T2 Takedown

Mary Greeley program helps people who are at risk for type 2 diabetes be proactive in their fight against the disease.

For Jane Jackson, this was a must do. Both her parents battled type 2 diabetes late in life. Her brother also suffers from the disease. Jackson knows she has prediabetes so when Mary Greeley launched a program called Prevent T2, she knew she had to be part of it. “I am afraid of getting diabetes,” Jackson admits. “I saw what happened with my parents and know how hard it is to control when you get older. This program was so appealing because I like the idea of a group focusing on the same challenge. It has been extremely beneficial.”

Prevent T2, offered through Mary Greeley’s Diabetes and Nutrition Education Center, is based on the Center for Disease Control’s National Diabetes Prevention Program (NDPP). Backed by 15 years of research, NDPP has been shown to lower the incidence of T2 by 58 percent. A decade after doing the program, 33 percent of participants who met their goals were still diabetes free.

Mary Greeley’s program started last year with a pilot group involving nine employees of the medical center and McFarland Clinic. Two new classes have since started, and now the medical center is hoping to attract more individuals and businesses to the program.

Lifestyle Focus

Stethoscope with glucose meter, fruit and dumbbells1 in 3 American adults
has prediabetes.
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Prevent T2 participants have prediabetes or are at-risk for the condition. This status is determined from a brief CDC test of risk factors each participant completes (see right) and whether a participant has had an elevated fasting blood glucose level. A blood glucose level test is a typical lab test. In most cases a participant will have this information in their medical records. Risk factors for prediabetes include being 40 years old or older, gender and ethnicity, a family history of diabetes, high blood pressure, weight and a lack of physical activity.

Prevent T2 is taught by Thyra Cox, MSN, RN, CDE, supervisor of Mary Greeley’s Diabetes and Nutrition Education Center, and Liz Burkland, RD, a diabetes educator with the center. Both women have gone through lifestyle coach training, which is required to teach the program. The program has received financial support from a state of Iowa grant and gifts to the Mary Greeley Medical Center Foundation.

During the first four months of the year-long program, the group meets weekly. The next two months involve meetings every other week. The group gets together monthly for the final half of the year. At each session, various topics are discussed, including exercise, meditation, yoga and mindful eating.

Prevent T2 is not a diet program. Instead, it focuses on total lifestyle, and encourages participants to increase their level of activity to 150 minutes a week and lose 5 to 7 percent of their baseline weight by the end of the program.

“Our aim is to prevent or delay the onset of type 2 diabetes through moderate weight loss that results from eating better and being more active,” says Burkland. “Participants are encouraged to take an honest look at their lifestyles with the goal of seeing those achievable opportunities for better health.”

The group sessions can be personal and emotional and people face the consequences of weight gain or inactivity, and express their struggles to drop pounds and exercise.

“People in the pilot group have talked about becoming more aware of how they see themselves and how they need to see themselves,” says Burkland. “Prevent T2 is about being a caretaker for you. It reminds you to care for you. It helps you carve that 30 minutes a day for physical activity because you deserve it, and to making good food choices because you know it makes you feel better.”

Cox adds that “losing weight shrinks insulin resistance, which drives your metabolic functions to act like they should. That’s the real concrete outcome. The other outcomes we see are softer, as people, maybe for the first time in their lives, are understanding the emotional aspects of the disease and what they need to do to avoid it.”

The sessions are confidential and the classes involve small groups, no more than 12 people, in order to facilitate open and supportive give-and-take between participants.

“Tears are not unusual, and it’s cool to watch these people be so supportive of each other,” says Cox.

Exterior of Mary Greeley Medical Center's North Addition

Learn More

Prevent T2 is offered at Mary Greeley. Program coordinators can do presentations on the program for organizations and businesses. If necessary, the program can be offered at sites outside of the hospital.

“We are willing to come to the place of work to provide this program,” says Thyra Cox, supervisor of Mary Greeley’s Diabetes and Nutrition Education Program. “It is that important to the health of the communities we serve.”

To learn more, email the Diabetes and Nutrition Education Center or call
515-956-2880.

I Feel Better

Three members of the Prevent T2 pilot program share thoughts on how it has changed their lives.

Jane Jackson

Jane Jackson, BSN, RN

Director, Outpatient Nursing Services

Mary Greeley Medical Center

Jane Jackson’s family history with diabetes, as well as having prediabetes herself, was all the motivation she needed to join the Prevent T2 pilot group. Since joining, Jackson has increased her physical activity by using an exercise bike at home and working out with hand weights. She also has increased the amount of vegetables in her diet and
paid closer attention to portion sizes.

How Prevent T2 group sessions have contributed to her success: “The group sessions are extremely beneficial. You get help from the group when you need the help, and you can give it when others need it. Sometimes you have a bad week. You don’t lose weight or
you gain a few pounds. You don’t find time to exercise. You feel down, but you have the support and encouragement of other people in this amazingly supportive group. Being able to talk to a group of people about these topics is a relief. You realize that you’re not alone in this struggle. It’s really great emotionally and physically, and these are relationships we will keep long after the program.

How Prevent T2 changed her life: “I think we are all seeing changes in our lives. The realization that you don’t have to lose a ton of weight is significant. I am becoming more and more addicted to exercising daily and being more active, and I’m more cognizant of what I’m eating. I feel better. My brain works faster. My mood is better.”

Ellen Owings

Ellen Owings, RN

Population Health Nurse

McFarland Clinic

Ellen Owings was motivated to join the pilot group because she has a sister with diabetes, and notes that, “I will do anything to avoid going through what she has gone through.” Her diet has changed for the better. “It wasn’t really bad but I’m practicing more mindful eating, thinking before I eat,” she says. As for exercise, Owings is walking more and working with hand weights. She also has an elliptical machine under her desk, “so I can pedal while working.”

How Prevent T2 group sessions have contributed to her success: “It is very helpful to know that people are going through similar things and some even have more risk factors than I do. I’m making new friends in this group.”

How Prevent T2 changed her life: “Learning how just a 5 to 7 percent weight loss can really make a huge impact on your health has been very important. It’s doable for most of us. I’ve lost a few pounds. I’ve realized how much of this is a mental thing. I feel way
better. I’m sleeping better. People have noticed that weight loss. That kind of feedback is wonderful. It’s also made me more empathetic. It’s helping me understand what my sister goes through. She’s excited about the class and me a being part of it. As a population health nurse I see a lot of patients with diabetes, so it’s also helping me understand my patients more. It’s impacting me personally, as well as professionally. I’m walking the
walk.”

Lori Baker

Lori Baker

Education Specialist

Mary Greeley Medical Center

Lori Baker has always been physically active, and has always struggled with her weight. She has tried various diets, but her weight consistently goes up and down. Knowing
this, and her risk for prediabetes because of age and weight, Baker opted to give Prevent T2 a try.

How Prevent T2 group sessions have contributed to her success: “It’s a cohesive support group. We all seem to feed off of each other. I was comfortable right from the beginning. I talk to my family about everything I learn. I want the kids to see it and understand it.”

How Prevent T2 changed her life: “I pay attention to what I eat. They’ve given me little tricks that I can use so I never feel deprived. We had a meeting just before Thanksgiving and as we were discussing the holidays and all of the eating that goes along with them, Liz (Burkland) gave us the advice that if there’s something you really, really want, go ahead and have it, but keep that in mind and maybe pass up something that isn’t as important to you. I use that a lot. When we go out to eat, as I look at the menu, I may feel like I really want a burger and fries, so I make some adjustments– no bun, no cheese, side
salad instead of fries. I’m making better choices and still enjoying myself.

“I feel better and I’m noticing it. This program is not about dieting. It’s about lifestyle; making mindful healthy choices. I think anybody can be successful at it. My husband, my son and I run together quite frequently. During our runs at Ada Hayden (Heritage Park near Ames), they were typically running twice as far as me and finishing before me. Now, they
still go farther than me, but not twice as far, and I get done about the same time they do. I’m not struggling to finish those five miles. My pace is better. They are still beating me, but they aren’t kicking my butt, and that feels great.”

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