Sonoma County residents at high risk for diabetes

A recent study that shows a majority of Sonoma County residents are on a path to become diabetics has local health officials and health care providers sounding alarms and calling for more interventions to address the growing diabetes epidemic.

According to a study by the UCLA Center for Health Policy Research, 49 percent of Sonoma County residents are prediabetic  - a precursor to type 2 diabetes - and 10 percent are diabetic. That’s 59 percent of the county’s adult population, compared to 55 percent for the rest of the state.

“It’s very concerning because it has enormous potential health impacts,” Sonoma County Health Officer Karen Milman said.

Milman pointed out that 30 percent of local residents who are prediabetic will have “full diabetes” within five years.

“The thing that is most important is that this is preventable. ... We have a chance to intervene and prevent this from becoming a bigger problem,” Milman said.

The study, which was commissioned by the California Center for Public Health Advocacy, provides the state’s first prediabetes rates by county, age and ethnicity. The study analyzed hemoglobin A1c and fasting plasma glucose findings from the National Health and Nutrition Examination Survey, as well as data from the California Health Interview Survey.

Milman said unless more is done to prevent the disease, the study is a window into the future of the epidemic in the county, state and across the country. She said the number of people who are becoming prediabetic in Sonoma County is likely increasing, given the documented rise in rates of obesity and diabetes.

Local health experts said reducing rates of prediabetes requires helping people improve their nutrition and ensuring that they have more physical activity.

Melanie Larson, a certified diabetes educator who is manager of outpatient nutrition services for Kaiser Permanente’s Santa Rosa Medical Center, said the study’s findings reflect a trend she sees every day.

“I’m just glad that it’s finally being publicly acknowledged,” Larson said.

At Kaiser, patients who are found to be prediabetic are assigned a clinical health educator and enrolled into a prediabetes class.

Larson, a registered dietitian, said poor diet coupled with obesity often leads to insulin resistance, which inhibits glucose from entering the body’s cells for energy. As a result, glucose accumulates in the bloodstream causing damage to tissues and organs, she said.

When someone is prediabetic, insulin resistance begins to increase.

“Research has shown us that regular activity and a 5 to 7 percent decrease in body weight can significantly improve your blood-glucose levels,” Larson said. “That’s not as much weight as people think.”

Larson said that simply changing your diet will not reduce insulin resistance. Exercise and some weight loss has to be part of the mix.

“Until the insulin resistance has improved, it’s difficult for diet alone to make an impact,” she said.

At the Santa Rosa YMCA, a yearlong diabetes prevention program offers participants more than a dozen sessions aimed at reducing weight, improving nutrition and increasing physical activity. The program, which uses curriculum approved by the Centers for Disease Control and Prevention, is geared toward adults who have a body-mass index of 25 or greater and who have a prediabetes diagnosis, said Nicole Martinovich, the local YMCA’s diabetes prevention program coordinator.

“The goal of the program is to prevent or delay the onset of type 2 diabetes,” Martinovich said. “Participants lose 7 percent of their body weight and increase physical activity to 150 minutes a week.”

Such activities include brisk walking, bike riding, exercise classes, aqua-aerobics classes, cardiovascular machines, treadmills, ellipticals and stationary bikes. Program participants get a notebook with worksheets they use for each session. They also get a food journal to track their food consumption and physical activity.

“Some of the topics we cover include healthy eating, problem solving, managing stress and ways to stay motivated,” Martinovich said, adding that the program is led by a trained lifestyle coach.

As part of a broader effort to combat diabetes in the county, last year Kaiser Permanente awarded a $1 million grant to the Sonoma County HEAL program, which funds a variety of nutrition and exercise programs in south Santa Rosa. HEAL, which stands for Healthy Eating and Active Living, encourages Roseland and Kawana Springs residents to eat healthier foods and become more physically active from infancy through adulthood. The goal is to prevent obesity-related diseases such as diabetes and hypertension.

The initiative is a project of the Community Activity and Nutrition Coalition of Sonoma County and is funded by Kaiser.

The grant is being used to fund a number of initiatives, including creating greater access between the Roseland Village shopping site and the Joe Rodota Trail; bolstering school wellness programs; reducing sugary drink consumption and installing water stations in Roseland schools and the surrounding neighborhood; and creating more access to healthier food at Roseland retail outlets.

Milman said such efforts are crucial for changing the eating and activity habits of a community.

“There are programs going on across Sonoma County, the state and the country helping to educate people and creating environments that are conducive to having this healthier lifestyle,” Milman said.

The study found that the rates of prediabetes for young Latinos and Native Americans in California between the ages of 18 and 39 were higher than that of whites or the overall state population. For Latinos, 36 percent were prediabetic, while 38 percent of Native Americans were prediabetic. Among whites, 29 percent were prediabetic, compared to the overall state average of 33 percent.

Milman said the county public health department has been working with schools to offer healthier lunch options and to promote the Safe Routes to Schools program that encourages kids to walk to school. For adults, the county’s Healthy Retail Project seeks to improve the variety and quality of fresh produce while reducing unhealthy product promotion.

Model markets, she said, include Super Latino Market and Camacho’s Market in Roseland and Casa del Mole in Healdsburg.

“It’s proven successful in terms of what people are purchasing,” she said. “They’re selecting healthier items, and the stores are actually making money off of it. It’s about placement advertisement and pricing.”

Raquel Campos, owner of Super Latino Market, said she believes diabetes rates are on the rise partly because people are cooking less with fresh ingredients and eating more processed foods, or simply eating out altogether.

“Diabetes is taking over a lot of people’s lives,” Campos said. “A lot of people don’t cook anymore like they used to. ... Now, both parents have to work. Sometimes when you get home, you make whatever’s easier. Everything now is more processed, even the dairy. I don’t know if the kids are into fruit and different salads. It’s more like let’s just get a burger or chicken tender.”

But Campos said she has noticed that people do respond to food placement.

“If I put cases of water in front of our counter, nuts and fruits, people will pick it up,” she said.

For more information about the?YMCA’s diabetes prevention program, visit scfymca.org/main/diabetes-prevention-program.