Eisenhower Diabetes Education Services

From left: Melina Hurtado,BSN, RN, CDE; Emily Groves-Nemati, MSN, RN, PHN and Marielena Cid, MSN, RN, CDE, PHN
The numbers are staggering. An estimated 30.3 million Americans, or 9.4 percent of the population, have diabetes. Of these, 7.2 million don’t even know they have this condition (see sidebar for an explanation of the different types of diabetes).

Bringing it closer to home, consider this: more than 10 percent of adults in the Coachella Valley have diabetes — one of the highest prevalence rates in the entire state. What’s more, according to the U.S. Centers for Disease Control and Prevention (CDC), around 25 percent of people 65 and older have diabetes — a statistic that has serious implications here in the desert, given the large population of retirees.

These numbers add up to a daunting public health issue — one that Eisenhower Health is helping to combat through its Diabetes Education Services. To help people with diabetes take control of their condition, a team of three highly trained registered nurses and two registered dietitians who specialize in diabetes education provides a comprehensive array of resources, including:

• One-on-one education about diabetes self-management (the first such program in the desert to earn American Diabetes Association recognition)

• Group educational classes

• Instruction on insulin pump therapy

• Instruction on continuous glucose monitoring,

• Training on insulin injection and using manual blood glucose monitors

• Medical nutrition therapy with a registered dietitian

• Free community-based classes for people (including Spanish language groups) with diabetes and prediabetes

• A support group for people with Type 1 diabetes

“When you have diabetes, keeping your blood sugar levels within a normal range is vital in order to reduce the risk of developing complications,” explains Marielena Cid, MSN, RN, CDE, PHN, Diabetes Education Services Manager. These complications — some life-threatening — can include heart disease and stroke, nerve damage, kidney damage that can result in kidney failure, eye damage leading to poor vision or blindness, skin problems and poor wound healing that can result in limb amputation.

“Achieving tight blood glucose control requires a careful balance of diet, exercise, medication — including taking insulin when your body can’t process or produce its own — and regularly monitoring your blood sugar levels,” she continues. “It’s a lot to learn all at once, so we provide resources to help people gain the skills and confidence they need to take care of themselves — because diabetes self-management is the key to good outcomes.

“Through careful self-management, people with diabetes can improve their quality of life and prevent or delay complications,” she stresses.

A program to prevent diabetes in the first place

Another important service that Cid and her team of certified lifestyle coaches offer is a Diabetes Prevention Program. It’s designed for people with prediabetes, defined as having a fasting blood sugar level of between 100 and 125 (under 100 is considered normal; 126 or higher fasting on two different tests is considered Type 2 diabetes).

But there are other numbers associated with this condition that underscore why a prevention program is so critical. Today, an estimated 86 million American adults have prediabetes, which can lead to full-blown Type 2 diabetes if they don’t make healthy lifestyle changes. Equally alarming is the fact that nine out of 10 people prediabetes don’t know they have the condition because there are no symptoms.

Developed by the CDC, the Diabetes Prevention Program is a 12-month weight-loss and lifestyle-change program for those with prediabetes (or a history of gestational diabetes) who have a body mass index (BMI) of more than 25 and a fasting glucose of 100 to 125 (or an A1C between 5.7 and 6.4; this is an average of your blood sugar level over the past three months). Eisenhower is the only facility in the desert to offer this program.

Most importantly, it works. The program has been shown to reduce the risk of developing Type 2 diabetes by up to 58 percent in all adults, and by up to 71 percent in adults over age 65. “It’s so much easier to prevent a health problem like diabetes than to treat it once it starts,” says Emily Groves-Nemati, MSN, RN, PHN.

“This program provides education, motivation and support in a non-judgmental, collaborative way,” adds Melina Hurtado, BSN, RN, CDE.

It’s also important to know that most of Eisenhower’s Diabetes Education Services are covered by insurance, including Medicare.

For more information about diabetes education services, please call 760.773.1403. If you are specifically interested in the Diabetes Prevention Program, please email Marielena Cid at mcid@eisenhowerhealth.org.

To learn more about Eisenhower’s Diabetes Education Services Program and its classes and education, visit EisenhowerHealth.org/Diabetes or call 760.773.1403. To find a primary care physician, call 760.568.1234.

Diabetes Symptoms

While these are the most common symptoms of diabetes, some people with this condition have symptoms so mild they go unnoticed. That’s why it’s important to have your blood glucose levels checked regularly by your health care provider.

  • Frequent urination
  • Excessive thirst and hunger
  • Feeling hungry even though you are eating
  • Extreme fatigue •Blurry vision
  • Cuts or bruises that are slow to heal
  • Unexplained weight loss or gain
  • Tingling, pain or numbness in the hands and feet
  • Irritability
  • Nausea
  • Breath that smells fruity or sweet, or that has an acetone odor

The Categories of Diabetes

diabetes is a group of diseases in which the body doesn’t produce enough (or any) of the hormone insulin (which regulates blood sugar levels) or doesn’t properly use the insulin that it does produce. When this occurs, the body is unable to get the sugar (glucose) it needs for energy from the blood into the cells, which leads to high blood sugar levels — and a range of health problems.

Today, doctors have four categories of diabetes:

  • Category 1: autoimmune diabetes, such as T1dM (Type 1 diabetes mellitus) or lada: in this autoimmune form of diabetes, the beta cells of the pancreas (which produce insulin) are mistakenly attacked and destroyed by the immune system
  • Category 2: insulin resistance with insulin deficiency, such as T2dM: the most common form of diabetes, accounting for 90 to 95 percent of all cases; it occurs when the body’s cells stop responding to insulin, or the beta cells can’t produce enough of the hormone
  • Category 3: gestational diabetes: a type of diabetes that occurs during pregnancy
  • Category 4: everything else. includes pancreatic dM, medication-induced dM, post-transplant dM, HiV-induced dM, genetic dM syndromes, etc. Many different types of dM fall under category 4. They are usually labeled as Other types of dM