Can Education and Awareness Prevent Diabetes?

Linda Siminerio, R.N., Ph.D., a professor of medicine at the University of Pittsburgh, has been named the new chair of the NDEP.

The NDEP is a joint program of the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC).

More than 29 million Americans, or about 9 percent of the U.S. population, have diabetes. Another 86 million have prediabetes, a condition that places them at increased risk for developing type 2 diabetes.

Since 1997, the NDEP has developed public and private partnerships to improve diabetes management, promote early diagnosis, and help people prevent or delay the onset of type 2 diabetes.

Healthline sat down with Siminerio to find out how she plans to help NDEP meet its challenges over the next two years.  

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What do you hope to accomplish in your new role?

Siminerio: What we want to do most is develop our partnerships with health systems and organizations. How do they work? What can we learn from them? How do we enhance those partnerships with organizations that may not be strong? How do we communicate all of the great resources the NIH, CDC, and NDEP have available for our diabetes community?

What do you think are the most important approaches to preventing or delaying diabetes?

Linda Siminerio

Siminerio: One of the areas that requires a lot of attention is helping people with behavior change strategies. Diabetes, in many cases, is a lifestyle disease. Whether you have it, or are trying to prevent it, it often takes a shift in the way you think about how you eat and your activity. It also expands into your community. What kinds of things are happening in your neighborhood? There’s a lot of exploring we need to do.

We also need to push out some of the programs that we know have been effective in promoting good healthy living through lifestyle interventions. The National Diabetes Prevention Program has been effective. How do we reach more people in different communities with those approaches?

The NDEP wants to reach out to underserved groups, according to a press statement. Who are these populations?

Siminerio: Diabetes has been a very difficult challenge for some of our ethnic populations. African Americans and Latinos are growing populations in our country. They are at higher risk for diabetes and its complications. Native Americans are also at risk. Many of these groups are socioeconomically disadvantaged. People in poor rural communities are also hit hard by diabetes. We need to think about those communities and how we can best help them.

What can help these underserved populations overcome the healthcare barriers they face?

Siminerio: We need to educate folks about what foods to buy. We need to find out how we make these things available to them. I went to a store in rural Pennsylvania. There weren’t many fresh fruits and vegetables, and the prices were higher for the items I saw. That deters people, especially when you are on a limited income. It will take a lot of partnerships and policy to make things more available and to make information about these services available to different communities.

Diabetes in many cases is a lifestyle disease. Whether you have it or are trying to prevent it, it often takes a shift in the way you think about how you eat, your activity, and what kinds of things are happening in your neighborhood.
Linda Siminerio, chair of the National Diabetes Education Program

What kinds of programs are currently available to help these underserved populations?

Siminerio: In Latino communities there have been some very effective peer support programs. People can learn about healthy living from their healthcare workers. There’s a great program that we tested in Pittsburgh called New Beginnings. This program was developed through NDEP for African American communities, and it specifically targeted foods they appreciate and enjoy.

What is the key to diabetes prevention and treatment?

Siminerio: Diabetes is 24/7. Self-management, education, and self-management support are the bedrocks of good diabetes care. Information is available on websites, such as the American Diabetes Association. There are resources such as diabetes educators, nurses, dieticians, parish nurses, and community health workers. Community pharmacists can help explain what your medication means, or review how to use your blood glucose meter. We've got to pull in everybody. 

blood sugar test

What do you see as the biggest challenge going forward?

Siminerio: One of my big concerns is how diabetes is affecting groups of people we never saw diabetes in before. When I was in practice in just pediatrics, we never ever saw a child come in with type 2 diabetes. Now, that’s not unusual.

Many children are overweight and some are obese. That puts them at higher risk for adult disease. If you get an adult disease when you’re 12-years-old, what is the landscape going to be when you are taking care of young people in their 20s and 30s when they’ve had diabetes already for many years?

What role can healthy school lunches play?

Siminerio: We have to make healthy foods available to children. There are things kids should be exposed to through their families, so that seeing carrots and fresh vegetables for lunch and fruits is appealing to children. The school is an incredibly important forum to promote healthy living. [But] it can’t all be done in the school. It takes a village.