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Episode #1904
Health: Diabetes
Brown: Natalie Bullock Brown,
host
Beuse: Doctor John Beuse, Director of the Diabetes Care Center,
University of North Carolina School of Medicine
Davis: Janice Davis; Community Advocate; Associate Minister,
Martin Street Baptist Church, Raleigh, NC; volunteer leader,
Project Direct
Brown:
According
to national statistics, diabetes is one of the leading causes
of death in the African American community. We’ll discuss
the link between diabetes and what and how much we eat tonight
on Black Issues Forum.
Voiceover:
This program was made possible by contributions to UNC-TV
from viewers like you. Thank you.
[THEME
MUSIC]
Brown:
Good evening, everyone. I’m Natalie Bullock Brown. Welcome
to Black Issues Forum. Diabetes places a tremendous
health burden on the citizens of North Carolina. The North
Carolina Department of Health and Human Services reports an
estimated five hundred and eighty four thousand people State-wide
have the disease, and only forty-two percent of that number
even know that they have diabetes. The bad news is that the
incidence of Type Two, or Adult Onset Diabetes, has tripled
in the last thirty years and is responsible for one hundred
and eighty thousand deaths nation-wide per year. The good
news is that among the controllable risk factors associated
with diabetes, experts say that obesity is, by far, the most
important. In fact, experts say more than eighty percent of
people with Type Two diabetes are overweight, but there is
help available, as our guests will attest. So, here, tonight,
to help us understand what can be done about diabetes are
Doctor John Beuse, Director of the Diabetes Care Center at
the University of North Carolina School of Medicine. Also,
Janice Davis, Community Advocate and Associate Minister at
Martin Street Baptist Church in Raleigh and a volunteer leader
with Project Direct, which we’ll get into a little later.
But first, welcome to both of you.
Beuse/Davis:
Thank you.
Brown:
Now, Miss Davis, I’d like to start with you, because
you are going to be our face for diabetes today. So, tell
us about your early struggle with diabetes and obesity. I
understand that you, at one point, were two hundred and twenty
pounds.
Davis:
Yes, I was a couch potato. I was a very miserable person,
and I was afraid I was going to kill myself, so I prayed,
“Lord, help me to lose this weight and keep it off.”
And I was reading an article one night, and it said, “Smart
people don’t diet. They eat well-balanced meals, and
they exercise.” So I thought, “Lord, is it that
simple?” So, I began to learn what a well-balanced meal
was, and I chose walking as my exercise, and I learned how
to cook my food more nutritiously. I cut back on the fat.
Mind you, I said I don’t “diet.” I learned
how to eat properly, is what I tell people.
Brown:
Well, tell me, how did your obesity impact your diabetes?
I mean, there’s a direct link between being overweight
and diabetes.
Davis:
Okay. Actually, when I lost the weight the first time,
I did not have diabetes, and I was so proud of myself, and
then I got sick and went on medications, and I gained the
weight back, and then my doctor told me I had diabetes. And
I’m, like, in denial. “I just learned how to eat.
I lost the weight. I know I can’t have diabetes.”
But, yes, I did have diabetes, and I had to learn how to eat
correctly all over again, because what I had just taught myself
did not work for people that have diabetes.
Brown:
Dr. Beuse, help us understand what this relationship is
between obesity and diabetes.
Beuse:
You know, we don’t know all the answers, but I think
the best idea that we have of how this relationship occurs
is that when people are really overweight, fat occupies a
lot of spaces that it’s not supposed to occupy. So it
gets in the liver, actually gets in the muscle, you know,
like marbled beef that you look at at the grocery store, and
that causes the liver and the muscle not to be able to use
sugar appropriately, and so the sugar builds up in the bloodstream.
So, one concept is that there’s so much fat that the
body can’t store it in all the right places. Then it
starts interfering with other systems.
Brown:
And this buildup of sugar — since this is an African
American show — that’s why a lot of African Americans
call diabetes “sugar,” because of this buildup.
What are some of the hidden costs of obesity, especially as
it relates to diabetes?
Beuse:
You know, I think it’s hard to really estimate the
true impact of obesity. You know, it’s a major contributor
to arthritis, to cancer, to diabetes. I think reasonable estimates
would be that it probably contributes or is really the major
cause for about seventy percent of heart attacks and strokes,
which is the biggest killer of people in the United States.
So, it’s huge.
Brown:
Miss Davis, how close were you to having your diabetes,
which was being impacted by your obesity, really become very
serious, I mean, even dangerous?
Davis:
I was so afraid that I was going to have a heart attack
that I asked my doctor to let me have a stress test, and I
remember that day that I had that test, it’s like, “Lord,
help me. You know, I’ve been walking, trying to do better.
You know, I don’t want to die.” And I got on that
treadmill, and I met my targeted heart rate, and the doctor
said to me, “Miss Davis, there’s nothing wrong
with your heart. You stayed on that treadmill longer than
the average teenager.” I said, “Thank you, Jesus.
I did it.” So, it’s my mission to help others
know, “You can do it, too.”
Brown:
Well, let’s talk about that, because I know you’re
involved with Project Direct. Tell us, what is the mission
of Project Direct?
Davis:
The mission of Project Direct is to teach people how to
take care of themselves, how to eat properly, how to manage
their diabetes once they get it. But I tell people it’s
easier to prevent it by eating properly than to live with
it, but once you get it, you have to know how to live with
it, or it can kill you.
Brown:
Why is Project Direct in Southeast Raleigh? You were telling
us a little earlier about the statistics.
Davis:
The project came to Raleigh, North Carolina, and it’s
located in Southeast Raleigh because diabetes in Southeast
Raleigh was the highest rate of anywhere in the United States.
That tells me that we, in Southeast Raleigh, don’t know
how to eat. We quote-unquote “eat soul food,”
and it’s killing us.
Brown:
Um hmm. Dr. Beuse, can you address this issue of what
we eat, particularly in the African American community, you
know, the cultural acceptance of a little extra weight and
the relationship to diabetes.
Beuse:
Right. I think you’ve covered it, so part of the
issue is that in the African American community, being thin
is sometimes viewed as being, you know, sickly. And a lot
of the food choices that are culturally determined are really
very high in fat and calories. Vegetables are very healthy,
but you throw a ham hock in a pile of vegetables, and it’s
not the healthiest food any more. The other issue in Southeast
Raleigh is because there’s not very good public transportation;
people largely rely on cars to get here and there. Because
safety is an issue, children aren’t in the street all
the time, and I think another big problem is a lack of physical
activity — is a major contributor to the risk of
both obesity and diabetes.
Brown:
And I was going to ask about — I’m sorry.
I lost my thought, but let me…
Davis:
Because I was a couch potato — and when I say
that, I didn’t get a lot of activity. I drove to work.
Basically, like you said, you drive and go to where you want
to go, so I had to figure out how to get exercise in on a
daily basis, and I’m working, so I purchased a treadmill,
because I had every excuse in the book not to exercise. So,
I purchased a treadmill, a manual one. That way, I did the
work, and I would exercise before I would go to work.
Brown:
Now, Miss Davis, your situation, I mean, I don’t
know how typical it is that someone is able to actually bounce
back from diabetes, lose the weight — as much weight
as you have lost. Dr. Beuse, can you speak to that?
Beuse:
Well, you know, the old statistics — we used to
say that less than five percent of people will lose ten percent
of their body weight or just ten, twenty, thirty pounds, and
keep it off for one year. Part of, I think, the reason that
was is that doctors would say, you know, “You can’t
do it.” That would be, at least, the hidden message.
We now have a number of studies where thousands of people
have lost substantial amounts of weight and kept it off for
some period of time. And also, we now know that just losing
a little bit of weight — ten pounds, fifteen pounds,
twenty pounds — can have a huge impact on blood
sugar, blood pressure, heart attack risk. So you don’t
have to accomplish everything that Miss Davis accomplished.
If you accomplish half of what she’s accomplished, you’ve
done a great thing for your health.
Brown:
Well, with Project Direct, what do you do in the community
to help people understand what Dr. Beuse is talking about,
that you don’t have to lose seventy pounds; you can
lose ten, fifteen, twenty?
Davis:
We do training. We teach people how to walk properly.
We teach them how to prepare their foods more nutritiously,
and we have a program called Ready Set Walk where community
leaders get together. They’re trained, and we have walking
clubs, so to speak, and we’re out there in the community.
As a matter of fact, we’re going to be at Mountain Street
Thursday doing a diabetes forum all day long to teach people.
We’re reaching out, and we’re having an impact,
because people are making better health choices. Churches
now are getting onto the band wagon, because that’s
were you meet your people. So, we went to the churches, and
the pastors in the pulpits are telling their people about
more nutritious cooking. We have banquets now — the
food is more nutritious and I, personally, when I go a table
— I don’t care where I am — I look
to see what you have to offer me that I can eat, and if it’s
not nutritious, I don’t put it in my body.
Brown:
Now, Dr. Davis — Miss Davis, excuse me — has
become a strong advocate for community education on diabetes
as a direct result of her activity with Project Direct. Let’s
take a look at some of the successful work this program is
doing in Southeast Raleigh.
[KNOCKING]
Male
reporter: Workers and volunteers with Project Direct go
door-to-door, passing out information about the program and
about diabetes. It’s part of the outreach component
of the project and an effective way to reach some residents.
Female
voice: Ready Set Walk is a program designed to get African
Americans physically active in the community.
Female
voice: We got a real good group here, and we just come
every week and, you know, it helps you. It really do.
Female
voice: If it weren’t for them, I’d probably
be home not walking, and my health would get even worse, because
exercise and your diet is the two important things.
Male
reporter: Two important things that Project Direct emphasizes.
Not only through walking groups, but also through diabetes
management classes. These classes provide nutrition information
and guidance for those living with diabetes and for the general
public.
[MUSIC,
SINGING]
Male
voice: The church is the most significant cultural institution
in Black America. It is the church that has given focus to
so much of the community, development community, improvement
efforts.
Male
voice: We went not only to the churches, we went to the
barber shops, we went to the beauticians, we went to the fraternities,
we went to the sororities. We touched base with every organization
in the Black community or in Southeast Raleigh that we could
find.
Female
voice: With Project Direct, the community is an equal
partner. They’re not just sitting around the table to
occasionally give us advice. They are there from the time
that we plan the program. They’re there when we implement
it, and they’re there when we discuss changes. They’re
always present in everything that we do.
Brown:
So, Dr. Beuse, in light of what we’ve seen in this
package we just viewed, what sort of societal pressure is
there? It seems that there has to be quite a bit of pressure
on people, in general, and African Americans, in particular,
to eat and to eat certain foods.
Beuse:
Yeah, I think it happens in families. It certainly happens
in communities. When you want to be hospitable to somebody,
you offer them something tasty, and often that’s not
the healthiest food — cookies and cakes. And then,
if your guest were only to have one cookie, then you might
almost take it as an insult, so I think we have issues at
that level. But we also have societal issues on the order
of all the advertising there is for McDonald’s. You
know, you can’t be happy if you don’t eat McDonald’s.
You know, you have to get the Happy Meal. So, I think there
are hundreds of millions of dollars, probably billions of
dollars, spent on encouraging us to eat more, where we need
the kind of messages that you’re trying to deliver here
to get an equal voice.
Brown:
And, Miss Davis, given the fact that you’ve gone
through the experience of having diabetes and having been
obese and dealing with diabetes, was this a heredity disease,
or is this something that anybody can develop just by doing
what you were doing?
Davis:
Diabetes is hereditary, but you don’t have to develop
it just because it’s in your family. There are a lot
of family members in various families that have diabetes,
but, you know, other sisters and brothers that may not have
it. They are watched closely, because they know they may be
prone to getting it, but I had a problem with eating per se.
I ate for the wrong reasons. That’s what I tell people
now, “Don’t eat for the wrong reasons. You need
to eat for nutrition. If you’re not hungry, don’t
eat.” We eat to satisfy other people. We eat because
somebody died, and we want to be with the family, so they
feed the family, and we eat. We eat. Somebody gets married.
There, again, we celebrate. We eat. But you have to learn
how to make better choices. I ate during Christmas, and I
actually lost weight, and I had parties back-to-back, because
I’m a minister. I’m in an environment, they would
invite you to parties. It was, like, “Okay, Lord. Help
me to do this.” And I actually went to three parties
one weekend, and I got up and weighed Monday morning — because
I weigh on Mondays. I had lost weight.
Brown:
How hard is it? You were talking earlier about how you
will take nutritious food with you to events. How hard is
it for you to do that? What sort of reaction do you get?
Davis:
It’s not hard for me, because I only have one body,
and if you don’t offer me nutritious food, I make sure
I have something with me that I can eat. I even went to — the
first meeting I went to at Project Direct — I had
been working that day — I worked then, I’m
retired now — I went to the table that afternoon, and
I looked at what they had to offer me, because I do that now,
and I said, “I can have this. I don’t need that.
I already had that.” And I said, “Where’s
the water?” They did not have water on the table. They
had all these soft drinks, diet drinks, coffee, tea, nutritious
food, but they didn’t have water. So, I teach people
now to drink water.
Brown:
Dr. Beuse, isn’t diet drink okay?
Beuse:
Yeah, I thing diet drink is okay. It’s certainly
much, much, much less worse than sugary soft drinks. I think
another common misconception is that juice is health food.
You know, eating fruit is okay, but juice is like taking many
pieces of fruit and squeezing all the calories out of it,
and leaving most of the good stuff in the trash. So, I think
juice is something we really should try and minimize.
Davis:
I’m glad you mentioned that, because I had to learn
that I couldn’t drink orange juice once I thought I
had diabetes and, see, before I developed diabetes, my breakfast
was a banana and a glass of orange juice — a double
whammy of sugar. I didn’t know that. That’s why
I said I had to learn how to eat all over again after I had
taught myself to eat correctly. So, now I know I can only
have four ounces of orange juice, and not very often, because
that raises my sugar level.
Brown:
Well, now, you’re scaring me a little bit, because in
my household, we enjoy drinking all kinds of fruit juices.
Am I to understand that if we continue to do pretty much only
fruit juice, maybe some soda every once in a while, but if
we focus on the fruit juice and don’t take heed to other
more healthy choices, that we could develop diabetes in my
family? In my immediate family?
Beuse:
Well, it has calories in it, so it’s really, it’s
a matter of calorie balance. So, if in your family, you get
plenty of exercise, you will be able to drink more juice than
a family that doesn’t get exercise. But, that said,
if, you know, if you were going to look for a place to cut
down calories, cutting down juices will have a major impact.
It’s about a hundred and fifty calories for a medium-size
glass of juice. You know, some people get those twenty-ounce
bottles. They have almost three hundred calories.
Brown:
So we really have to be very careful about how much we’re
intaking and realize it’s not…
Davis:
It’s balance. It’s about balance, and I’ve
learned how to balance what I eat. Instead of eating three
meals a day, I eat six, and I make sure they’re healthy,
nutritious meals, and I focus on getting X number of fruits,
X number of vegetables, cutting back on my fat. I didn’t
say cutting it out. You need fats. You need carbohydrates.
You still need protein. So, I would learn how to balance it.
Brown:
We are going to be talking about obesity in an upcoming
show. How can parents — especially since childhood obesity
has become such an issue in this country — how
can parents help their children? I’m talking about even
their babies, their newborns, to start out on a good path
towards a healthy diet?
Beuse:
I think it starts with first setting a good example. You
know, I think it’s important for parents to know about
nutrition. If they don’t feel as comfortable as Miss
Davis seems to be about how she’s making her choices,
you know, finding a class, perhaps looking into Project Direct
is a place to learn more about nutrition, and then helping
children to make good choices — that if you’re
going to have a cookie as a dessert, to make sure that it’s
one cookie and not the whole bag of cookies — to avoid
television watching as a major activity. I mean, people should
be out — children should be out in the yard playing,
being physically active and, certainly, not television watching
with snacks. I mean, to watch television with a Coca Cola
and a bag of potato chips — I mean, you might as
well just, you know, decide they’re going to have diabetes
now, using that approach.
Brown:
You are definitely setting your child on a course for
health problems if you allow this type of activity.
Beuse:
Right. But, you know, it’s important for — parents
can’t say, “You know, that’s what you should
do, Billy,” and then they sit on the couch all afternoon,
all evening, you know, drinking beer and watching sports on
television. I mean, you have to set a good example. It’s
a tough job being a parent.
Davis:
I’m glad you mentioned television and eating, because
I tell people it’s okay to watch television while you
eat, but it’s not okay to eat while you watch television.
Now, what’s the difference in what I just said? When
you’re eating, your main focus is eating. You’re
going to finish, so you can watch television while you’re
eating. But if your main focus is watching television, you’re
never going to finish, which means you’re never going
to finish eating.
Brown:
So, you’ll just be feeding yourself.
Davis:
Little tidbits like that got me where I am. Right. And
activity is very important. And kids need activity. It’s
like you said. They need to see their parents doing it, and
the parents, if they don’t know how to feed their kids
correctly, there’s training out there. There are classes
out there. That’s what Project Direct is all about.
Brown:
What are the excuses that you’ve heard, Miss Davis,
for parents and children not getting out and being physically
active?
Davis:
The number one excuse I hear from parents is that “I
don’t have time.” And I can understand that, because
I have been to the point where I didn’t have time, but
if you love yourself enough and your family and your children,
you will make the time. I found out, in this lifetime, that
you do the things that are important to you that you want
to do.
Beuse:
You know, to add to that, I think another thing is that,
as parents, we have to agitate with our school principals
and school boards to make sure that physical education in
school is running around, climbing, jumping, those sort of
things and not sitting in a classroom, learning about this
is the theory of how you play basketball. I mean, children
need to be physically active, running around for at least
thirty minutes every day, and as households are getting busier,
since they do have time assigned for physical activity, they
need to be active during those times.
Brown:
Well, let me go to a slightly different angle on this.
Miss Davis, you said that you did not realize that you had
diabetes until you had lost weight, gained some back, and
went to the doctor, and he informed you of that. Dr. Beuse,
tell our viewers what sort of signs do they need to look out
for?
Beuse:
That’s the problem. You can’t wait for signs.
By the time you have signs or symptoms, you’ve probably
had diabetes for ten years. So, what you need to make sure
— and in the African American community, diabetes
is so common that probably starting, if you’re overweight,
starting as a teenager, you should every one to three years
have a fasting glucose check, a fasting blood sugar, and it
that value is much over a hundred, you’re at risk. If
it’s over a hundred and twenty-five, if it’s a
hundred and twenty-six or higher, you, in fact, probably have
diabetes. But the idea is to catch the risk early so that
you can really redouble your efforts, you know, with diet
and exercise before you have diabetes. Twenty percent of people
have a complication of diabetes by the time they’re
diagnosed.
Brown:
So, Miss Davis, in light of this, any final words of advice?
Davis:
I feel so blessed, but my doctor was on top of everything,
because he got my attention, and I turned things around. Just
two weeks ago, I went to my doctor, and I was doing so well
that he took me off of my diabetes medications.
Brown:
So it is possible.
Davis:
Yes, it’s possible.
Brown:
And, Dr. Beuse, any final words from you — advice
for our viewers to just live better and avoid diabetes if
they don’t already have it.
Beuse:
I think the most important thing is to think about everything
that you put in your mouth — the kind of food,
how it’s prepared, when you eat it, why you eat it,
and if you have a problem with obesity, to really focus on
that, as well as getting regular physical activity.
Brown:
Right. Miss Davis, once again, tell us your — just
how did you come back from diabetes? Tell us what sort of
mind set you developed to help yourself?
Davis:
I had to change my attitude. I had to learn to love myself
— with the weight, with the diabetes, and once
you love yourself, you can stay focused, because if you’re
not doing it for you, you’re going to get tired. If
you’re doing it because somebody criticized you because
you’re heavy, because you’re frightened about
the diabetes — eventually, that’s going to
wear off, and you’re going to say, “What the heck.
I got to die with something.” But, no, that’s
the wrong attitude. It’s all about attitude and loving
yourself.
Brown:
Well, I want to congratulate you for doing — just
being a model for our viewers and for other people in the
communities that you’re working, and I’d like
to thank Dr. Beuse and Miss Davis for talking with us about
this most important topic, diabetes. Again, information in
our program is for informational purposes and is not intended
for use as diagnosis or treatment of a health problem or as
a substitute for consulting a licensed healthcare professional
for medical advise, instruction, diagnosis, or treatment.
If you have specific questions or concerns, please consult
your physician or appropriate licensed healthcare professional.
To learn more about diabetes and what can be done to control
it or about the work of our two guests, please visit the Black
Issues Forum website at www.unctv.org/bif.
We’d also like to hear your feedback and suggestions,
so send up an email, or you can call the BIF line at 919-549-7167.
Tonight’s show is the first in a series of three that
we’ll be bringing to you as part of UNC-TV’s Health
Initiative, so be sure to join Black Issues Forum each
Friday night at nine-thirty. I’m Natalie Bullock Brown,
reminding you to be encouraged, no matter what. Good night.
[THEME
MUSIC]
Voiceover:
This program was made possible by contributions to UNC-TV
from viewers like you. Thank you.
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