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DIABETES Dec-21-2004 (830 words) With photo. xxxn
Catholics bring faith to fight against diabetes in urban, rural areas
By Michelle Martin
Catholic News Service
CHICAGO (CNS) -- Dr. Theo Sai directs the Esperanza Centro de Salud in Chicago's Pilsen neighborhood, a community health center affiliated with St. Anthony Hospital.
His patients are about 98 percent Latino, mostly of Mexican origin, and most of the adults under age 65 do not have insurance.
Deacon Bill Grimes, a physician assistant and nurse practitioner, works out of a tiny storefront space on a street in downtown Owingsville, Ky., population 1,488. The community is more than 95 percent white, according to the U.S. Census Bureau, with more than 25 percent of its people living in poverty.
But the doctor and the deacon are fighting a common problem: diabetes.
Diabetes has become epidemic in the United States, with more than 8 percent of people over age 20 affected. But the prevalence is higher among certain populations, including the Appalachian people served by the New Hope Clinic in Owingsville and the mostly Mexican-American client base served by Esperanza in Chicago.
"Just being Hispanic is a risk factor for diabetes," Sai said, noting the American Diabetes Association estimates that a Hispanic American is one-and-a-half times more likely to be diabetic than a non-Hispanic white of the same age.
"If you break it down further, to Hispanics over age 50, it's something like one in four is diabetic," he told The Catholic New World, Chicago's archdiocesan newspaper.
For both men, finding a way to prevent diabetes -- and prevent complications for those who already have the disease -- has become a cause.
Deacon Grimes, who grew up in Mundelein, Ill., and explored life as a monk before getting married and landing as a Catholic deacon in Kentucky, sees health care as a basic right and part of the social justice mission of the church.
"Health care is a basic right," said Deacon Grimes, who holds a doctorate in ministry in health care and also serves as an assistant professor at the University of Kentucky. "I don't mean necessarily a lung transplant or a heart transplant, but basic health care."
After seeing dozens upon dozens of diabetic patients who could not afford everything from the glucose testing supplies they should use on a daily basis to laboratory work, nutritional counseling and eye and foot exams, Deacon Grimes came up with an idea. He proposed a research project to take a group of poor, rural diabetics, give them everything they needed to follow the American Diabetes Association's guidelines for treatment for a year, and see if it would make them healthier.
While the study has yet to be published, Deacon Grimes said, preliminary results show that it is working.
"Anecdotally," he said, "we've seen a significant improvement in the most important marker -- A1c," which is a measure of the amount of glucose in blood over time.
"It shows that if you give this population of indigent people the information and the tools they need, they can do what they need to do. We were able to make a cohort of people healthier," the deacon added.
Sai emphasizes educating his patients about the disease and what they can do to control it. Since many patients bring family members to their appointments, he works to teach the whole family.
"It's not like he's got diabetes and that's his problem," said Sai, who was born in London and grew up in Ghana and Cuba. "He's got diabetes, and it's up to the whole family to help. Because if that's my dad sitting there, I'm probably looking at me in 30 years."
The lifestyle changes he encourages, from a healthier diet to more exercise to getting regular checkups, could help prevent other family members from getting the disease, Sai said.
While the populations with the problem might be different in Appalachia and Pilsen, the roots of the diabetes problem are the same. The first is genetics: Type II diabetes, the most common form to affect adults, runs in families and in certain populations.
It is most often diagnosed in middle age -- a time when many poor people are uninsured. While Deacon Grimes' clinic sees only uninsured patients, about half the 1,000 patients at Esperanza have some form of health coverage, Sai said.
But taking out children under 18, pregnant women who are eligible for the state's KidCare program, and seniors on Medicare, nearly 80 percent of the other patients have no coverage at all, Sai added.
Then there are lifestyle factors, such as level of exercise and diet, both of which are related to the amount of education people have and which can be changed at a relatively small cost, the men said.
Poverty also stops people from following doctors' advice, Sai said.
"I can write a prescription for someone, but if they have a heating bill that needs to be paid before they can turn the heat on, they'll do that before they buy the medicine, and they won't tell me," he said.
END
Copyright (c) 2004 Catholic News Service/USCCB. All rights reserved.
This material may not be published, broadcast, rewritten or otherwise distributed.
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