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Tackling Diabetes in Wisconsin by Empowering Patients to Manage Their Disease: The Healthy Living with Diabetes Program

Management of diabetes lies almost entirely in the hands of those who live with the condition. The Wisconsin Institute for Healthy Aging and the Health Innovation Program are providing individuals with diabetes the resources they need for effective self-management of their disease.

The State of Wisconsin is currently in the midst of an overwhelming diabetes epidemic. It is estimated that 10% of the state population is living with diabetes, with a 13% increase in diagnoses from 2008 to 2011 alone. The rate is much higher for adults over age 65 (25%), and in communities of color: 15.6% of Hispanic/Latinos, 21% of African Americans, and 43.2% of Native Americans have diabetes. Diabetes can lead to severe and costly complications, such as amputations, cardiovascular disease, end-stage renal disease, blindness, and other problems that dramatically effect quality and longevity of life. Each year, diabetes and its complications costs Wisconsin $6.15 billion in direct and indirect costs.

As management of diabetes lies almost entirely in the hands of those who live with the condition, it is vital that individuals with diabetes have the resources they need for effective self-management. To help address the diabetes epidemic and provide these resources to individuals in Wisconsin, in 2013 the Wisconsin Institute for Healthy Aging (WIHA) launched the Healthy Living with Diabetes Program with support from the University of Wisconsin Health Innovation Program (HIP). Through funding to the Health Innovation Program from the Wisconsin Partnership Program, the Healthy Living with Diabetes Program targets individuals in both community and clinical settings.

Betsy Abramson, JD<br />
Executive Director, Wisconsin Institute for Healthy Aging (WIHA)
Betsy Abramson, JD
Executive Director, Wisconsin Institute for Healthy Aging (WIHA)

This group-based diabetes self-management program is effective and well-established. Assessments of the program nationally have shown a 53% reduction in emergency department visits; improvements in A1c, self-rated health, and communication with physicians; and reductions in health distress and symptoms of hypo- and hyperglycemia.

The program consists of a series of self-management workshop sessions that meet for 2.5 hours once a week for 6 weeks. Workshops are held in a variety of locations, such as workplaces, health care facilities, Aging and Disability Resource Centers, educational settings, libraries, senior centers, faith-based organizations, village halls, and food pantries. Individuals with type 2 diabetes or individuals who live with someone with diabetes attend the program in groups of 12-16. Two trained Lay Leaders—one or both of whom have type 2 diabetes themselves—facilitate the workshop using a Stanford University-developed Leader Manual, after completing a rigorous four-day Leader Training.

The goal of the program is to enhance patients’ self-efficacy using skill building, goal setting, and reinforcement, and it is highly interactive, emphasizing action planning and problem solving. Most of the learning in the workshop comes from sharing and helping others in the workshop with similar challenges. The program does not replace a patient’s existing treatments; instead, it compliments their current medical treatment plan.

Topics discussed include, among others:

  • Monitoring blood sugars and preventing high and low blood sugars
  • Healthy eating and nutrition, food label reading, and meal planning
  • Relaxation techniques and stress management
  • Short-term goal setting and planning for the future
  • Communicating effectively with friends, family, and the medical team
  • Fitness for exercise and fun
  • Preventing and delaying complications

People who have taken the workshop have been shown to have better health and increased confidence in managing their diabetes, improvements in their blood sugar levels and A1c, and fewer doctor and emergency room visits, among other benefits.

One volunteer who has been trained as a leader says of the program, “Volunteering as a facilitator for Healthy Living with Diabetes helps me keep the importance of my health at the forefront of my life. As someone who lives with Diabetes I have found it is important to know that I am not alone. I feel the class is motivating and helps me stay on top of managing my diabetes. It also makes me feel good knowing that I am able to help others. Diabetes is a lifelong journey and I feel if I can successfully help people through a part of it I am positively giving back to my community!”

The Healthy Living with Diabetes program started in 5 counties in Wisconsin, and has now grown to cover almost the entire state. WIHA’s community and health system partners project that they will have held a cumulative total of 240 Healthy Living with Diabetes workshops by the end of 2016, with over 2,300 total participants having attended a workshop session. WIHA projects a cumulative total of 15 workshops will have been held in Spanish by the end of 2016. Additionally, WIHA conducts Leader Trainings, which have resulted in over 200 Leaders, including 21 Spanish-speaking, who have been trained since March 2013 who are able to facilitate the Healthy Living with Diabetes workshops. 

The Health Innovation Program is currently working with WIHA to use workshop participant data to assess and improve the program. Dr. Maureen Smith, Director of the Health Innovation Program, says, “Tackling diabetes is a challenge for our healthcare systems and for our entire community. It’s exciting to support and help grow evidence-based programs that benefit people with diabetes who live here in Wisconsin.”

Newly trained Healthy Living with Diabetes Leaders pose with their Certificates of Completion at the end of their four-day training in March, in Milwaukee, WisconsinNewly trained Healthy Living with Diabetes Leaders pose with their Certificates of Completion at the end of their four-day training in March, in Milwaukee, Wisconsin

 

Related information about diabetes and the Healthy Living with Diabetes Program:

Healthy Living with Diabetes Fact Sheet:
https://wihealthyaging.org/_data/files/HLWD/HLWD_FACT_sheet.pdf

Stanford University Diabetes Self-Management Program:
http://patienteducation.stanford.edu/programs/diabeteseng.html

The Wisconsin Diabetes Prevention and Control Program:
http://www.dhs.wisconsin.gov/diabetes/

Wisconsin Diabetes Surveillance Report 2012:
http://www.dhs.wisconsin.gov/publications/P4/P43084.pdf

2011 Burden of Diabetes in Wisconsin:
https://www.dhs.wisconsin.gov/publications/p0/p00284.pdf

American Diabetes Association – Wisconsin chapter:
http://www.diabetes.org/wisconsin