While the prevalence of diabetes in Richmond County has increased, the mortality rate has decreased slightly, but is still 31 percent higher than the state average, according to statistics released by FirstHealth.

“That’s a pretty big deal,” said Roxanne Leopper, policy director for FirstHealth’s Community Services Department. “It’s important for people to understand if they have diabetes they need to manage it.”

A contributing factor to the higher death rate is that diabetes is often underdiagnosed.

“A lot of times people are afraid of diabetes,” Leopper said. “They have the signs and symptoms but they don’t want to be on medicine or can’t afford it. Obesity affects 21 percent of Richmond County adults, higher for children, and that affects it as well.”

The prevalence of diabetes is also higher in Richmond County than the state’s average. In Richmond County, 18.8 percent of the population has been diagnosed with diabetes, the state average is 9.1 percent. That’s up from 12.4 percent in 2003.

But Leopper said the increase in prevalence isn’t necessarily a bad thing, because it means people are being diagnosed, which means there’s an opportunity for diabetes management.

The FirstHealth First-In-Health 2020 Vision goal is to decrease the mortality rate to 16.8 percent and decrease the prevalence to 8.2 percent.

FirstHealth has a First-In-Health 2020 task group made up of Richmond County community members who have identified diabetes, obesity and cancer prevention as the three areas of focus.

As a way to meet their goal, FirstHealth is holding more blood sugar screenings to get people diagnosed sooner so they can begin their diabetes management program.

One of the problems they’ve seen, though, is that patients are not following through with their diabetes management.

“The devil is in the details,” said Melissa Herman, program coordinator of the FirstHealth Diabetes Program. “The key is to understand why they’re not managing their diabetes. A lot of our patients are uninsured and they can’t afford their testing supplies and prescriptions, so when a physician asks someone to check their blood sugar three to four times a day, it’s costly. We have to work around these obstacles.”

Herman said the FirstHealth Diabetes Program offers a chance for patients to sit and work with diabetes educators to link them to proper resources.

Herman said FirstHealth will not turn anyone away for care if they can’t afford it. Rather, they’ll have them work with the financial assistance program to at least get them to participate in the educational programs FirstHealth offers to diabetics. The program also receives grants to make funds available for prescriptions and testing supplies for some patients while they await enrollment in Prescription Assistance programs through the drug companies.

FirstHealth is certified through the American Diabetes Association and follows the organization’s curriculum when it comes to educating diabetes patients. The hospital offers A-Z diabetes care that covers what diabetes is, what medications are available, what sorts of preventive methods are out there to prevent complications from diabetes, etc. These classes are typically for patients who are newly diagnosed.

Patients who have had a diagnosis for a while can receive one on one consultations through the diabetes program.

Herman said there’s another disturbing trend in the diagnosis of county residents.

“We’re seeing it in a much younger population now,” Herman said. “Type 2 is being diagnosed in folks under 40 and as young as elementary school, which is a frightening statistic.”

Both Leopper and Herman agree that one of the most important things is to get prediabetic patients informed about their condition.

“Seize the opportunity now and make lifetime changes,” Herman said. “Many patients transition from prediabetic to Type 2 diabetes within the first year. This is an early warning sign to make changes. You don’t want to wait too long.”

“If you can catch it then you can prevent or prolong the onset of diabetes,” Leopper said.

Herman said diet and exercise are key in preventing and maintaining diabetes but that it’s something few people will see through.

“Diet and exercise has a significant ability to reduce the chance of developing diabetes and reducing complications,” Herman said. “I encourage folks to watch their carbohydrates - not sugar specifically - but starchy carbs. Limit portions of fried foods and fast foods, and more specifically, rice, potatoes and bread. Corn, peas and beans are vegetables, but they’re starchy vegetables so you have to watch your portions of those as well. People need to get educated about what foods impact their blood sugar more and work that into their lifestyle, they don’t have to give it all up.”

As a way to keep the community informed and better prepared for diabetes, FirstHealth has received a grant to place Certified Diabetes Educators in clinic settings to meet one on one with patients about managing their diabetes.

“When it’s not managed, that’s when you get the terrible side effects,” Leopper said.

There are also regular blood sugar screenings through the FirstHealth mobile health van.

“The great thing about that is it’s free and fast and you don’t have to starve yourself before going,” Leopper said. “You just go get your finger pricked and in minutes you have your blood sugar number. It’s usually better to go after you’ve eaten so you can see how your body breaks down the sugars.”

Leopper said FirstHealth is trying to do more just blood sugar screenings to increase participation.

In 2008, North Carolina ranked 17th highest for adult diabetes prevalence among all 50 states. In the state there are an estimated 643,000 residents diagnosed with diabetes, 232,000 residents undiagnosed with diabetes and an estimated 376,000 adults with prediabetes.

And while it’s not clear why the state and county numbers are so high, a study done this year by the state Department of Health and Human Service found that residents with less than a high school education were among the most diagnosed at 13.6 percent. And of residents earning less than $15,000, 16.7 were diagnosed with diabetes. The study also found that the prevalence of diabetes is higher for African Americans and American Indians.

If not treated or managed correctly, diabetes can lead to blindness, heart disease, stroke, kidney failure and amputation. It kills almost 210,000 people each year.

There are three main types of diabetes. Type 1, which is typically diagnosed in children and young adults and requires insulin therapy; Type 2 which is when the body does not produce enough insulin or the cells ignore insulin; and gestational diabetes which occurs often during the 28th week of pregnancy or later.

According to the American Diabetes Association, 57 million Americans are at risk for Type 2 diabetes.

If you have the following symptoms you should contact your doctor: Extreme thirst, frequent urination or unexplained weight loss. There is also a 10-question test you can give yourself to assess your risk of developing diabetes at www.diabetes.org.

The next free mobile diabetes screening is Wednesday, Nov. 18 from 9 a.m.-12 p.m. at Richmond Health and Fitness Center in Rockingham.

n Staff writer Eren Tataragasi can be reached at (910) 997-3111 ext. 19 or at etataragasi@yourdailyjournal.com.