Dozens of people showed up at the doors of Community Services Agency on Tuesday, some arriving an hour early, to get screened for diabetes. It may not sound like an occasion to get excited about, but needy residents of Mountain View appeared eager to take advantage of a new program that takes on diabetes and fights the root causes of the disease.
The program, called Challenge Diabetes, is a four month-long pilot program where people, free of charge, can come in and get their blood sugar tested for diabetes and pre-diabetes. While at CSA, they can pick bags of food, recipes and information on how to stave off the disease. The program is a partnership between El Camino Hospital, Community Services Agency (CSA), Sunnyvale Community Services, West Valley Community Services and Second Harvest Food Bank.
When participants made it past the bustling line outside the door at CSA this week, they were greeted with an extensive screening process including checklists on risk factors, surveys and blood tests. The table in the front included a 3D diorama of all the parts of the body affected by diabetes -- the brain, the kidneys, the feet -- and a pile of fake body fat to give people a visual idea of what can cause diabetes.
Diabetes affects about 29 million Americans, of which 8.1 million of the cases go undiagnosed, according to a report by the Center for Disease Control. The rate of diabetes in the United States has been steadily increasing since 1980, and if left untreated, the disease can cause grave complications, including blindness, heart disease, kidney failure and death.
Because catching the symptoms and risk factors early is key to managing diabetes, CSA has been reaching out to its clients to get people screened. Between the five agencies, hundreds of people have shown up to see if they're at risk. But for Maureen Wadiak, program director for CSA, the prevalence of diabetes isn't just some meta, country-wide statistic.
"We've seen it in our food and nutrition center throughout the years," Wadiak said.
The program is funded by El Camino Hospital as a community-run way of bringing down the "looming health care issue" of diabetes, according to Cecile Currier, vice president of community health services at El Camino Hospital. Currier said the incidents of diabetes and pre-diabetes are very high, particularly in Latino communities, where the rate of diabetes is twice that of Caucasians. Working with CSA, which helps clients every day with food services and referrals to clinics, was just the right fit for the outreach program.
"We wanted to work with a group of community organizations that work with food and serve a cross-section of the community, and reach out to people that may not know they have pre-diabetes and may not know what to do about it," Currier said.
Prediabetes is when a patient's blood sugar is too high, but not high enough to be diagnosed with Type 2 diabetes, according to the Center for Disease Control, and the prevalence is staggering -- about 86 million Americans have it, but only 1 in 10 know about it. Wadiak said of the people that come in to CSA for the screening, nearly all of them have either diabetes or prediabetes.
Challenge Diabetes is a structured, months-long program that kicks off with a prediabetes test, developed by the Center for Disease Control, where patients answer questions to see just how at-risk they are. If they score high enough, they go on to the A1C or "finger prick" test, where a small sample of blood is used to monitor a person's blood sugar level. Major risk factors include high body weight and lack of exercise, but just being over the age of 65 gives people enough points to immediately move on to the A1C test.
Program attendees also fill out a survey with questions about their level of food insecurity and knowledge about diabetes, as well as whether they might be depressed.
"Some of the research has shown that there's a correlation -- that people who have food insecurity and diabetes have higher rates of depression," Wadiak said.
Diabetes can be linked to food insecurity and the availability of healthy food, Wadiak said, which is a problem for people whose budgets have been squeezed by the high cost of living in the area. She said the program is mostly tailored for CSA clients who rely on food pantry services to stretch their budgets, but it also targets low-income families and seniors.
"Diabetes is fast-becoming an epidemic of the poor," she said.
While the program includes testing and monitoring of blood glucose across several months, the real focus is on diet and education. Each month, program participants come back for a big bag of food, recipes and information on how to eat healthily, which is a natural fit for a place with pantry services. Wadiak said CSA has a nutrition education program to try to get people to eat food they might not know how to cook, like squash. The recipes also consider recipes that are culturally relevant to people using different ingredients.
"If white rice is a staple in their diet, we introduce brown rice and then provide recipes that people will use," Wadiak said.
The program also includes information on "portion control" of meals. Because body weight and daily caloric intake plays a big role in diabetes, she said, it's not just about what people cook, but how much of it they eat. During one nutrition program, CSA had nurses come in to show how half a sandwich with a salad instead of a full sandwich with a cookie can make all the difference in the world.
Currier said the turnout for screenings has been good so far, but the real challenge is keeping people engaged. She said with any program that calls for a change in lifestyle, it has to include a place -- like CSA -- where people visit frequently and identify with others who are trying to adopt new eating and exercise habits.
"It's really important to have that connect point," Currier said.
To get feedback from the participants and make sure they are adhering to the program, Challenge Diabetes program coordinator Vanesa Ieraci has been establishing relationships and following up with people who got food bags to get a sense of how well the dietary program is working, whether people are heeding the advice and suggestions, and to figure out how to adjust the program to better work for them.
While the El Camino Healthcare District is helping to fund the program, Wadiak said, it is also helping to translate all the educational material and information into different languages, including Spanish, Russian, Chinese, Vietnamese and possibly Korean. Translators from both El Camino Hospital and CSA were at the screening Tuesday, squeezed into the front room with the rest of the participants, and were in high demand as people speaking Mandarin, Spanish and Russian made their way in.
"We need a translator for Chinese!" yelled Todd Trowbridge, director of preventative medicine at BaySport. Trowbridge was one of two people from the Los Gatos-based health company doing the A1C blood tests for patients, and needed to use a translator to explain to many of the CSA clients what was going on.
Wadiak said being able to communicate that information in the language people are most comfortable with is an important tool for outreach and helps keep people engaged in the program.
"El Camino has been awesome in helping us with language translation, and that's key -- letting people understand the information in their own language and read the steps they can take and feel empowered," Wadiak said.