Blake Farmer / WPLN
Chains, saws, and old woodwork are located in the backyard of Wendy Norris' family farm near the county town of Altamont, Tennessee. Norris was part of the local wood industry, and the rusted tools are relics from a time when health problems prevented them from felling hardwoods.
"I was nine months pregnant," says Norris. "My husband and I stayed in a tent for about 16 or 24 km in the middle of nowhere for a long time."
These outdoor adventures are just a memory. A few years ago, when Norris turned 40, her feet began to go numb. She first assumed that she had been working in a nursing home all day.
"But it was not like that," she recalls now. "It was this neuropathy that my [blood] sugar was high and I did not know it." Norris had developed type 2 diabetes.
Grundy County, Tennessee, has a long list of public health issues, and Type 2 diabetes comes first. The county is amazingly scenic; It also has one of the lowest life expectancy rates in the region.
Norris was relatively active. She also enjoyed lemonades, sweets and frozen foods. Meanwhile, diabetes is in her family. When her diagnosis of diabetes was made, the doctor prescribed insulin for her and told her to watch what she ate.
"You're sitting there I thought," Well, what does that mean? "" Norris says.
Type 2 diabetes can be reversed with weight loss and exercise; However, research shows that people need a lot of help to get their blood sugar controlled with just one change in their diet and lifestyle, and rarely receive enough support. It is easier for physicians and patients to rely on medication in the first place.
Norris says that trying to revise her diet herself was confusing and difficult. And when nothing changed, the doctor just continued to increase her insulin dose.
But then Norris lost her health insurance. The injectable insulin cost her hundreds of dollars a month – money she simply did not have.
Fortunately, a few nurses who were members of their community came in to help – not with cash, but with the crucial support of a different kind.
At the not-for-profit Beersheba Springs Medical Clinic, a not-for-profit clinic, Founded in 2010 to bring free or low-cost healthcare to the region, Norris was presented with an alternative approach to fighting their type 2 diabetes – and the prospect of a complete reversal of their diagnosis.
Retired nurses on mission
In a former rectory near the clinic, Karen Wickham draws a lentil stew as a handful of attendees of the evening's reconnaissance session arrive.
She and her husband Steve are white-haired, half-rented nurses who have dedicated their lives to what they call "diabetes reversal." They offer six-week seminars for type 2 patients like Norris, who also brought their father and daughter.
"That's our goal," says Karen. "Our purpose in life is to try to make a difference – first in our church."
With slide presentations, the Wickhams explain the difference between sucrose and glucose and the science behind it that foods such as potatoes increase blood sugar levels. while sweet potatoes do not. They preach that they eat as much fiber as a stomach can tolerate and drop almost any type of sweetened drink.
Blake Farmer / WPLN
They then demonstrate ways to burn all those calories. One evening Steve invents the "Beersheba Boogie" on-site and asks the participants to lift their knees and pump their fists up.
All these people will have to find a way to get active at home because there is no gym nearby. There is no real grocery store nearby, so healthy cooking can become a real job. These Community-wide barriers make it clear why it can be difficult for people to maintain their health in rural America. But the Wickhams are working to overcome these barriers.
Steve calls for applause while attendees share their latest health statistics: "Your blood sugar is going down! it is somehow. Steve and Karen Wickham feel compelled to do this work as part of their Christian faith as Seventh-day Adventists – members of a denomination known for their focus on health.
"I think God blames us for living in the midst of people and doing nothing," says Steve.
The Wickhams originally moved to Grundy County to look after sick parents and built their dream home there. They planted extensive orchards, vegetable gardens and berry fields to satisfy their vegetarian diet – a diet widely used among Seventh-day Adventists With 13,000 inhabitants, Tennessee is considered the least healthy each year. Grundy County has the shortest life expectancy in the state and an increased diabetes rate (16 percent of adults), which can eventually lead to blindness, kidney failure and amputations.
"I've cared for diabetes patients for so long, and I knew the progress," says Karen. "If you really want people to get better, you need to treat them with lifestyle improvement measures."
A revised diet and activity level is the obvious answer, but these changes are difficult to start and even more difficult to maintain.
"Actually, no one will make any lifestyle changes we recommend," says Steve. "But if you make the kind of decisions that will lead you to a healthier lifestyle, you will get better." A more hopeful message Give a disclaimer recommending that doctors tell you about their condition and treatment. They also acknowledge that their seminars are not yet "evidence-based" or supported by peer-reviewed scientific literature. This is one of the reasons why they could not receive government grants to directly finance their program.
However, there are studies that show that people with blood sugar levels in the area of "prediabetes" can return to normal blood sugar by losing 5% of their body weight.
And weight loss and exercise have already been shown to lower the hemoglobin A1c level, which allows doctors to monitor a patient's blood glucose levels two to three months.
In addition, new research by Dr. med. Roy Taylor of Newcastle University in the UK, that a real remission is possible.
Most studies show that type 2 diabetes is unidirectional in most patients. But Taylor says these studies also involve people who continue to gain weight, which is typical for diabetics.
"Doctors tell their patients:" They have a lifelong state, we know that it will steadily worsen. "Then they turn around, and their patients neither lose weight nor do they exercise, but they have given you this most depressing message, "he says.
Taylor's research has shown that when weight loss is about 30 pounds of diabetes can be reversed in its early stages. Taylor prescribes a strict fluid diet and – initially – a limited exercise to not stimulate the appetite. People with type 2 diabetes need to lose fat from the liver and pancreas.
Ultimately, Taylor hopes that a better diet over the next decade will be the preferred response to high blood sugar levels.
"I think the main headwind [against progress] These are conceptual cases only – scientists and physicians believe that this is an irreversible condition because of the circumstances observed," he says.
Even the American Diabetes Association has changed their views. Advocacy has a new position on Type 2 inversion: "If a patient wishes to seek remission from type 2 diabetes, especially within 6 years of diagnosis, evidence-based weight management programs are often successful."
John Buse, chief physician of endocrinology at the University of North Carolina School of Medicine, helped draft the revised guidelines from the American Diabetes Association. "We literally know since the 17th century that diet is the key to treating diabetes," he says.
However, it is difficult to write a lifestyle change recipe.
"Doctors do not have time to do well, we often used the kind of Short Shrift," he says. "Eat less carbohydrates and go for a walk every day." This basically has no effect. "
The Wickhams do their part to supplement the scientific data and blood glucose of participants in their program to pursue. And even the occasional short-term evidence they've gathered so far resonates well beyond Grundy County, and they've been traveling lately.
Blake Farmer / WPLN
The couple has just sold their retirement home so they can accept all the invitations they have received, mainly from Seventh-day Adventist groups, to introduce their program to other communities in the United States.
In the meantime, Wendy Laut Norris has already changed her overall attitude to health with the prospect of turning back type 2 diabetes.
"I felt like I could not live with three or four beats a day for the rest of my life," she says. "I've already brought it to one."
This story is part of NPR's reporting partnership with Nashville Public Radio and Kaiser Health News.