Well Wisconsin Radio

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Hello and welcome to Well Wisconsin Radio, a podcast discussing health and wellbeing topics with experts from all over the state of Wisconsin. I’m your host, Jennifer Schmidt, and today’s episode is called Resilience and Prevention. Did you know that one in three Wisconsinites are at risk for diabetes?

Today we are exploring how people across the state are taking action not just to prevent diabetes, but to thrive despite health challenges. We will hear from Pam Geis with the Wisconsin Department of Health Services, division of Public Health, who coordinates Wisconsin’s Diabetes Prevention Program and Deb, who has lived the experience and recently graduated from the program.

Thank you both for joining me today. To get us started, can each of you introduce yourselves and share a little bit about your connection to the Diabetes Prevention Program?

Pam: Sure. My name is Pam Geis. I am the Diabetes Prevention Program Coordinator for the Chronic Disease Prevention Program. We sit in the bureau of Community Health Promotion at the Division of Public Health at the Department of Health Services. If that isn’t a mouthful enough and I manage our CDC grant for diabetes and the primary role for me is support to National Diabetes Prevention program suppliers and Medicare Diabetes Prevention Program suppliers. And I work with organizations who want to become CDC recognized organizations that are CDC recognized like WebMD in Well Wisconsin. And I work to do all sorts of things that help them have a successful program. That is the goal.

Deb: I’m Debb and my involvement came from a lifetime of rollercoaster weight. I’ve recently retired from 46 years in the early childhood education field and at my 2023 annual physical, my blood work showed that I was pre-diabetic. So, having been retired, I sort of threw myself into research and I found way too many things on the internet, but fortunately, one of the things that I came across was the Well Wisconsin WebMD program for prevention of type two. And it luckily it caught my eye and I was able to, to read about it and it helped put things in perspective for me so, I was able to really benefit from joining the program.

Jen: Thank you, Deb. So, Pam, let’s start with the big picture. The Diabetes Prevention Program, which we refer to as DPP, most often, is an evidence-based program and developed by the CDC or the Centers for Disease Control. Pam, can you describe what the Diabetes Prevention program is and how it was kind of developed?

Pam: Sure. So, this program has an enormous amount of evidence behind it. It is still the largest study in pre-diabetes. Over 3000 people in 10 or 11 centers across the nation participated in the study. And you know, what the study said was that with good support and facilitation and group interaction on focused topics that individuals could lose five, 5% of their starting weight successfully in this year long program, and many times more than 5%. And as a result, greatly reduce their risk for developing type two diabetes because in the pre-diabetes stage, this is the one point where it is reversible. Once you get type two diabetes is not reversible. You can control it. And, you know, through diet, exercise, oral medication, insulin, but it never goes away.

It may go into what you might consider remission, but it does not go away. So now is the time if a person has pre-diabetes to reverse that trend. So, it, the program is also has an enormous amount of fidelity behind it. Participating suppliers every six months submit de-identified data to CDC and CDC has multiple checkpoints that they look at to say, yep, you’re doing a really great job or, hey, you need to work on this. So, lots of fidelity behind the program too. As far as some impact we’ve seen across the state Wisconsin right now has 35 CDC recognized delivery organizations, many who do distance learning, so we have statewide scale for the program and that includes WebMD in their well Wisconsin program.

We’ve had nearly 12,000 Wisconsin residents enroll in this program, and over 6,700 of them fall into that 45 to 64 age group which is certainly a prime group for developing type two diabetes. If you’re looking for more information on pre-diabetes and the program, easy way to find it is to go to https://www.dhs.wisconsin.gov/prediabetes/index.htm. That will take you to our pre-diabetes webpages at the Department of Health Services.

Jen: Thank you, Pam. So, what makes the Diabetes prevention program unique compared to maybe some other programs that are out there?

Pam: I think certainly the enormous amount of evidence that shows it works beyond a shadow of a doubt. You follow the program, it works. I think the other extremely unique thing about it is the facilitated setting. So, this program is run by trained lifestyle coaches. It is not required that they be medical professionals. Anyone can be a trained lifestyle coach. I always say anyone who’s enthusiasm and has, likes the wellness area, makes an awesome coach, but those coaches aren’t there to stand up in front of a group and teach. The coaches are there to introduce topics, hit some high points, and then turn it over to the group and the group. Works together to talk about solutions to issues that they’re having.

You know, maybe they’re talking about eating out and what are some of the tips we can do to eat healthier when we eat out or make better decisions. And so, the group actually works together and comes up with those solutions. And I think that really is what sets this program apart from a lot of the others.

Jen: What types of lifestyle changes does it focus on, and why do you think that it works? You know, there’s obviously lots of studies, lots of success, but ultimately, what do you think it comes down to that makes this program, you know, the most successful?

Pam: I think, well, as far as what does it focus on? Eating healthier, moving more, managing stress, making decisions that help you reach your desired goal, which in turn help you lose weight. That facilitation that I mentioned, I think that certainly makes a big impact. Some of the criteria for enrollment too, I just wanna mention everyone who participates in the group must be 18 or years or older, have a body mass index, BMI of 25 or greater, if they’re Asian or Asian American, 23 or greater. And then one of the following, a blood test, which could be a fasting glucose of 100 to 125 milligrams per deciliter. Plasma glucose of 140 to 199 milligrams per deciliter or an A1C of 5.7 to 6.4. Or a clinical diagnosis of gestational diabetes mellitus during a previous pregnancy. Women who’ve had gestational diabetes are at 50% increased risk for developing type two diabetes within, I believe it’s within the next 10 years, five to 10 years or individuals could have a positive screening on the pre-diabetes risk test, which you can find again at https://www.dhs.wisconsin.gov/prediabetes/index.htm

Jen: Perfect. Yeah, it’s good to know the criteria for enrollment and to, you know, see the commitment as well because this program is a 12-month commitment. And generally, they meet with the lifestyle training coach for weekly sessions for the first part of the program, which is what we refer to as the core program, and then they kind of transition to every other week for a few weeks and then go down to monthly sessions until they’ve essentially, you know, been meeting with each other for a year.

And then they approach graduation and hopefully take that knowledge with them to be successful long term. But Pam, building off of the criteria, you know, from enrollment and a little bit deeper dive into the program, what challenges and also opportunities have you seen in bringing this program to like diverse communities?

Pam: I consider all challenges opportunities. At this time, I really think the biggest challenge is insurance cover coverage. It’s a major barrier for anyone and everyone. We are working with commercial insurers and Medicaid to move toward coverage of the DPP. Medicare has covered this program since 2018.

So that, that has been in place. We need to get more on board and I, instead working individually with employers. We’re working in Wisconsin at the insurer level because we really feel this is a program that should be picked up as a population health initiative for those insurers not to be a check box for employers when they’re signing up for that insurance.

And right, right now, one of the bigger things we overcome came, I believe it started, what January 1st, 2024 is that all state of Wisconsin employees have access to the program through Well Wisconsin. So that was a big win. Big win. We’ve been working on that for eight years.

Jen: Wow, that’s a long time, but definitely brought in the impact and the reach across, you know, Wisconsin communities, so that’s great. A great accomplishment.

Intro to Ads: And now we’ll just take a quick break to hear about some well Wisconsin program offerings.

Diabetes Prevention Program: If you have pre-diabetes or at risk, the Well Wisconsin Diabetes Prevention Program can help you build healthier habits with small daily changes. This year long virtual program includes one-on-one support from a CDC trained lifestyle coach, group classes for motivation, connection, daily tracking tools to stay on top of your health. Eligible participants can join at no cost. Questions call 1-800-821-6591 to learn more.

Coaching: WebMD Health Coaching connects you with a real person who cares about your wellbeing. Aside from supporting you with goals related to nutrition, sleep, physical activity, and stress, we also offer specialty coaching that is more tailored to your individual needs than ever before. Learn about coaching by calling 1-800-821-6591. You’ll get connected with programs that will be most impactful for you. Here’s what a fellow well Wisconsin coaching participant said about their experience.

Coaching Participant: Hello, I’m delighted to talk about the health coaching session that I had today. I’ve been really concerned about type two diabetes and trying to manage it, and it’s been really helpful for me to talk to a health coach.

I realize I have a lot of questions and a lot of times the doctor doesn’t have time to, to talk with you at length about some of your concerns, so it was really helpful to me today, and these coaching sessions have helped me to manage a disease that’s not easy to manage. And they give me the encouragement and the hope to keep whacking away at it. And that’s how I came away from this call today, that I’m highly encouraged to continue working at a condition that I’ll have for the rest of my life. And so, I would recommend it to anyone that needs help with understanding difficult medical condition. It was really helpful, and I can’t thank my health coach that I had today enough. So once again, thank you. Bye-bye.

Return to Interview: And now we’ll head back to the Well Wisconsin Radio interview.

Jen: So, it’s really inspiring to hear how the Diabetes prevention program is changing lives across the state. But what does it look like in someone’s everyday life? Let’s hear from Deb about her personal journey.

So, Deb, can you share a bit about your health journey and what led you to join the Diabetes Prevention program?

Debb: I thought I had a lot of good information and one of my biggest challenges, which Pam, you’re saying is an opportunity, was that I was trying to do too much all at once. The real benefits to this program is that it helped me slow down. It helped me look at one topic at a time. It helped me take the time to fully understand what was happening in my own life. I was super fortunate. I grew up with a mom who had a degree in food sciences, so my brother and I grew up with a love for, an appreciation for, a curiosity about all kinds of foods, and we had wonderful pastries and rich curries and French sauces and fancy candies, and I grew a fondness for all of that. And then between a really hectic career and convenience food in the eighties and nineties that led me down the path of being pre-diabetic. So, to have things broken down for me topic by topic, so I could actually take the time to understand it. The rest is history.

Jen: Yes. A great you know; point to the program that it breaks it things down that’s really easy to follow and then not too overwhelming with all of the topics at once because yes, there’s so many different things to work on to exactly lower our blood sugars and it can be very overwhelming if you don’t know where to start first. Deb, going off that, what was one of the biggest personal challenges you faced early on and how did you overcome it? And then what were some of your more favorite parts of the program?

Debb: Personal challenges were maybe technologically being a fifties kid. Technology doesn’t come natural to me and I’ve not put the time to really become well equipped to deal with a technical world. But so that was a little bit of a challenge though. Anyone other than me could probably handle it beautifully. What I loved, one of the things that I loved about the program was being able to continue my day-to-day life. It fit in so well. Sometimes we’re in Virginia with grandchildren and it was so easy for me to tap into our weekly meetings. It just fit with everything that I was doing, and I had started doing lots once I retired because I had all this extra time. So, it fit perfectly with that. Another favorite thing of mine about the program, of course, were the, we’re the group leaders. And it was just so fun, Jen to have you were so patient and Katie, while you were on maternity leave was also so patient. But you understood us. You were flexible. You gave us the resources that we needed because I’m sure every group that you work with is different from another group. So, you gave us. Resources, recipes, books, podcast recommendations. Hey, did you hear that? Fifties kid using the word podcast? But it was so wonderful to have that ongoing support. It made the journey easier and actually kind of fun.

Jen: Thank you, Deb for those lovely words, and yes, we certainly had a very successful group. And I dearly miss all of you guys and I’m glad things are going well. But Deb, looking into like resilience, what does it mean to you now compared to maybe before, you know, we met and did the diabetes prevention program together.

Debb: Resilience to me now means taking your time. Taking a breath, not having to tackle everything all at once. It also means depending on other people, letting other people in. You don’t have to face things alone. Having a cohort of people that all are experiencing some of the same health concerns was also really supportive.

So, resilience means taking advantage of all of the resources that are there and slowing down enough to really learn and understand what each piece is about and that will help, that will just help straight through the process.

Jen: Thank you, Deb. So now we’ve heard about the statewide impact and Deb’s journey. Let’s explore Deb and Pam, what we can, you know, take our listeners away with about resilience and building habits that last. So, Pam and Deb, what tools or habits from the Diabetes prevention program tend to stick with people long after the program ends?

Pam: I think some of the basic things, and Deb certainly answered this better than I will, but you know, things like food journaling and more awareness of your food intake and your activity. Eating foods and portions that support your goals. I think ability to identify the common triggers when you’re grocery shopping, eating, sitting still, and ways to change those unhealthy patterns associated with those triggers. I never send my husband to the grocery store when he is hungry. It’s not good. It’s very interesting the things we end up with, but and healthy ways to manage stress. Right. That’s a big one. So, I don’t know, Deb, you probably, I have a better answer for this than I do.

Debb: No, you’re exactly right with all of that. For me, things that really, the tools that really worked for me were tracking my weight all the time, whether I wanted to step on that scale or not. Logging food in the food journal was so important because I could see a connection between that weight and the food journal. Logging exercise was kind of a motivator for me also. So, I’m, you know, those are three things that I’ve continued to do after the program ended. But also, we were provided with a great a great resource compilation of articles and topics. I have a little binder that I can flip through that I do flip through. When I’m struggling with a particular issue and I can go back over and just see in and notes from our meetings. You know, oh, this is, this worked for Russ when he was struggling with going out to eat, or gee, Vicki had this great idea about how to buy chocolate if you want a little bit instead, you know, I mean, there were just so many parts that I now have that I can use for support.

Jen: Yeah. And that’s what the program’s all about is support, resources, and then just that camaraderie that you guys develop naturally after meeting each other for so many weeks. It would really built up a strong support system that I really think, you know, your group has kept going even now, several months, you know, post-graduation. Deb, how can somebody turn a setback into part of their, you know, their progress story? Because as you know, they’re, everybody in class at one point or another had some kind of setback, had some kind of event that, you know, got them off track. But how can you know, from what you’ve learned in the program, how can you turn those setbacks into part of, you know, progress?

Debb: And we each did struggle with very different, but also common themes as we went through the process. But I hold to food journaling and if I journal a day that had only Snickers and potato chips, you know? Well, I’m still going to write it down. I’m gonna be honest. I need to be honest with myself. That’s part of pulling yourself back on track is being honest. And so, my food journals really show very accurately what I do. So, one of the things that helped me is that after a while of food journaling, you have some really excellent weeks and when I’ve kind of had some missteps for whatever reason. I can go back and pull up a week that had great results and I can repeat that week. I can redo those same food options another week and just plan. Planning’s important, but plan around those foods and have another very successful week again to kind of get me back on track.

Jen: Exactly. Exactly. And even if we have setbacks or off weeks we talked about, you know, just look ahead or look back at notes and, you know, say next week or next day is another day and you can start right back on track.

Debb: And to be kind. Be kind to yourself. You would be supportive of a friend. I would want to support anyone in our group, and I know they would support me, so I need to support me too. So being kind.

Jen: Exactly. Be kind. Good. Item, so we’ve, you know, leave everybody with is to remember to be kind to yourself and be kind to others. Pam, how can the same tools used in the diabetes prevention program support resilience in other areas of life?

Pam: Sure. I think, you know, Deb mentioned some of those, but like, like the goal setting, the ability to identify the common triggers, healthy ways to manage stress, those are all things that can be taken across different areas of your life and put into play and you know, help you be successful in all of those areas. Successful and resilient. Certainly.

Jen: Yeah, exactly. So, it’s not just about, you know, lessons to lower your blood sugar. Overall, it’s a good life lessons on ways to just promote and live a healthy lifestyle, manage stress, follow good nutrition, develop habits and goal, you know, learn about goal setting for one, and then set, you know, goals, whether it’s for, you know, your health or just helps you plan out your future. So, lots of different takeaways from the program, so thank you for summarizing that, whether it’s the big picture or just like a personal journey like Deb. There’s a lot we can learn from the diabetes prevention program about, you know, thriving with chronic conditions. So Deb and Pam, if you could share one piece of encouragement with someone just starting their journey, what would it be?

Pam: One piece of encouragement. Well, I think when it comes to the DPP, take the first step and be open to how the program can support your journey and how the, how your fellow program participants can support your journey. Take it for a trial run. Jen may not wanna hear this, but I will say it this way. Commit to the first four weeks. Make that your first goal. I’ll do it for four weeks and see where I’m at. And I guarantee you’ll get to the end of those four weeks and be like, this is making a difference. I’m sticking around. So I think just making that small step, a precursor to DPP was a program called Small Steps, big Rewards, you know, so make that first move and see if it’s, you know, if it’s helpful you know, don’t be afraid to make some new friends in the program and see what it’s all about.

Debb: I totally agree. And I think too, that people looking at joining the program should definitely, should and don’t let the yearlong commitment scare you off. Because really what it does is it breaks it down. It makes it so much easier and, and it doesn’t seem like a year. All of a sudden, it’s done and you miss that connect, but you have, you come out of it with so many skills and because it’s a year and not, not, you know, a month, we had a chance to really practice and set in those new habits. So it, that was really important. The year is not too much of a commitment. It’s just right. It’s exactly perfect. And my other encouragement would be get to know your cohort. Get to know the people in the group. Don’t be afraid to jump in. With your comments and your ideas and yeah, Pam making new friends, who would’ve thought, you know, here in my seventies, I’m making new friends and it’s just, it’s so awesome. We all start out with things in common and then we can build on that and we’re all so different, and that is a delight.

Jen: Yes. We definitely had a great cohort and I’m glad you had all those positive takeaways and things are going well Deb. So, I appreciate both of you joining me today and talking about this great program that we offer. Yes, with WebMD and the Well Wisconsin program, but there are plenty of other programs like Pam was discussing across our great state. So, it’s always something to, you know, dive into, look into a little bit more. And if you’re ready, yeah, jump in and try it with us. I look forward to our next group.

So, thank you for joining us today on Will Wisconsin Radio. If you’re ready to take the first step towards better health, check out the resources mentioned and remember, resilience is built one small habit at a time.

Thanks for listening to Well Wisconsin Radio. I hope you enjoyed this episode.

You can find our survey in the well Wisconsin Portal and transcripts and previous episodes are all available at www.webmdhealthservices.com/wellwisconsinRadio. If you’re listening on your favorite podcast platform, be sure to subscribe so you never miss an episode.

• www.dhs.wisconsin.gov/prediabetes/index.htm
• www.cdc.gov/diabetes-prevention/index.html
• WebMD Coaching and DPP Program, call 1-800-821-6591 or visit www.webmdhealth.com/wellwisconsin