Diabetes programme ‘changing my life’

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  • Road to reversal: from left, Bermuda Diabetes Association educator Sara McKittrick, programme participant Amanda Paulos and Karima Stevens-Smith, nurse case manager for Argus’s population health programme (Photograph by Lisa Simpson)

    Road to reversal: from left, Bermuda Diabetes Association educator Sara McKittrick, programme participant Amanda Paulos and Karima Stevens-Smith, nurse case manager for Argus’s population health programme (Photograph by Lisa Simpson)

  • Raising awareness: In partnership with the Bermuda Diabetes Association and to mark World Diabetes Month and World Diabetes Day on November 14, the Argus Building has been illuminated in blue this month (Photograph supplied)

    Raising awareness: In partnership with the Bermuda Diabetes Association and to mark World Diabetes Month and World Diabetes Day on November 14, the Argus Building has been illuminated in blue this month (Photograph supplied)


Both type 1 and type 2 diabetes are characterised by higher than normal blood sugar levels but the cause and development of the conditions are different.

• Type 1 diabetes is an autoimmune disease where the immune system attacks and destroys the insulin-producing beta cells in the pancreas. Although usually diagnosed in children and young adults, it can appear at any age and people need to take insulin every day to stay alive.

• Type 2 diabetes is insulin resistance, where the body does not make or use insulin well. The body compensates by producing more insulin, but it can’t always produce enough. The strain placed on the beta cells can destroy them. People may need to take insulin because they have low sensitivity to insulin or beta cell failure. It occurs in middle-aged and older people and is the most common type. Risk factors include being over 45, having a family history of diabetes, being overweight, physical inactivity, race, and high blood pressure.

• Gestational diabetes, meanwhile, is high blood sugar that develops during pregnancy. It occurs if the body cannot produce enough insulin to meet the extra needs in pregnancy.

Although it usually disappears after giving birth, women who’ve had it are more likely to develop gestational diabetes again in future pregnancies and type 2 diabetes.

Information via www.nhs.uk, www.diabetes.co.uk, www.cdc.gov and www.niddk.nih.gov

Amanda Paulos has struggled with type two diabetes for a decade.

But the 41-year-old said she was getting to grips with the chronic condition after joining a programme designed to reverse the disease.

The mother of four, from Smith’s, has lost weight, her average blood sugar readings have dropped and she was able to go off two of her medications.

Ms Paulos said: “In October, I had my HbA1c, which is a three-month average blood sugar reading, and I had that go down to 6.2 per cent.

“That is the lowest I’ve ever been at any time it’s ever been tested in my life and I cried tears of joy. That was down from 8.8 per cent in May.”

BDA diabetes educator Sara McKittrick explained that in someone who does not have diabetes the HbA1c should be under 6 per cent.

Ms Paulos, who also lost 14lbs, added: “I’ve gone from four medications down to two — that’s big news actually, very big news.”

She discovered she had gestational diabetes when she was pregnant with her second child, although she did not realise she had any symptoms.

Ms Paulos said: “I was tired, I was going to the bathroom a lot — these are just normal pregnancy things.”

It happened again when she was pregnant with her two youngest children.

She later went into a pre-diabetes phase and “sometime later type 2 diabetes”.

She said: “It’s quite a difficult thing to think about. I was very unhappy and I am sure many people will echo that.”

Ms Paulos visited dietitians and nutritionists with minimal success. Medications piled up until she was taking the maximums possible prescription.

A relative and her GP recommended the Diabetes Reversal Programme, developed by diabetes specialist Dr David Cavan, Dr Stanley James, of Premier Health & Wellness Centre, and the Bermuda Diabetes Association.

Ms Paulos in June started the 12-month programme designed to help people with type 2 diabetes find ways to eat better and increase physical activity.

She said: “It is a really good programme. The first six weeks was quite intensive meetings — three hours every night.”

Ms Paulos said the discussion groups were the best part and added: “There’s really something to be said for that — people in a similar situation discussing and trying to work together. You take home from that steps that you can take personally that might have worked for someone else and you didn’t think of.”

Ms Paulos has increased her exercise and changed her diet since she started the programme.

She said: “I’m really making a huge effort to decrease my carbohydrate intake and just really pay attention to that. And I’m much better at testing my blood sugar levels.”

Ms Paulos added she also slept better, was less tired and had more energy.

And she said her new diet had also had a knock-on effect on what her children ate.

Ms Paulos was part of the fourth group to go through the programme, free for eligible Argus members.

The goal is to lower blood sugar levels, reduce the need for medication, and improve general health.

Karima Stevens-Smith, nurse case manager for Argus’s population health programme, said they had seen some “really early successes” with the 35 members who had taken part.

Average blood sugar readings have dropped by 1.5 percentage points and participants have lost an average of two inches off their waists.

Ms Stevens-Smith said that meant in a decreased risk of heart attacks, strokes and other complications associated with the disease. Ms McKittrick said 13 per cent of the island’s population are probably affected by diabetes — 95 per cent type 2 and 5 per cent type 1.

She added: “We know diabetes is prevalent and an extensive problem in Bermuda and that is not going away.

“There is a genetic component to it, we’re here obviously on a small island, but obviously lifestyle is huge.”

Ms McKittrick, one of the programme facilitators, said group work and goal-setting are key to the programme’s success.

She added: “It’s facilitating the patient’s individual understanding and comprehension and we’re putting that in a way where you are all getting it as a group. It’s really exciting to see that happen. You can almost see bells going off in people’s heads.”

But she said: “It does take effort and commitment. But I’ve truly been inspired by the commitment people have been showing.”

Ms Paulos added: “I recommend anyone who has type 2 to definitely inquire and get on board.

“It’s truly changing my life and I know that if they put in the effort and participate, that it could change theirs too.”

For more information, visit www.argus.bm/health/thrive/diabetes-reversal-programme/ or www.phwcbermuda.com/our-services/diabetes-reversal/ or call 292-5111

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Published Nov 21, 2017 at 8:00 am (Updated Nov 20, 2017 at 11:03 pm)

Diabetes programme ‘changing my life’

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