In the United States, nearly 26 million people have diabetes. Diabetes mellitus (DM) is a key public health problem caused by inadequate glucose regulation. DM is the primary cause of foot and leg amputations, chronic kidney disease, stroke, and retinopathies including blindness. Proper management can significantly reduce complications (McLeod, 2016; Zakowski, 2017). Many individuals are undiagnosed or continue to have elevated glucose levels.
Almost 79 million adults have prediabetes, which is defined as a glycosylated hemoglobin level (HbA1C) level between 5.7% and 6.4% (McLeod, 2016; NIDDK, 2018). Individuals with prediabetes have a five to fifteen-fold higher risk of developing type 2 diabetes over the next three to five years than those with normal glucose levels (McLeod, 2016;NIDDK, 2018). Prevention through early detection and education can help decrease the prevalence and complications of type 2 diabetes mellitus (T2DM) (Watts, Stevenson, & Russell, 2018; Pawlak, Ito, Cahill, & Sweatt, 2019). The prevalence of diabetes nationally is 9.4% (American Diabetes Association, 2018). However, in Alabama the rate of diabetes is 15.4% and almost 31,000 people per year are diagnosed. The purpose of this presentation is to discuss a cost-effective interdisciplinary educational event to increase diabetes awareness in a rural community.
Methods:
A nursing professor and PGY-1 pharmacist collaborated to provide diabetes screening and education at Pioneer Day, a free event in Loachapoka, Alabama. The nine-hour festival included crafts, musical entertainment, and children’s activities. Loachapoka is a small, rural town representative of communities in east Alabama with a low socioeconomic status. The median household income is approximately $40,000 per year, which is significantly lower than the national average (Onboard Informatics, 2019; United States Census Bureau, 2018). Community partners and academic organizations with a shared vision can address health inequalities with innovative solutions (Mayer, Braband, & Kellen, 2017). The diabetes screening and education was made possible by pooling resources and had a greater impact on participants because of the alliance. The partnership was characterized by clearly defined roles and expectations, clear communication, and shared goals. Funds for the HbA1C screening supplies were provided by a grant from the Alabama Nurses’ Foundation, and the booth fee was financed by the Auburn University Harrison School of Pharmacy.
Results:
While waiting on the HbA1C reading, appropriate education was provided by an Auburn School of Nursing faculty member, PGY-1 pharmacy resident, and Harrison School of Pharmacy students. Handouts and discussion topics included risk factors, management, and prevention of disease progression. At the event, 38 participants received HbA1C testing, results, and counseling. Seven participants had an HbA1C of 5.7% to 6.8%, which represents prediabetes and one participant had an HbA1C of 6.5% or higher, which is indicative of diabetes mellitus. Participants received a copy of their test results at Pioneer Day.
Conclusion:
Diabetes is a public health issue in which patient knowledge and skills for self-management are crucial. Early detection of prediabetes and diabetes can decrease the impact of related complications. Interdisciplinary educational events in rural communities can be a cost-effective way to raise diabetes awareness, improve diabetes control, and increase self-efficacy.