Free support provided by Community Health Team
*This article primarily discusses prediabetes and Type 2 diabetes. For more information about living with Type 1, please call 802-728-7715 or email Certified Diabetes Educator Jennifer Stratton, RD, at .
By Maryellen Apelquist
RANDOLPH, Vt.—Like many retirees, Richard Lacaillade, 68, keeps busy. He can be found running the score clock at Randolph Union High School athletic events, volunteering with the Chamber of Commerce, even working a few days a week in patient registration at Gifford Medical Center. He takes long walks in his neighborhood, occasionally works in some golf, and spends time with his wife, children and grandchildren.
And like many Americans—more than one in three of them, according to the Centers for Disease Control—Lacaillade has prediabetes. His blood sugar measures higher than normal but not high enough to be diagnosed with Type 2 diabetes. Unlike Lacaillade, 90 percent of the 84.1 million people who have prediabetes don’t know it, according to the CDC, because they haven’t been diagnosed.
To lower his risk of developing Type 2—a leading cause of heart attack, stroke, blindness, kidney failure, and lower-extremity amputation—Lacaillade committed to making lifestyle changes. In June his Primary Care provider encouraged him to begin working with a health coach, a free service offered by the Community Health Team at Gifford, to help set and achieve his goals.
“The fact is, I’m not training to be an Olympic athlete or a marathon runner or anything like that,” said Lacaillade of his sessions with Gifford Health Coach Carolyn Higgins. “It’s just to establish some good habits. We talk about food, what I eat, how I’ve been walking, what I’ve been dealing with … she even gives me sleeping tips.”
Lacaillade began meeting with Higgins weekly, then decided meeting every two weeks was enough.
“Each time we get together, based on whatever we talk about, we set goals as to what we want to do,” he said. “Then [at the next meeting] we hash over how it went and where we go from here.”
The tailored approach Lacaillade describes is one that Higgins takes with all of her patients, many of whom have prediabetes.
“I primarily meet with people one-on-one for health coaching,” said Higgins. “For many people it’s about weight loss and getting physically active, but it’s really individualized. We provide support, guidance, and the ability to get them where they want to go.”
“It’s really about lifestyle change,” she said. “There is no specific diet here. I want to help put them on a path for lifelong healthy habits. You can prevent diabetes with lifestyle change—food and activity.”
Working the Plan
After their first session, Higgins asks patients to write a personal vision statement to answer the question, “Why am I doing this?” She subsequently works with them to develop a custom plan that is tweaked with each session to incorporate “smart goals”—a specific, concrete goal each week—to help them achieve their vision.
Lacaillade’s smart goals have included drinking more water, substituting fruit for other snacks, and being mindful of portion control.
“It’s not like we are changing a lot there,” he said. “If I want a burger, I’ll have a burger, but I try not to have too much of any one thing. I’m not living on celery and rice cakes, and I’m not doing a crash diet or anything like that.”
After his last session, as a reality check, Lacaillade decided to begin a food journal.
“I’m starting to record everything I’m eating,” he said. “I think it makes you more aware of what you’re actually doing. Part of the issue I have, one of the challenges, is that my schedule fluctuates a lot. I work per diem and also work various athletic events, doing the score clock. A lot of times my evening meal may be later, after I get home from an event, at 8 or 9, which isn’t the best.”
Lacaillade also has found it challenging to drink more water. One of his smart goals is to drink water in place of his nightly glass of milk.
To make sure he’s getting exercise, Lacaillade established a walking program.
“When we started, it was minimal, just in my neighborhood, a few laps around the park, but now I’ve changed my route and I’ve increased to probably 40 minutes, four times a week,” he said. “It depends on my schedule and the weather. But even on a bad day, 10 minutes is better than nothing.”
While he hasn’t set any firm weight loss goals, Lacaillade said he’s lost about 6 pounds over the last few months.
“I’m not looking to lose a ton of weight, but I feel better, with the 6 pounds gone, and feel better mentally, too, though I’m pretty positive mentally anyway.”
He also said he enjoys setting and achieving goals for himself.
“Once you lose a few pounds, it changes your attitude. If someone tells me I can’t walk for 15 minutes, I’m going to walk for 20.”
Lacaillade plans to continue health coaching long-term.
“I see no reason to stop,” he said. “To actually sit down with someone and go over stuff, it’s really low-key, and there’s not a lot of pressure. It’s not like you are punished for saying you’re going to walk four days and only walk three. You’re not getting read the riot act.”
Partnering in Health
Like Lacaillade, Karen Lowry Reed, 63, of Braintree appreciates the judgment-free nature of not only the one-on-one health coaching but also the various support groups and workshops offered by the Community Health Team. Reed participated in a recent Healthier Living with Chronic Pain group and, while not diagnosed with prediabetes, decided to begin health coaching with Higgins given a family history of diabetes and the fact that she had had gestational diabetes with one of her pregnancies.
“Most helpful with both programs is the accountability that develops,” said Reed. “I make a commitment to do something … and think of Carolyn [Higgins] as an accountability partner who also has resources and ideas. She’s like a partner in developing better habits.”
Among Reed’s goals was a desire to be more fit.
“I wanted to get more exercise. Carolyn said I strike her as social, so maybe I should try a gym. I joined Movement Evolved. Two years later I am much fitter. I have much better balance. I am stronger. I burn calories better.”
“And I have the numbers to prove it,” said Reed, who usually goes to the gym four times a week. “It’s very empowering to see that happen, and I really credit Carolyn with seeing that the gym would be a good fit for me.”
Empowerment and accountability are themes Reed revisits time and again during our conversation.
“Part of me is really interested in encouraging people to be more responsible for our individual health,” she said. “I am just delighted and empowered that I can enhance and improve my health through changes I make. I realize, though, that some people may find it scary to get started. If anyone wants to reach out to me, I’d be happy to talk to them about my experiences.” (Please contact us if you’d like to be connected with Reed.)
Living with Type 2
Randolph Center resident and retired engineer Carol Mowery, 71, was diagnosed with Type 2 diabetes three years ago. And before, looking back to the time of her prediabetes diagnosis, Mowery said she felt out of options. The Community Health Team hadn’t yet launched Gifford’s free resources, and Mowery’s insurance didn’t cover prediabetes education. She encourages others to take advantage of the free health coaching and prevention workshops available now.
“Anyone who has been diagnosed with prediabetes should just jump on the resources available, the earlier the better,” said Mowery. “There’s no reason why someone can’t attack it through their diet.”
For her part, while managing Type 2 through diet was her original goal, she said, the stress of life changes in recent years, including the loss of loved ones, has made living with diabetes even more challenging.
“I cannot emphasize enough how much stress affects diabetes. My A1C shot up in the last year—up to 9,” said Mowery, referring to the blood test that measures average blood-sugar level.
According to the Mayo Clinic, “An A1C level above 8 percent means that your diabetes is not well-controlled and you have a higher risk of developing complications of diabetes.”
“This year is the first year I have felt so much stress, and I cannot believe how much it has affected my diabetes,” said Mowery. “I am trying to work through it.”
Helping her manage the disease is Jennifer Stratton, a registered dietitian and certified diabetes educator who has provided diabetes education for the majority of her 19 years working with Gifford patients. Stratton works with patients of all ages who have either Type 1 or Type 2 diabetes, gestational diabetes, or prediabetes. She estimates that 90 percent of the patients she counsels have Type 2.
“When someone is talking with me, the stress of life reveals what is behind their choices—in some ways I become more of a therapist,” said Stratton, who helps patients set goals like monitoring blood-sugar and activity levels and making healthy eating choices. “I love working with people, and getting to share in their little successes.”
“Jennifer has been my coach, and is the one I turn to besides [Primary Care physician] Dr. Borie,” said Mowery, who also participates in cardiac rehabilitation following recent heart attacks. “We talk about lifestyle changes, exercise, portion control, how to give myself shots, alternative medications, and the choices that I have—really, everything related to diabetes management.”
Mowery said she has learned the importance of setting realistic goals when it comes to exercise.
“Both of my knees are bone on bone, so walking most of the time is very hard for me,” she said. “I try to swim three or four times a week. Any diabetic should find the exercise they can do. Mine is that I can do the pool.”
Stratton, too, emphasizes that we all have unique needs, including when it comes to how and what we eat.
“I spend a lot time retraining people to realize they have to balance their meal,” she said. “Not everybody responds the same to different foods, so it’s completely individualized.”
Because diabetes is a progressive disease, and because she realizes “life gets in the way for a ton of people,” Stratton works with patients to adjust their goals as time goes on.
As the director of Gifford’s Diabetes Clinic, she places a high value on the free workshops and coaching provided by the Community Health Team to both those living with diabetes and those working to prevent it.
“It’s great to be able to refer people to these workshops,” Stratton said.
A variety of free, weekly support groups and workshops are offered by the Community Health Team at Gifford locations throughout central Vermont. For more information about the resources listed here, call Megan at 802-728-7714 or email .
Diabetes Prevention Program: Healthier Lifestyle and Weight Loss
Prevent T2: Type 2 Diabetes Prevention Program
Healthier Living and Weight Loss / Prevent T2
Healthier Living with Diabetes
If you’re thinking about joining a group but want to learn more about what to expect, please watch this helpful video: https://youtu.be/DI8EcBIOWNQEcBIOWNQ
Health coaches provide free support and guidance to anyone wanting to make a lifestyle change. Possible coaching topics include weight loss, stress management, establishing an exercise routine, and improving diet. A healthy lifestyle is the best defense against the most common diseases, such as heart disease, stroke, diabetes, and cancer. For more information, call 802-728-7717.