A Lowcountry initiative's multi-pronged assault on diabetes - in libraries,
doctor's offices and churches - has improved the health of thousands of local
blacks dealing with the disease over the past six years.
Now those slow but significant gains in South Carolina's fight against the
deadly blood sugar disease are gaining national attention.
Racial and Ethnic Approaches to Community Health (REACH) 2010's Charleston
and Georgetown Diabetes Coalition, a venture spearheaded by the Medical
University of South Carolina's College of Nursing, recently earned two national
awards. Although South Carolina has one of the highest rates of diabetes in the
nation - more than 270,000 people have the disease - REACH 2010's work is being
recognized as a model for other states.
The Community-Campus Partnerships for Health annual award, which honors the
nation's best collaborations between educational institutions and community
groups, cited the local program for its unique efforts and its research showing
health improvements among participants.
REACH 2010's Library Partnership, which provides online training to help
patients better manage their care, was also selected as the winner of the 2006
Health Information Award for Libraries from the nation's top library and
information science commission.
Among the REACH program's achievements:
--Slashing the rate of diabetic amputations in the Charleston area by 50
percent.
--Getting patients to the doctor more often and ensuring they receive the
proper testing, for diabetes-related vision problems, cholesterol control and
hemoglobin A1c, which measures blood-sugar levels over time.
--Teaching Internet skills to help patients plan healthy meals, for instance,
or understand their medications.
--Linking more patients with assistance programs to pay for their glucose
testing strips, which can cost as much as $35 a week.
Despite the progress, leaders say the coalition's work is a long-term
investment that will expand in years to come.
"We really have just begun to make a difference in diabetes, so we cannot sit
back and say, 'Yeah, we've made a difference,' " said REACH principal
investigator Dr. Carolyn Jenkins, an MUSC nursing professor. "The health care
disparities that we see are still tremendous. The message is, 'Let's all join
arms and work to make a difference.' "
Education has been the biggest thrust of the program, after early surveys
showing dangerous misunderstandings about diabetes care.
"We learned a lot that people were receiving medication and not reading the
instructions," said Pastor Carl Grant of Greater St. Peters Church of Our Lord
Jesus Christ, in West Ashley, which along with more than a dozen other community
organizations is a REACH 2010 partner. "We discovered people who were taking the
morning medication at night and the night medication in the morning."
Small, personalized efforts have led to big improvements. By guiding people
to Web sites that clearly explain the medications they're taking, treatment
compliance has increased. And teaching patients how to check their feet for
wounds has been key to staving off amputations. Because of the circulation
problems associated with diabetes, the tiniest blisters or cuts can lead to
limb-threatening infections.
Joyce Linnen, the REACH program director for Nazareth AME Church in
Georgetown, recalls a woman who was shocked during training to learn that she
should avoid open-toed shoes and colorful socks.
"A lot of people look at having diabetes like the world has come to an end,"
Linnen said. "But now they see we can control this; we've just got to do the
right thing."
When the coalition began its work in 2000, researchers learned that although
most people saw a doctor four or more times a year - and many even had insurance
- they weren't getting the proper tests during their visit, Jenkins said. The
hemoglobin A1c test, for instance, is a crucial indicator of how well a
patient's blood sugar is being controlled and how to tweak his treatment
plan.
Now, after patient and provider education initiatives, 96 percent of program
participants are getting the test.
The library program, which garnered $20,000 to continue its efforts along
with its award from the U.S. National Commission on Libraries and Information
Sciences, is expected to pay big dividends when it comes to patient
empowerment.
Some people who have received REACH 2010 Internet training had previous
experience with computers and the Web, but librarians found that they weren't
particularly savvy about how they searched for information. When faced with a
health question, most participants headed to a search engine, which tend to
return sites based on popularity rather than substance.
"It isn't a matter of quality that rises for health in those instances, and
it may very well be some misinformation," said Barbara Carlson, a REACH
librarian. "We really wanted to steer people toward real, quality
resources."
Some of the coalition's work ripples to other health care issues in the
community, too. Dorothy and Melvin Carter got Internet training through the
REACH program at Greater St. Peters Church even though neither of them has
diabetes.
From browsing MedlinePlus, the U.S. National Library of Medicine's exhaustive
Web site, the couple learned lots of new information about their health
troubles, from lifestyle changes that might help Melvin beat his prostate cancer
to the possible side effects from Dorothy's glaucoma medication.
Now, they're both prepared to ask extra questions during doctor's visits.
"I never realized how much information is out there," Dorothy Carter said.
"It's kind of frightening, but it's exciting all at the same time."
Reach Holly Auer at 937-5560 or hauer@postandcourier.com.
