Diabetes has been running rampant in South Dakota, but the Mitchell Recreation Center is finding ways to prevent the epidemic from worsening.

From 2007 to 2017, South Dakota saw a 66% increase in diabetes, marking the highest increase in the country, according to the Centers for Disease Control and Prevention. The growing prevalence of diabetes is an alarming health issue that’s been on Thomas Gulledge’s radar over the past year.

It prompted the Rec Center fitness director to act and develop a program designed to reduce the risk of diabetes and hypertension, which Gulledge said go hand-in-hand.

“Diabetes has been getting out of control lately, and it’s an epidemic that doesn’t receive the attention I feel it deserves,” Gulledge said. “We’ve been exploring ways we could help the people who have chronic conditions in our community, and diabetes and hypertension (high-blood pressure) are two of the conditions we see more than anything.”

While there are two types of diabetes, both affect the way the body processes and produces blood sugar or glucose, which is needed for energy. Type 1 diabetes occurs when the pancreas produces little to no insulin, while type 2 diabetes is a condition in which the body doesn’t use insulin properly. Type 2 diabetes is the only form of diabetes that’s preventable.

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According to the 2020 National Diabetes Statistics report, 1 in 10 Americans have either type 1 or type 2 diabetes, equating to roughly 34 million diabetics in the country. Type 2 diabetes is the most common type, as it accounts for roughly 90% of the 34 million diabetics. If untreated, diabetes can cause serious health issues, ranging from extreme fatigue and dehydration. While diabetes is more commonly found in adults, children can also develop the disease.

Gulledge’s first major response to the increased prevalence of diabetes among adults and children was the creation of his hypertension prevention program, which focuses on cardiovascular fitness and carefully monitoring blood pressure levels. After Gulledge applied for grant funding through the state Department of Health to help roll out the program, it caught the eyes of the South Dakota Department of Health, and they awarded the facility with a $20,000 grant to offer the program in the Mitchell area.

The program entails providing participants with blood pressure cuffs to track results, along with heart health education courses and fitness intervention workouts. There are 50 participants in the year-long program as of now, and Gulledge said the results have proven its worth already.

“We just had 11 of the 50 participants complete the program in full. And all 11 of them have shown marked decreases in systolic and diastolic blood pressure, so the program is working,” Gulledge said, noting hypertension programs are typically only offered in clinical settings such as hospitals. “You go home and track your results and we can then give those to the participants’ physician if they want us to, and we package free tailored personal training sessions with it as part of the intervention piece.”

The results of the program can be seen in Randy Oldenkamp’s story. Oldenkamp has type 2 diabetes and entered into the hypertension prevention program right away. After a couple months into the program, Oldenkamp’s A1C level dropped from 7.2% to 6.6%.

A1C tests are used to monitor blood levels in type 2 diabetics. An A1C level between 5.7% to 6.4% classifies as prediabetes, and anything over is considered full on diabetes.

“It’s amazing to see how much my A1C dropped after getting into this program,” said Oldenkamp, while he worked up a sweat on the elliptical. “I’ve lost 30 pounds already.”

The results Oldenkamp has achieved thus far is exactly what the program was designed to do: help participants see a minimum 7% weight loss in one year. To achieve that weight loss goal, the program strives to make each participant fulfill 150 minutes of activity per week, which Gulledge calls as a “realistic goal.”

“Hypertension and type 2 diabetes are things that can be controlled through lifestyle modifications,” Gulledge said, pointing to a CDC study that recently found lifestyle changes can reduce the risk of developing type 2 diabetes by 58%. “Activity and moving to a more nutritious diet are the most critical aspects in diabetes prevention.”

Adding programs

As the hypertension prevention program was in full swing and seeing success, another diabetes related program with the state Department of Health caught Gulledge's attention. However, the program was heavily focused on the education side of diabetes prevention. Perhaps the biggest draw to it for Gulledge was the CDC's involvement in creating the curriculum for the program.

The Rec Center is now the first fitness facility in the state to offer the CDC program, and at no cost to participants. Gulledge recently became certified as a “lifestyle modification coach” to teach the program.

“The program is a CDC-written curriculum, which is wonderful because it provides the best content from the nation’s top experts in chronic diseases like diabetes,” Gulledge said. “For the community, this program is a necessity because we are seeing the uptick in type 2 diabetes and obesity.”

Gulledge emphasized the diabetes prevention program is “not a bootcamp type of workout.” Rather, he said it’s centered around diabetes education.

A major facet of the program entails tracking food intake and the time being spent on activity, two elements that Gulledge said are the “most effective and easiest way to make huge lifestyle changes” to reduce the risk of diabetes. Throughout the course of the year, the group of participants meet every Monday night of the week for Gulledge’s diabetes prevention education session.

“This is education, and this is us talking about how to facilitate a group of people who have like-issues that you can lean on for information about diabetes,” Gulledge said. “It’s really cool to see the social interaction of this program, and we have seen participants interact and talk to each other about what they are eating and the type of activities they find most effective.”

For participants to enter the program, there are several requirements to qualify, including a blood and diabetes risk test that reveals they have prediabetes. Each participant self reports those results to the Rec Center -- which are kept confidential -- to qualify for the diabetes prevention program.

“There are statistics out there that show there are many undiagnosed prediabetics, and that number is growing every year,” Gulledge said. “I have some friends who are in the category that I encouraged to get into the program.”

‘Timing couldn’t have been better’

For Rec Center Director Kevin DeVries, the diabetes prevention efforts that are being made at the state and local level come at a critical time with the COVID-19 virus running its course.

The CDC has found people with diabetes are at a greater risk of suffering serious effects from COVID-19, adding more incentive for making healthy lifestyle choices to prevent diabetes.

“Now that we know people who have health conditions like diabetes are at greater risk of having more severe cases of COVID-19, the timing of these programs couldn't have been better,” DeVries said. “As a community facility, it’s our job to provide all aspects of health and wellness. And these programs are doing just that.”

With the state Department of Health renewing the Rec Center’s diabetes prevention program for another year, Gulledge said it’s a testament to the shared goals fitness and health professionals have toward preventing diabetes and other diseases.

“The efforts to prevent this epidemic from getting worse are only going to get better from here on out,” Gulledge said. “I’m proud to be a part of it.”