Angie Fagerlin and Robin Marcus: Making headway toward driving out diabetes

(Courtesy photo) University of Utah Health Wellness Bus

Diabetes is one of the leading causes of death and disability in the United States, posing a national health crisis. Here in Utah, more than 200,000 people have diabetes and another 600,000 have pre-diabetes — meaning they may be on the path to developing diabetes. Sadly, of those with pre-diabetes, 90 percent don’t know they have it. One of the keys in dealing with the diabetes crisis is early diagnosis and education. The good news is we have begun to take steps in this direction.

Take the example of 45-year-old Angelo Restrepo. On his way to work every morning in Midvale, he drives by a parked bus imprinted with the words “The Wellness Bus.” Driving by in July, Restrepo was hit with a headache. He had noticed the same sort of sharp pain before, always following overeating. He pulled his car to the side of the road and looked at the bus more closely. He read the words: “Screenings for Blood Pressure, Blood Glucose, and Cholesterol.”

“l decided to get on the bus,” Restrepo says, “hoping to find out why I was feeling so lousy.”

That was the first day of better health for Angelo Restrepo.

Carmen Ramos, registered dietitian and health coach at University of Utah Health, greeted Restrepo. After testing his blood glucose level, she told him his blood sugar was at a level high enough to trigger a headache and within a range that indicated he was likely living with type 2 diabetes. Ramos outlined a nutrition and exercise plan and told Angelo to test his blood sugar at least twice a day. She recommended he visit his physician for advice on medications that might lower his blood glucose and asked him to come back to The Wellness Bus once a month.

On that first visit in July, Angelo weighed 320 pounds. Last week, his weight had dropped to 293. His blood pressure decreased from 160/86 to 118/72. His A1c number, which provides an average three-month summary of blood glucose level, has decreased from 6.7% to 5.7%.

The Wellness Bus is just one part of Driving Out Diabetes (DODi), a Larry H. Miller Family Wellness Initiative. The program began two years ago, when the Larry H. and Gail Miller Family Foundation partnered with University of Utah Health to confront diabetes through screening, education and coaching people in communities at high risk for developing diabetes.

By reaching people where they live, work, pray and play, DODi delivers vital prevention services to those who need it most. DODi also supports innovation in clinical care and cutting-edge research.

But for every person like Angelo Restrepo who has adapted to a healthier lifestyle, tens of thousands of people in Utah still need access to what he has received: health screenings, education and coaching to prevent or treat diabetes.

Since DODi started, we’ve screened more than 3,200 people on The Wellness Bus, which is stationed every week at four locations in Salt Lake County — all in communities where residents are at a high risk for diabetes. In clinic, we’ve coached over 1,000 people on improving their diet, losing weight and lowering blood-sugar levels.

DODi started programs that have reached more than 30,000 middle and high school students to deliver messages on lifestyle changes that can prevent diabetes. We’ve taught hundreds at homeless or transitional housing facilities how to eat healthy on a limited budget.

We’re off to a good start, but much more needs to be done. Utah is growing rapidly. It’s also getting older and more racially diverse. While we embrace this diversity, we must be prepared to meet specific health needs. Diabetes risk increases with age and is higher among Latinos, African Americans, Pacific Islanders, American Indians, and Asians. As our population grows, reducing the burden of diabetes statewide will become more and more difficult—now is the time to act to protect the ones we love.

November is Diabetes Awareness Month, a perfect time to bring more attention to the diabetes epidemic with more volunteers spreading the word. According to Angelo Restrepo, DODi provided a wake-up call.

“Stepping on the Wellness Bus was what I needed to move my life in a new direction,” he says. “If not for Carmen and others, I wouldn’t have started.”

After Christmas, he plans to start volunteering at the bus to inspire others who might stop by.

“I just need to find some hours when I’m not working out at the gym.”

Angie Fagerlin, Ph.D.

Robin Marcus, Ph.D. PT

Angie Fagerlin, Ph.D., is director of DODi and professor and chair of Population Health Sciences at University of Utah Health. Robin Marcus, Ph.D. PT, is on the leadership team of DODi, chief wellness officer at University of Utah Health and professor of physical therapy and athletic training.