“Diabetes is a silent killer,” said Madolyn Agrimonti. For 25 years, Agrimonti has been a diagnosed diabetic and is now chairing the Diabetes Committee for the Sonoma Valley Health Roundtable, linking Sonoma health agencies and nonprofits to the community in order to spread awareness of and increase prevention of the disease she has battled for so long.
The Sonoma Valley Health Round Table is a group comprised of health professionals in the Valley who collaborate to improve health in the greater community. Sonoma Valley Health Roundtable members include representatives from Sonoma Valley Hospital, Sonoma Valley Community Health Center, City of Sonoma, Sonoma Valley Unified School District, St. Joseph Health, Boys & Girls Club of Sonoma Valley, and Sonoma County Department of Health Services. In 2012, Sonoma Valley Health Roundtable became a chapter of Sonoma County Health Action, a countywide collaborative effort to make Sonoma County the healthiest county in California.
One agency Agrimonti said is doing especially important work toward that end is Redwood Empire Food Bank, which is based in Santa Rosa and serves all of Sonoma County. In fall 2011, the food bank received a grant through Feeding America and the Bristol-Myers Squibb Foundation to fund a Diabetes Wellness Project. Through the project, the food bank aims not only to help individuals gain access to healthy foods and live with their diabetes under control, but also provide education to prevent high-risk individuals from getting diabetes.
Diabetes Wellness Project leader and registered nurse, Morgan Smith, said, “Managing a chronic disease like diabetes can be a tremendous challenge. Managing diabetes while also struggling with access to food makes that challenge even harder.”
Through its project, the food bank is trying to address both food insecurity and diabetes.
“Sometimes you really feel like you are pushing a big rock ahead of you … and you can go through life just not feeling well until something really bad just happens, you can’t see the internal damage,” Agrimonti said.
Symptoms of diabetes include excessive thirst and frequent urination, but left untreated diabetes can lead to more serious complications such as heart disease and kidney failure.
According to the Centers for Disease Control and Prevention, 25.8 million Americans – or 8.3 percent of the U.S. population – have diabetes, with more than 7 million people unaware they have the disease. Diabetes is the seventh leading cause of death in the nation.
There are three types of diabetes, type 1, type 2 and gestational. Type 1 diabetes is a lifelong chronic disease in which there is an insulin deficiency due to destruction of cells in the pancreas, while type 2 diabetes is a metabolic disorder that is characterized by high blood sugar with insulin resistance and deficiency. Gestational diabetes occurs during pregnancy. Type 2 diabetes is of particular concern in the U.S. as it accounts for 90 to 95 percent of all diagnosed cases of diabetes in adults. Obesity is considered the primary cause of type 2 diabetes.
It is also estimated, according to the National Diabetes Education Program through the National Institutes of Health, that 79 million Americans ages 20 and older have prediabetes. Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough to be called diabetes. Studies have shown that by losing weight and increasing physical activity, people can prevent or delay prediabetes from progressing to diabetes.
Rates of diabetes among elderly and ethnic populations are much higher, Smith said.
Smith and his team members drive a van to 35 locations throughout Sonoma County, including a site at La Luz Center in Sonoma, to screen individuals over 18 years old for type 2 diabetes and elevated blood sugar levels indicating high risk of diabetes. Once the individuals are screened, if their tests indicate diabetes, they are given a 22- to 25-pound box of healthy foods. Individuals who have already been diagnosed with type 2 diabetes can bring proof of their diagnosis to be added to the sign-up for healthy foods distribution.
Smith said another component of the project is that all individuals must meet income requirements, at 150 percent of the federal poverty line, or $1,436 a month for singles and less than $1,939 for couples.
Boxes consist of foods such as brown rice, high-fiber cereal, canned fish, low-fat milk and fresh fruits and vegetables.
Educational material related to diabetes maintenance and referrals to clinics are also provided. For instance, at La Luz, Smith explained, people with test results that indicate diabetes and do not have access to steady health care are often referred to the St. Joseph mobile clinic that also comes to La Luz. “We are promoting health through partnerships,” Smith said. “These partnerships help to create and sustain an environment where everyone in our community – especially those most in need – have access to the things necessary to live a healthy, productive life.”
“It feels like it’s a ground-up operation, which I think is really important,” Agrimonti said, “getting to the people who don’t have access, possibly, to health care or to food that is really very good for them. That crosses all ethnicities, anybody who doesn’t have money.”
In the last year, Smith notes, he and his team have enrolled 600 people in the Diabetes Wellness Project with nearly 350 clinic referrals. Currently, the food bank distributes 400 boxes through its diabetes program each month.
Upon testing, Smith said, he and his peers let many people know that they have elevated blood sugar levels and would be diagnosed with prediabetes, so they can get preventative care.
The food bank is one of three sites (one in Texas and the other in Ohio) where researchers at the University of California San Francisco are evaluating the link between chronic disease management and food insecurity through the Feeding America project. The idea, Smith said, is that increasing access to healthy foods will not only reduce cases of diabetes but also reduce cases of other diseases that diabetics are more prone to.
People are also given educational information on living a healthy life with diabetes and preventing diabetes. For people in the program who actually have a diagnosis, education is really important, Smith said.
“I wish somebody would have spoken to me 20 years ago about this – eating better, taking care of myself, and I wish I would have looked at alternatives to medication,” Agrimonti said.
While the food bank is still collecting data through this fall, Smith said surveys conducted at mobile sites every three to six months indicate the organization has already seen improvements in clients’ overall glycemic control and in the confidence of diabetics’ in terms of managing their disease.
He said there is notable excitement from Valley health-care providers about the program, adding he is working to formalize partnerships with both Sonoma Valley Hospital and the Sonoma Valley Community Health Center.
The Diabetes Wellness Project van is at La Luz Center, 17560 Greger St., Sonoma, the third Wednesday of each month from 11 a.m. to noon. In December, the mobile clinic will not be on site, but healthy food boxes will still be distributed. For more information on the Diabetes Wellness Project, go to refb.org/dwp/index.html.