Orlando free clinic Grace Medical Home part of pre-diabetes study

Grace Medical Home is one of two free clinics in the nation selected for a yearlong study that aims to improve the health of uninsured patients with pre-diabetes.

The program gives them education and boxes of healthy food; the results have been promising so far.

“I wasn’t losing weight because I was eating only one time a day. … but when I started this program and learned that I needed to eat three meals a day and have a snack every two hours, I started losing weight. It is so awesome,” said Joan Reid, 54, who has pre-diabetes and is a patient at Grace. “I was so amazed how it’s been life-changing for me.”

Patients are diagnosed with pre-diabetes when their blood-sugar level is high enough to put them at a high risk of developing type 2 diabetes. Pre-diabetes affects nearly 86 million Americans. That’s one out of three American adults, but less than 10 percent of them are aware that they have it, according to the American Diabetes Association. In Florida, more than 6 million adults don’t know they have pre-diabetes, according to the state health department. If left untreated, pre-diabetes increases the risk of type 2 diabetes, heart disease, stroke and death.

The good news is that it is preventable, particularly when patients follow evidence-based diabetes prevention programs that encourage healthy eating and physical activity.

About four years ago, Americares, a nonprofit provider of medical aid to organizations that serve low-income and uninsured patients, began exploring the impact of a CDC-backed diabetes prevention program on patients that visited free and charitable clinics like Grace. Results showed that when given access, this vulnerable population with pre-diabetes had improvements in their health scores similar to the insured population.

Now the organization is trying to find out if it can take the study a step further and address food insecurity, which plagues many low-income families.

Late last year, Americares launched Americares Diabetes Prevention with Healthy Food Program, combining CDC’s Diabetes Prevention Program with a regular supply of fresh produce, low-fat meats and non-perishable foods. Two free clinics — Grace Medical Home in Orlando and Greenville Free Medical Clinic in Greenville, S.C. — were chosen to test the pilot.

Grace recruited more than 30 participants with pre-diabetes from its clinic’s patient population and individuals who go to Healthy Eatonville Place.

Five weeks into their program, the 14 participants in Eatonville have already lost a total of 94 pounds, said Anderson.

“They’ve made this their full-time job,” she said.

The program provides participants with regular education and supplies them with about a quarter of their household’s annual food needs.

“Food boxes are great, because you don’t know what to eat right away when you start the program,” Reid said. “They give us an idea of what to eat, so my husband and I look at stuff we have and it makes it easier for us to cook the food. And the fruits and vegetables are awesome.”

In the regular one-hour classes, participants learn about physical activity, good eating habits, identifying triggers that signal hunger, stress management, and other lessons that aim to prepare them to continue their new habits after the program ends.

“We don’t develop bad habits overnight,” said Bonnie Anderson, a registered dietitian at Grace Medical Home and one of the program’s instructors. “So it takes a few weeks to figure out what their bad habits are. Then we have to undo those bad habits, put on new habits and then make them become a habit. So it’s a process.”

The project is a partnership between Americares and Feeding America and is funded by Baxter International, a Fortune 500 health-care company. Researchers at Loyola University in Chicago will analyze the data and eventually publish the results. In Orlando, Second Harvest Food Bank, a community partner of Feeding America, provides the food.

Its ultimate goal is to develop tool kits to implement the initiative in more free clinics.

If you have pre-diabetes and aren’t part of the study, you can access evidence-based diabetes prevention programs — minus the food boxes — in your community. The CDC provides a list of classes on its website. Some local health departments, including the ones in Seminole and Lake counties, also offer the program for free.

And just this month, Medicare launched the Medicare Diabetes Prevention Program. Diabetes affects more than a quarter of Americans age 65 and older and that number is expected to double by 2050 if the current trends continue, according to the federal agency. Nearly half of seniors have pre-diabetes.

“We know these patients are pre-diabetic and what’s that going to look like in five years if we can’t stop it?” asked Stephanie Nelson Garris, CEO of Grace Medical Home. “I believe as a country, we’re not going to get a handle on health-care spending unless we really look at all patient populations, and especially the low-income, uninsured population is a huge piece of that.”