Air Force diabetes prevention program shows promising results
"I wish I knew this 30 years ago," is a common feeling among Air Force veterans after receiving diabetes education. Like most of the 89 million Americans with prediabetes, many active duty Airmen do not know the ways they can prevent or delay the onset of diabetes.
With 1 in 3 Americans at risk for diabetes, researchers and health professionals at the Wilford Hall Ambulatory Surgical Center in San Antonio, found it critical to implement and test the Group Lifestyle Balance program. The GLB program is a diabetes prevention program that was originally developed at the University of Pittsburgh and piloted at seven Air Force bases. The program targets those at risk for developing diabetes, including anyone with elevated blood sugars, metabolic issues, or a family history of diabetes.
Diabetes, specifically Type 2 diabetes, is largely attributed to a poor diet and a sedentary lifestyle. Targeting these factors is at the core of the GLB program. The Diabetes Center of Excellence utilizes this program to help patients prevent or delay diabetes by engaging active duty, veterans, and their families in preventative health behaviors.
"Diabetes is a costly and progressive disease," said Nina Watson, a retired Air Force Lt. Col. and current certified diabetes educator with the Diabetes COE at Wilford Hall. "Many people do not realize they can delay or even prevent diabetes just by changing their lifestyle."
Initially the GLB program consisted of an intensive 12-week program that focused on overall health and behavior change. It has expanded to a one-year program that provides ongoing group and lifestyle coach support after the initial 12 weeks. The course relies on periodic, face-to-face meetings, weekly assignments, and group support. During this time, patients learn how to improve their diet and make healthier dietary choices. Additionally, they learn ways to increase their physical activity; the goal being to develop positive behaviors that become lifelong habits.
"Continuing education and support after the initial intervention is integral to preventing relapse and solidify behaviors," said Nina Watson.
Currently, the Diabetes COE has a manuscript accepted for publication in Military Medicine describing their experience providing the GLB program. The program demonstrated impressive results for those who completed the first 12 weeks. Significant improvements were seen on weight, body mass index, and cholesterol in the participants. These improvements not only mean improved overall health, but also mean participants are more likely to delay or prevent the onset of diabetes.
In addition to the focused education, group support for the participants created much of the program's success.
"The group accountability and support makes it easier to overcome challenges and celebrate successes," said Regina Watson, the health promotions program manager for the Air Force Medical Support Agency. "Just knowing that they would meet with the same people every week made participants look forward to these meetings. They felt better knowing other people were dealing with similar challenges."
The GLB pilot did yield another important finding – active duty participants with prediabetes dropped out of the program at a higher rate than any other group. With almost 13,000 active duty Airmen with prediabetes, it is an issue that needs to be addressed.
"Airmen may believe that because of their physical fitness requirements, they are not at risk for diabetes. Many Airmen can pass the physical fitness test despite poor lifestyle choices. They may not realize how difficult treating diabetes can be later in their life if they continue the same behaviors," said Nina Watson. "It is vital to get this information to younger Airmen so they adopt lifestyle behaviors that could help them live a long and healthy life."
The GLB program is looking to increase its reach to all at-risk Airmen using technology like telemedicine, mobile messaging, and fitness applications. This can expand the program to all Air Force medical facilities and allow Airmen to receive support even after the program ends.
"The Diabetes COE is the best kept secret in the Air Force and we want the GLB program to be a priority for all at-risk active duty Airmen," says Nina Watson. "After all, a healthy, fit Airman is the most valuable asset the Air Force has.