Ending Type 2 Diabetes One Exercise, Nutrition, and Gardening Class at a Time

Posts Tagged ‘Diabetes mellitus’

Diabetes Prevention Program Nutrition Classes & Cooking Demonstrations

In Nutrition Class on February 17, 2012 at 5:56 PM

Since 2007, the Fair Haven Community Health Center’s Diabetes Prevention Program (FHCHC DPP) has offered 1-hour nutrition classes once per week for participants in the 12-week Intensive Lifestyle Intervention. The nutrition curriculum is based on the National Institutes of Health’s Diabetes Prevention Program curriculum, amended by the University of Pittsburgh to fit larger groups, and further translated to fit FHCHC’s particular low literate and predominantly Latino population. Classes are taught by FHCHC DPP clinicians, and are delivered in both English and Spanish. Bilingual PowerPoint presentations and handouts support participants in understanding the content of each session, while detailed facilitator scripts and facilitator guides support facilitators in addressing the widely diverse needs and experiences of participants. Cooking demonstrations and discussions are an experiential learning component of each class, and foods prepared each week reflect the ripe produce harvested that week from the program’s garden. Between 10-20 adults attend classes on a weekly basis, and often that same group stays the next hour for a professional trainer-led exercise class. Children attend their own exercise classes during the adult nutrition and exercise classes, while infants and toddlers attend onsite childcare. Aligned with the notion that diabetes is a family-oriented disease, when one patient is invited to attend nutrition classes, DPP staff invites members of the patient’s family to attend as well.

OGTT Sketch

In OGTT Screening on February 10, 2012 at 11:18 AM

Some drink the Glucola solemnly, obediently. It’s unclear whether they know the full extent to which we are testing their health status this morning. Others seem somewhat nervous, and still others chat away cheerfully until their name is called for the needle and flat orange sugar drink event.

The kids are restless, sucking on the backs of chairs as they watch the phlebotomy, or any sign of movement in the room.

The best is the tough guy with the mohawk. His name is called and he stays sitting, in a sheepish stand-off with the clinician’s assistant. And then, as he eventually pulls his tee shirt up over his tattooed forearm, he describes how much he hates needles.

Amazing how for style or nostalgia, an inked needle is welcome! And for an oral glucose tolerance test, it is so thoroughly resisted.

And yet resistant or not, bored or cheerful, nervous or curious, the 21 adults and their families present today will leave here with knowledge of diabetes, their risk, and some implementable-tools for improving the quality of their health. Cheers to them!

Tatoo!

OGTT!

Diabetes Prevention Program Participants Featured in Opening of Fair Haven Farmers Market

In About the Program on July 8, 2011 at 5:42 PM

Yesterday, two families from the Fair Haven Community Health Center performed a cooking demo at the opening day of the Fair Haven Farmers Market. This market, run by local nonprofit City Seed, is an effort to bring fresh fruits and vegetables to some of the lower income New Haven neighborhoods. Those neighborhoods, like Fair Haven, suffer high incidences of chronic disease, and disease related to nutrition. It was fitting, therefore, that City Seed asked wether some of the families participating in the Fair Haven Community Health Center’s Diabetes Prevention Program could share with market shoppers some of the things they are learning in their nutrition and gardening classes. The families chose two recipes they learned in class that used in-season vegetables: yogurt and mint dip, and a tomato and basil salad. Both were a big hit, especially with the daughters of the DPP participants serving and promoting the nutrient-dense foods.

Here are the recipes (thanks to Alex Grizas, our demo cook extraordinairre), which were also provided in English and Spanish to market shoppers:

Tomato, Orange, Basil Salad

Time to Prepare: 10 minutes                                    Serves: 4 as a side salad                                         Cost: $3.00 total

 

Fresh, ripe tomatoes bursting with both color and favor are one of the best treats of the summer. This Spanish salad can be eaten at breakfast, lunch, dinner, or as a snack.  Enjoy it alone or even better with fish or chicken.  For variety, you can add other fresh herbs, spinach, or other greens.

 

Salad:

2 tomatoes

1 orange

¼ cup basil leaves

2 Tsp Olive Oil

¼ Tsp Salt

⅛ Tsp Pepper

 

  1. Chop the tomato into bite sized pieces and place in a bowl.
  2. Peel the orange and cut into bite sized pieces, adding it to the tomatoes with the juices from the orange.
  3. Add the salt, pepper, and olive oil, and toss to coat well.
  4. Stack the basil leaves on top of each other.  Roll them up from bottom to the top.  Cut into thin slices along the length of the roll, creating ribbons of basil (this technique is called chiffonade (French term)).
  5. Stir the salad and chill in the refrigerator until serving, about 10 minutes ideally.

 

Nutrition Facts

Serving Size

1 serving (100.9 g)

 
Amount Per Serving
Calories 49                                          Calories from Fat 22

% Daily Value*

Total Fat 2.5g                                                                4%
Saturated Fat 0.4g                                                         2%
Cholesterol 0mg                                                           0%
Sodium 123mg                                                               5%
Total Carbohydrates 6.9g                                          2%
Dietary Fiber 1.6g                                                          6%
Sugars 4.6g
Protein 0.9g

Vitamin A 14%

Vitamin C 48%

Calcium 2%

Iron 2%

* Based on a 2000 calorie diet

 

 

Ensalada Con Tomates, Naranja, y Albahaca

Tiempo de preparar: 10 minutos                             Porciones: 4                                       Costo: $3.00 total

 

Ensalada:

2 tomates

1 naranja

¼ tazo hojas de albahaca

2 cdta aceite de oliva “extra virgin”

¼ cdta sal “kosher”

⅛ cdta pimienta negra

 

  1. Pique los tomates en pedacitos medianos and ponga en un tazón.
  2. Pele la naranja y pique en pedcitos medianos.  Ponga la naranja y sus jugos en el tazón con los tomatoes cortados.
  3. Adicione el sal, la pimienta negra, y el aceite, y mézclelo bien.
  4. Amontone las hojas de albahaca, arrolle las hojas del fondo a la cima, y cortelas en rajas delgadas.  Este técnica se llama “chiffonade” en francés.
  5. Mézcle la ensalada y mantengala en el refrigerador hasta que vaya a servirla, acerca de 10 minutos idealmente.

 

 

Información Nutricional

Tamaño de la Porción

1 porción  (100.9 g)

 
Cantidad por porción
Calorías 49                                         Calorías de grasa 22

% Daily Value*

Grasa total 2.5g                                                            4%
Grasa saturada  0.4g                                                     2%
Colesterol 0mg                                                              0%
Sodio 123mg                                                                   5%
Total de carbohidratos 6.9g                                     2%
Fibra dietética 1.6g                                                        6%
Azucares 4.6g
Proteínas 0.9g

Vitamina A 14%

Vitamina C 48%

Calcio 2%

Hierro 2%

* Basados en una dieta de 2,000 calorías

 

 

Homemade Plain Yogurt

Time to Cook: 3 hours                             Serves: many as a topping or snack                                                            Cost: $2.00 total

 

In Middle Eastern countries like Turkey, Syria, and Lebanon, plain yogurt is a delicious part of many dishes, including both meats and vegetables.  It is a thicker type of yogurt than what we usually see in the United States, and because it is so thick, it can be mixed with many different things to make sauces, dips, and dishes, both hot and cold.  One of the great benefits of eating yogurt is digestive health, as yogurt contains good bacteria to help process the foods we eat so we can get the most nutritional benefit from all of our healthy eating choices.  This week we will sample plain yogurt, as well as a cold cucumber dip, to be eaten with any of your vegetable fresh vegetables.  Remember, the vegetables should be the bulk of what we eat, with just a little cucumber dip to taste with each bite.

 

Yogurt:

1 gallon whole milk

1 Tbsp plain yogurt

 

  1. Boil 1 gallon of milk in a large pot until there is a film on the top in a large pot.  Take the pot off the heat and cool until the milk is warm (not too hot and not too cold).
  2. Put 1 tablespoon plain yogurt in the warm milk and stir until completely mixed in.
  3. Place a lid on the pot, wrap the whole pot in a towel or blanket, put a plastic bag (or trash bag) around the wrapped pot, and wrap another towel or blanket around plastic bag containing the wrapped pot.  Let this sit out for 2 hours.
  4. After two hours, remove the outer towel, plastic bag, inner towel, and lid from the pot.  Place the pot in the refrigerator until the yogurt is cold and thick; then it is ready to eat!  If the yogurt is not thick enough after it becomes cold, repeat the process of covering the pot with a lid, towel, plastic bag, and another towel, and then let sit outside of the refrigerator for 30 minute to 1 hour.  Then remove all of the coverings again, and place in the refrigerator again until it is cold and thick.

 

Cucumber Dip

Time to Prepare: 10 minutes                                Serves: 8 (1 serving = 2 Tbsp)                                            Cost: $4.00 total

 

1 cup homemade plain yogurt

2 cloves garlic

1 large cucumber

½ small red onion

1 lemon

1 Tbsp mint (if you like)

Salt and Pepper, to taste

Variety of your favorite vegetables (cucumber slices, carrots, peppers, tomatoes, radish, celery, broccoli)

 

  1. Chop the garlic, mint, and red onion very small.
  2. Peel the cucumber, remove the seeds, and chop the cucumber into little pieces.
  3. Wash and cut your favorite vegetables.
  4. Mix the cucumber, onion, and garlic with the yogurt.  Add the juice of 1 lemon and mix gently.  Add black pepper to taste (about ½ Tsp) and a little salt, to taste.
  5. Chill in the refrigerator until ready to serve, and stir before serving.

 

Nutrition Facts

Serving Size

11 serving (80.3 g)

 
Amount Per Serving
Calories 28382                                            Calories from Fat 9110

% Daily Value*

Total Fat  1.0g12.2                                                               2%19
Saturated Fat  0.6g1.8                                                        3%9
Cholesterol 4mg  8                                                         1%3
Sodium 136mg557                                                               6%23
Total Carbohydrates 3.8g44.9                                         1%15
Dietary Fiber 0.6g                                                          2%15
Sugars 2.5g6.2
Protein 1.4g21.0

Vitamin A 1%72

Vitamin C 9%44

Calcium 1%52

Iron 1%11

* Based on a 2000 calorie diet

YOGURT                                                                          CUCUMBER DIP

Nutrition Facts

Serving Size

11 serving (227.3 g)

 
Amount Per Serving
Calories 142382                                        Calories from Fat 68110

% Daily Value*

Total Fat  7.6g12.2                                                             12%19
Saturated Fat  4.7g1.8                                                      23%9
Cholesterol 33mg8                                                       11%3
Sodium 118mg557                                                               5%23
Total Carbohydrates 11.4g44.9                                       4%15
Sugars 11.4g6.2
Protein 7.6g21.0

Vitamin A 6%72

Vitamin C 0%44

Calcium 28%52

Iron 0%11

* Based on a 2000 calorie diet

 

 

 

 

 

 

Yogurt Casero

Tiempo de cocinar: 3 horas                                  Porciones: se sirve como snack                                          Costo: $2.00 total

 

En países del Oriente medio como Turquía, Siria, y Líbano, el yogurt natural es parte de muchos de sus platos típicos, incluso se usa con carnes y vegetales. Este yogurt es mas espeso que el yogurt que se usa en Estados Unidos, y por su espesura es que se puede mezclar con otras cosas para hacer salsas, y platos, fríos y calientes. Uno de los muchos  beneficios del yogurt es que ayuda a mantener una Buena salud del sistema digestivo, ya que contiene Buena bacteria que nos ayuda a digerir los alimentos y obtener todos los nutrientes de nuestras comidas. Esta semana estaremos probando yogurt natural simple, también estaremos probando una salsa de pepinos  para acompañar unos vegetales frescos. Recuerda que los vegetales deben ser la mayor parte de nuestra comida  y solo usar un poco de salsa de pepinos con cada bocado.

 

Yogurt:

1 galón de leche entera

1 Cucharada de yogurt simple-sin sabor

 

  1. Hervir 1 galón de leche en una olla grande hasta ver una capa gruesa en la parte de arriba. Remueva la olla del calor y espere a que enfríe la leche y este tibia (no muy caliente, no muy fría)
  2. Ponga 1 cucharada de yogurt simple en la leche tibia y revuelva hasta que se disuelva completamente
  3. Ponga una tapa sobre la olla, envuelva la olla con una toalla o manta, luego ponga una bolsa plástica (o bolsa para la basura) alrededor de la olla ya envuelta y ponga nuevamente otra toalla o manta alrededor de esta. Permita que se quede así por 2 horas.
  4. Después de 2 horas, remueva las toallas, la bolsa plástica y la tapa de la olla. Ponga la olla en el refrigerador hasta que el yogurt este frío y espeso; y luego ¡estará listo para comer! Si el yogurt no llegara a estar lo suficientemente espeso después de enfriar, repita el proceso de cubrir la olla con una tapa, toalla, una bolsa plástica y otra toalla, y luego permita que se quede por fuera del refrigerador por 30 minutos o una hora. Luego remueva todo lo que cubre la olla, y ponga en el refrigerador otra vez hasta que enfrié y espese.

 

Salsa de Pepinos

Tiempo de preparación: 10 minutos                     Porciones: 8 (1 porcion = 2 cda)                            Costo: $4.00 total

 

1 taza de yogurt casero simple

2 clavos de ajo

1 pepino largo

½ cebolla roja pequeño

1 limón

1 cucharada de menta (si le gusta)

Sal y pimienta, al gusto

Vegetales variados, sus favoritos (rebanadas de pepino, zanahorias, pimentones, tomates, rábanos, apio, brócoli)

 

  1. Picar el ajo, menta, y la cebolla roja en pedazos pequeños.
  2. Pelar el pepino, remueva las semillas, y pique en pedazos pequeños.  Luego, lave y corte sus vegetales frescos.
  3. Combine el pepino, cebolla, y el ajo picado con el yogurt. Adicione el jugo de 1 limón y mezcle suavemente. Adicione pimienta negra al gusto (alrededor de ½ cucharadita) y un poco de sal, al gusto.
  4. Deje que la mezcla enfríe en el refrigerador hasta que vaya a servir, revuelva antes de servir.

Información Nutricional

Tamaño de la Porción

11 porción  (80.3 g)

 
Cantidad por porción
Calorías 28382                                           Calorías de grasa 9110

% Daily Value*

Grasa total 1.0g 12.2                                                           2%19
Grasa saturada   0.6g1.8                                                    3%9
Colesterol 4mg8                                                             1%3
Sodio 136mg557                                                                   6%23
Total de carbohidratos 3.8g  44.9                                   1%15
Fibre 0.6g                                                                       2%
Azucares 2.5g6.2
Proteínas 1.4g21.0

Vitamina A 1%72

Vitamina C 9%44

Calcio 1%52

Hierro 1%11

* Basados en una dieta de 2,000 calorías

YOGURT                                                                  SALSA DE PEPINOS

Información Nutricional

Tamaño de la Porción

11 porción  (227.3 g)

 
Cantidad por porción
Calorías 142382                                       Calorías de grasa 68110

% Daily Value*

Grasa total 7.6g 12.2                                                         12%19
Grasa saturada   4.7g1.8                                                  23%9
Colesterol 33mg8                                                         11%3
Sodio 118mg557                                                                   5%23
Total de carbohidratos 11.4g44.9                                   4%15
Azucares 11.4g6.2
Proteínas 7.6g21.0

Vitamina A 6%72

Vitamina C 0%44

Calcio 28%52

Hierro 0%11

* Basados en una dieta de 2,000 calorías

 

Dr. Camp’s Diabetes Prevention Research Featured on MDLinx

In Diabetes Prevention Resources on April 14, 2011 at 6:03 PM

The article ‘Quality improvement in community health centres: the role of microsystem characteristics in the implementation of a diabetes prevention initiative’ in Quality & Safety in Health Care was recently featured on MDLinx.com! MDLinx carries an index of health-related articles for medical professionals. Click here to read the article.

Millions of Americans Have Diabetes and Don’t Know It

In About the Program on March 18, 2011 at 10:54 AM

On Diabetes Alert Day, Take Action to Learn Your Risk

In observance of Diabetes Alert Day (March 22), the National Diabetes Education Program (NDEP) and the Fair Haven Community Health Center’s Diabetes Prevention Program are encouraging people to take NDEP’s Diabetes Risk Test [http://ndep.nih.gov/resources/ResourceDetail.aspx?ResId=252] –available in English and Spanish –to find out if they are at risk for developing type 2 diabetes. This one-day ‘wake-up call’ asks people across the nation to know their risk of diabetes.

 

Nearly 26 million Americans have diabetes – including 279,000 people in Connecticut. It is estimated that nearly one-third of the people with diabetes, or 90,000 Connecticut adults, do not know that they have the disease.  An estimated 79 million adults have pre-diabetes, placing them at increased risk for developing the disease.

 

“Diabetes is a serious disease, particularly when it is left undiagnosed or untreated,” said Dr. Anne Camp, Director of Fair Haven Community Health Center’s Diabetes Prevention Program. “Everyone should be aware of their risk for diabetes.  If you have a family history of diabetes – such as a mother, father, brother, or sister with type 2 diabetes – or if you had diabetes during pregnancy – you need to know that you are at increased risk.”

 

Other risk factors for diabetes include being overweight, physically inactive, and being over the age of 45. Diabetes also is more common in African Americans, people of African Ancestry, Hispanics/Latinos, American Indians, Alaska Natives, Asian Americans, and Pacific Islanders.

 

If left undiagnosed or untreated, diabetes can lead to serious health problems such as heart disease, blindness, kidney disease, stroke, amputation, and even death.  With early diagnosis and treatment, people with diabetes can delay or prevent the development of these health problems.

 

“If you are at risk for diabetes, the good news is that you can take action now to lower your risk for developing type 2 diabetes by making – and maintaining – healthy lifestyle changes,” says Dr. Camp.

 

Studies have shown that type 2 diabetes can be prevented or delayed by losing a small amount of weight – 5 to 7 percent (10 to 14 pounds for a 200-pound person) – and becoming more active. Action steps include making healthy food choices and being active at least 30 minutes, five days per week. One way to help people achieve their health goal is to write down everything they eat and drink and the number of minutes they are active each day. They should review their notes daily.

 

The Fair Haven Community Health Center Diabetes Prevention Program provides diabetes testing to all patients and their families who are at risk for diabetes. Patients who are prediabetic are then invited to participate in exercise, nutrition, and gardening classes at nearby John Martinez School and Chabaso Bakery.

 

To learn more about your risk for developing type 2 diabetes, check out NDEP’s Diabetes Risk Test, available in English and Spanish. Additional diabetes resources can be found on the NDEP website, www.YourDiabetesInfo.org. For more information about the Fair Haven Community Health Center Diabetes Prevention Program, call 203.777.7411 or go to www.diabetespreventionprogram.wordpress.com.

 

 

For more information on the Diabetes Prevention Program, go to diabetespreventionprogram.wordpress.org or contact Rebecca Kline r.kline@fhchc.org. The Fair Haven Community Health Center is a not-for-profit primary health care organization that has been dedicated to serving the greater Fair Haven Community since 1971.  We provide comprehensive health care – from prenatal to pediatric, adolescent to adult and geriatric.  Our mission is to provide excellent, accessible health care to the residents of our community, regardless of their ability to pay.

 

The U.S. Department of Health and Human Services‘ National Diabetes Education Program (NDEP) is jointly sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) with the support of more than 200 partner organizations. Its Small Steps. Big Rewards Prevent Type 2 Diabetes. campaign communicates that type 2 diabetes can be prevented or delayed through modest lifestyle changes.

# # #

 

Tailoring Programs Is Essential

In About the Program on January 5, 2011 at 10:25 AM

Two recent videos, when combined, illustrate a driving force behind FHCHC’s Diabetes Prevention Program: tailoring. The National Institute of Health’s Diabetes Prevention Program is a brilliant and successful program. Central to its success, however, is that it is perfect for the population to whom it was originally delivered. Aligned with a long lineage of community health centers that focus on tailoring health care to fit their particular population’s character and constraints, so did FHCHC’s Diabetes Prevention Program adjust the original curriculum to fit the needs of Hispanic families in Fair Haven, Connecticut. Around the same time that FHCHC’s Diabetes Prevention Program was being translated and readied for execution, Malcolm Gladwell, author of The Tipping Point and many other noteworthy titles, delivered a Ted Talk in which he demonstrates the importance of tailoring products to fit the needs of those being served. Watch Gladwell’s Ted Talk here.

Malcolmgladwellflickr

wikipedia.com

And like FHCHC’s Diabetes Prevention Program, state politicians and health officials on the smallest and most obese republic in the world are implementing a site-specific diabetes prevention strategy to try to reverse the effects of a homogenous western diet on the Pacific island. See ABC News’ video on Nauru here.

janeresture.com

Although diabetes is a disease that is common to most developed and developing nations today, ensuring the success of diabetes-centered health interventions is contingent upon this tailoring principle.

Diabetes Prevention Programs: Not a One-Hit-Wonder

In About the Program on December 21, 2010 at 5:06 PM

This morning, traditional irrigation was replaced by gardeners’ tears. It’s no secret that around these parts, people’s lives are tough. That their stories are not surprising, however, doesn’t make them any less disturbing. It seems as though the garden fosters candor rarely found outside the doctor’s office. Tearing out dead hot pepper plants, Mirabelle was through suppressing her tears; a son unjustly incarcerated, a mother crippled by diabetes, and a friends’ children wondering where their recently deceased father has gone.

Being the Communications Manager for the Diabetes Prevention Program, my attention was momentarily diverted when she expressed her dismay at the 4 year old’s weight. Her recently deceased friend left behind a wife, 4-year old boy, and 10-year old girl. At the funeral, the boy was hungry. Mirabelle’s funeral pictures revealed the grave, the family in mourning, and the boy at work on a monumental sandwich. ‘Solo come, Rebecca. Esta engordando mucho.’ He only eats, Rebecca. He’s gaining a lot of weight.

In other words, diabetes is complex. The disease is bred from the full spectrum of life’s challenges. Diabetes prevention, therefore, is equally complex. It does not – it cannot – stop at exercise, nutrition, or gardening classes.

FHCHC’s DPP Intensive Lifestyle Intervention – An Overview

In Intensive Lifestyle Intervention - General on December 8, 2010 at 4:01 PM

ILI Overview & Intake Procedure

If a Hispanic woman between the ages of 18-55 has had a blood test in the past three months that has rendered her pre-diabetic, and she is a patient at the Fair Haven Community Health Center, she is eligible to participate in the Diabetes Prevention Program’s Intensive Lifestyle Intervention (DPP’s ILI). There are two study tracks: delayed and immediate. Those randomized to participate in the delayed group see their provider every three months for a year, as well as a nutritionist once during that time. Those in the immediate track participate in a 12-week exercise and nutrition program, seeing a provider weekly and having the opportunity to continue participating after the initial 12-weeks. At the end of one year, all delayed and immediate-track ILI participants have an OGTT screening to distinguish any changes in their physical wellbeing. Those in the delayed group can then enter into the immediate track if they choose. Those randomized to participate in the immediate study group begin their weekly nutrition and exercise classes immediately.

Prior to the randomization process, pre-diabetic patients are invited to the clinic for an intake (click here to see the Intake Checklist). There, their labs are confirmed, vitals taken, and they are given the opportunity to join the ILI study (click here to see intake checklist). These intakes are free, and are scheduled by the DPP staff, rendering most of the process outside the clinic’s traditional admission and billing processes. Typically, the appointment takes around 30 minutes, and is conducted by a trained DPP administrator.

The intention of the intake is to determine whether a pre-diabetic patient is interested in participating in the ILI study, and if so, collect all the essential study data to get them started. The consent form solidifies their participation, after which vitals and other medical-related data is collected, and physical activity and nutrition-related questionnaires are filled out. As part of the initial data collection, patients are also given pedometers and a pedometer tracking form, the data from which will indicate the amount of walking each patient does on a typical weekday or weekend. The DPP awards $10 gift certificates to Walmart if they return the pedometers and the pedometer tracking form after a complete week, a strategy that has fueled participation.

OGTT’s Evolution from Pilot to Paramount

In OGTT Screening on October 25, 2010 at 4:14 PM

There was a marked increase in the number of patients screened for diabetes and prediabetes when the Donoghue grant became operational. From 2006-2008 under the Connecticut Health Foundation’s initial grant, research was limited to hispanic women between the ages of 18-55 years old. Limited is not the best word, however. The number of Oral Glucose Tolerance Test (OGTT) patients perfectly matched the structures and resources available to the Fair Haven Community Health Center at the time.

During this initial 2-year period, OGTT screening referrals amounted to approximately 2-4 per week. Clinicians generated them conservatively, being new to the group-screening paradigm. One Diabetes Prevention Program staff member handled the entire referral to recruitment process. She stocked exam rooms with referral forms, collected filled-out forms each Friday. She called each patient within 3 weeks to schedule them for a screening, and filed the referral forms in patients’ charts herself. Mari also kept impeccable excel spreadsheets on all relevant numbers and names.

In 2004, when the clinic won a substancial Donoghue Foundation grant, however, this system needed to be expanded. Now, any patient that displayed a risk factor was offered a free diabetes screening. Having observed the previous two years’ success, clinicians were poised and ready to ramp up their referrals. And they did! Referrals went from the aforementioned 2-4 per week to 20-25 per week. The Diabetes Prevention Program had to hire another staff member who shared the referral and recruitment responsibilities. Once in a while there were so many referrals that Eva had to set aside entire series of workdays just to make referral calls. To meet the demand, the Diabetes Prevention Program also increased their screenings from one per month to three.  The success, therefore, of the initial two years of ‘limited’ access screenings established the program’s credibility and systematic foundation.

The Donoghue grant, however, made it possible for any patient at the Fair Haven Community Health Center, whether male female, child or adult, Balinese or African American, to get screened. Today, the DPP receives between 20-25 OGTT screening referrals per week, a major increase from the 2-4 one year ago.

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