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Release: May 10, 2000

New UI exercise, nutrition program helps people at risk for type 2 diabetes

IOWA CITY, Iowa -- A new University of Iowa Health Care program is helping people at risk for type 2 diabetes prevent or delay onset of the condition. The eight-week program, "Reaching Euglycemia and Comprehensive Health" (REACH), is designed to help people with impaired glucose tolerance (IGT), the precursor of type 2 diabetes, to normalize their blood sugar, which means reaching euglycemia.

In addition to their increased risk for diabetes, people with IGT are more likely to experience high blood pressure, abnormal blood cholesterol levels and heart disease. The REACH program provides physical exams, counseling, expert advice, exercise evaluation and exercise sessions. Participants attend bi-weekly educational and exercise classes to help them ward off diabetes. People with IGT may enroll in one of the next two programs, which run from May 16 to July 13 and from Sept. 19 to Nov. 9. The program fee is $190.

"The program really helps people remove barriers to improving their health and controlling their blood sugar," said Rhonda Barr, UI physical therapist and REACH program coordinator. "We are targeting the lifestyle changes that people have trouble sticking with, such as a healthy diet or exercising. Current participants are showing progress, including inches lost around the waist and improved aerobic fitness."

In addition to Barr, the UI Heath Care IGT team includes a dietician, mental health counselor, diabetes nurse educator, physician assistant and physician. Experts from the health areas speak on topics such as "Dining Out with Ease" and "Staying Vital at Any Age." Participants also have taken hikes at places such as the Coralville Reservoir and learned how to pick out appropriate exercise footwear.

"One of the best features of the program is that we're drawing on the resources of the entire academic setting," Barr said. "It takes a holistic approach to make sure that people are as ready as possible to make the lifestyle changes that it takes to be healthy. A lot of us know what we need to do to improve our health; it's just hard to put into action."

Joe Henry, assistant to the dean in the UI Graduate College, has nearly completed the eight-week session. Henry learned that he had impaired glucose tolerance after having his blood sugar tested in November 1999 at a UI Health Care health fair.

Armed with that information and having several IGT risk factors, including some family history of diabetes and being of African-American descent, he enrolled in the REACH program.

"I've definitely increased the amount of exercise I'm getting and exercise nearly everyday," Henry said. "I've also become more reflective about my eating habits. The nutrition experts helped us improve how we read nutrition labels and question product marketing techniques. To help curb my snacking, I eat a couple of pieces of fruit nearly every day instead of just periodically."

Henry added that it was fun to learn with other participants in a diverse group because while each person worked at his or her own pace, they shared similar goals. In addition, the evening program fit well with his 8-to-5 work schedule.

"The program is a nice mix between formal and informal events," he said. "We did activities based on group recommendations, such as weight lifting, in addition to hearing from the experts."

Henry said the program helped him understand diabetes as a medical condition and, most important, gave him tools and strategies to help him more effectively control his IGT condition.

"The REACH program has taught me that you can control for possible future complications by stepping up to the plate and making critical adjustments in your lifestyle today," Henry said.

Type 2 diabetes is usually adult-onset and causes insulin resistance, in which the body makes insulin but does not respond to it well. Type 1 diabetes is usually childhood onset and causes insulin deficiency, which then requires the person to take insulin injections. Left untreated or inadequately controlled, diabetes can cause complications including heart disease, blindness, kidney failure and infections.

"If we can help people keep their blood sugars as normal as possible," Barr said, "then their risks of developing diabetes, or developing complications if they already have the condition, are minimized."

Barr noted that the REACH program draws on the experience of UI staff who worked intensely on a large National Institutes of Health multi-center trial on effective control of type 1 diabetes that also has applications to type 2 diabetes.

People are at increased risk of developing impaired glucose tolerance if any of the following items apply: having family members with diabetes; having diabetes during pregnancy; giving birth to a baby weighing more than nine pounds; being overweight; having high blood pressure or high cholesterol levels; and being of Native American, African American or Hispanic descent.

The easiest way to determine if a person has IGT is to have a fasting (before breakfast) blood sugar test. The UI Health Care IGT Team offers a free fasting blood sugar test.

To get more information about the free test and/or enrollment in the REACH program, call UI Health Access at 1-800-777-8442.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.