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DIABETES IN ARKANSAS

Diabetes is a serious and costly chronic illness. In 2017, there were approximately 307,385 people in Arkansas with a known diagnosis of diabetes. There is an estimated additional 70,000 people in Arkansas who do not know that they have diabetes. Every year an estimated additional 17,969 people in Arkansas are diagnosed with diabetes. There were 796,000 people in Arkansas who had blood sugar levels higher than normal (prediabetes), in 2017.

Diabetes can also have a large financial impact on Arkansans. Diagnosed diabetes costs an estimated $3.1 billion in Arkansas each year. This includes direct cost as well as costs associated with serious complications including heart disease, stroke, amputation, end-stage kidney disease, blindness, and death.

WHAT IS DIABETES?

Diabetes (referred to in medical terminology as diabetes mellitus or DM) is a group of diseases in which the body either does not produce enough insulin or doesn’t properly use the insulin that the body makes. Insulin is needed to convert sugar in the food we eat into the energy needed by every cell in the human body. The symptoms of diabetes are often subtle and may go undetected for a long period.

Unfortunately, high sugar can cause serious and life-altering medical complications; but people with diabetes can take steps to control the disease and lower their risk of developing complications. Learn more and watch a video on how diabetes affects the body by clicking here.

THE DIFFERENT TYPES OF DIABETES

Type 1 diabetes, formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, occurs when the body’s immune system attacks and destroys its own insulin-producing beta cells in the pancreas. Individuals with this type of diabetes must be on some type of insulin every day to survive since their body can no longer create it on its own. Type 1 diabetes develops most often in children or young adults but can occur at any age. It accounts for about 5-10% of people diagnosed with diabetes. There is currently no way to prevent Type 1 diabetes, but with proper medical care it can be successfully managed. Check out CDCs about Type 1 to learn more.

Type 2 diabetes, formerly called noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, usually begins as insulin resistance-metabolic syndrome, a disorder in which the body’s cells do not use insulin properly. This form of diabetes usually develops in adults older than 45, however, Type 2 diabetes increasingly occurs in children and adolescents. Being overweight, having a family history, history of gestational diabetes, and inactivity increases the chances of developing type 2 diabetes at any age. About 90-95% of people with diabetes have type 2 diabetes. The exciting thing about Type 2 diabetes is that it can be delayed or even prevented with lifestyle changes. Find out more at CDC’s about Type 2.

Gestational diabetes is a form of glucose (blood sugar) intolerance that develops during pregnancy. It occurs more often among African Americans, Hispanic/Latino Americans, and American Indians and is also more common among obese women and women with a family history of diabetes. Gestational diabetes will usually go away after the baby is born but can increase mother’s risk of having Type 2 diabetes later in life. Gestational diabetes can increase the baby’s risk for having health problems and
their risk of developing Type 2 diabetes as they get older. To learn more, check out CDCs about Gestational Diabetes.

SYMPTOMS OF DIABETES

Symptoms of diabetes can be immediate or can occur over years depending on the type of diabetes diagnosed. Individuals with Type 1 diabetes will typically develop symptoms withing a few weeks or months of their body producing less insulin and eventually not making insulin at all. Symptoms can become very severe and result in a medical emergency. People with Type 2 may or may not notice symptoms at all until they have become so intense that they are interfering with daily life or result in a medical emergency. If you have any of the following diabetes symptoms, see your doctor about getting your blood sugar tested:

  • Urinate (pee) a lot, often at night
  • Are very thirsty
  • Lose weight without trying
  • Are very hungry
  • Have blurry vision
  • Have numb or tingling hands or feet
  • Feel very tired
  • Have very dry skin
  • Have sores that heal slowly
  • Have more infections than usual

Learn more about diabetes symptoms.

The most important thing you can do is find out if you are at risk for developing Type 2 diabetes. You may be at risk if you:

  • Have ever been diagnosed with being overweight or having obesity.
  • Are age 45 or older.
  • Have a parent or sibling with type 2 diabetes.
  • Are physically active less than 3 times a week.
  • Have non-alcoholic fatty liver disease (NAFLD).
  • Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds.
  • Are an African American, Hispanic or Latino, American Indian, or Alaska Native person. Some Pacific Islander people and Asian American people also have a higher risk.

If you have any of these risk factors, talk to your doctor about getting tested for prediabetes and diabetes even if you have no symptoms.

Social Determinants of Health (SDOH)

Social Determinants of Health (SDOH) are non-medical factors that affect a wide range of health, functioning, and quality-of-life outcomes and risks. They include the conditions in which people are born, grow, work, live, and age. SDOH also include the broader forces and systems that shape everyday life conditions.

Arkansas Diabetes Prevention and Control Program (DPCP) adapted this definition from CDC and Healthy People 2030 definitions of SDOH. You can also find more information about SDOH at the links above.

“Diabetes can be prevented or controlled only through supportive policies, social conditions, and environments and by promoting more prepared, proactive health systems practice teams that enable informed and activated patients.” (Source: Connecting SDOH and HRSN to Prediabetes and Type 2 Diabetes).

ARKANSAS DIABETES PREVENTION AND CONTROL PROGRAM’S APPROACH TO ADDRESSING SDOH FOCUSES ON:

  • Food and Nutrition Security – Having reliable access to enough high-quality food that is safe, affordable, and culturally acceptable to avoid hunger, and lead an active, healthy life.
  • Built Environment – Human-made surroundings that influence overall community health and people’s behaviors that drive health.
  • Community-Clinical Linkages – connections made between healthcare, public health, and community organizations to improve population health.

ARKANSAS WALKING COLLEGE

In July 2021, the Arkansas Department of Health engaged America Walks to deliver its national Walking College program within the State of Arkansas (Arkansas Walking College).

Goal: build the capacity of local change agents to increase walking and improve walkability in their communities

Focus: organizing for policy change to create safe, walkable, livable communities through:

  • 16 week online educational program for walkable community advocates
  • each fellow develops a Walking Action Plan for their community, which establishes specific goals and an implementation strategy

SDOH ASSESSMENTS

The Arkansas Diabetes Prevention and Control Program conducts periodic assessments in collaboration with Diabetes Self-Management Education and Support programs, Diabetes Prevention Programs, and complimentary diabetes programs in various communities. These assessments help those programs understand the current strengths, resources, and needs of the identified communities that will allow the programs and the Diabetes Prevention and Control Program to tailor activities, communications, and partnerships so that they are well-received and address the unique needs of the priority populations. The aim is to increase participation and retention in the diabetes programs, and to identify resources to assist participants in addressing social determinants of health to achieve prevention and management goals.

  • Complete a 1-hour interview (via zoom).
  • Introduce project team members to potential & current diabetes program participants who may be interested in participating in a focus group (via email, flyers, etc.).
  • Introduce project team members to additional practitioners who may be interested in completing an interview (via email)
  • Help us find a community space to conduct focus groups.

Partners will receive results of the assessments and financial (as available) and technical assistance with implementing awareness/marketing campaigns and tailoring materials.

For more information or to nominate your program/community for the assessments, please contact the Arkansas Diabetes Prevention and Control Program at 501-661-2075.

COMMUNITY HEALTH WORKERS (CHWS)

The Arkansas Diabetes Prevention and Control Program is collaborating with the Arkansas Community Health Worker Association (ARCHWA) to:

  • Implement a state-wide summit of Arkansas CHWs including sessions on diabetes related topics;
  • Train CHWs on barriers to social services and support needs (e.g., childcare, transportation, language translation, food assistance, and housing) within populations at highest risk of diabetes and/or cardiovascular disease;
  • Equip CHWs with regional community resources to enhance community-clinical links with HUD, food banks and pantries, and transportation resources for patients identified to have SDOH-related social service and support needs;
  • Host the Diabetes Prevention CHW Network and train the Network to better integrate diabetes Team-Based Care and referrals to National Diabetes Prevention Program (DPP) lifestyle intervention and Diabetes Self-Management Education and Support (DSMES) services;
  • Engage community organizations (e.g., churches, employers, healthcare clinics) to facilitate integration of CHWs into DPP/DSMES delivery teams.

OTHER STRATEGIES TO IMPROVE SOCIAL DETERMINANTS OF HEALTH

FOOD ENVIRONMENT

  • Promote local garden projects, small farms, farmers’ markets, farm to school, and gleaning programs.
  • Promote participation in nutrition assistance programs.
  • Utilize evidence-based nutrition education programs.
  • Educate health care professionals and cross-functional hospital teams in nutrition education and about access to healthy food.
  • Promote current public policies to assure inclusion of healthy foods for distribution to low-income Arkansans.

BUILT ENVIRONMENT

  • Connect more people to parks, particularly in nature-deprived communities.
  • Promote active transportation and land use policies to support physical activity.
  • Promote built environment interventions, (e.g., parks, walking paths) community programs (e.g., social support programs), and policies (e.g., complete streets policies) which can help reduce or eliminate barriers to making it easier for people to be physical active.

COMMUNITY-CLINICAL LINKAGES

  • Provide training and disseminate training resources on SDOH for CHWs, DSMES and DPP partners, Office of Health Disparities, Arkansas Pharmacy Association (ArPA), and other healthcare professionals through partnership with relevant entities.
  • Improve capacity of the diabetes workforce to address social determinants of health (SDOH) related barriers.
  • Collaborate with the Arkansas Community Health Worker Association (ARCHWA) to engage and educate CHWs to promote and disseminate diabetes-related culturally adaptive materials and services in Team-based Care for priority populations with diabetes.

FIND SDOH RESOURCES HERE.

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