take action now. Start increasing your physical activity. Remember, it doesn’t mean you have to be in the gym. You can start vacuuming and dancing, walking and exercising in between commercials, but do something. Also start making healthier food choices. Fruits and vegetables, making sure you’re increasing your grains, and of course, losing that weight if you are overweight will really help you to hustle and not have diabetes get you. Blessings.

[Dan Rutz] Good advice for everyone, whether thy are concerned about diabetes or not, I would say, and with that encouraging word I will thank both our guests, Sabrina Harper, Acting Director of the National Diabetes Education Program, and Magon Saunders, Public Health Advisor here at CDC. Thank you both for joining us. I’m Dan Rutz.

For the most accurate health information, visit www.cdc.gov or call 1-800-CDC-INFO, 24/7.