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emancipated patients:: don’t get diabetes
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don’t get diabetes
By Patrick Neustatter, MD
The guy I saw the other day was there with a twisted ankle. "So" he asked, "why did the nurse need to ask me about my blood pressure and if there's diabetes in the family?" It didn't have much to do with his ankle it's true, but what he didn't know is that at the Moss Clinic we're running a program to screen for a serious medical problem that affects a third of the population. But of that third, nine out of ten people don't know they've got it. The Problem What we're screening for is prediabetes - where fasting blood glucose is elevated, in the 100 to 125 mg/dl range (it shouldn't be more than 99 mg/dl - and above 125 mg/dl is in the full blown diabetes range) I tell my patients "don't get diabetes" - this because the toxic effects of elevated glucose, and the oxidative stress it causes is so widespread and pernicious. It causes damage to large and small blood vessels resulting in neuropathy (painful inflammation of the nerves), nephropathy (damage to the kidney) coronary artery and generalized vascular disease - resulting in heart attacks and heart failure, and poor circulation to the feet in particular (it is the commonest cause of foot amputation). It also effects the eyes and is a common cause of acquired blindness. So detecting it and "nipping it in the bud" is a good thing. Unfortunately, we are becoming less active and eating more processed and fast foods, which promotes diabetes and obesity. Instigated by Natalia GiscombeSimons as part of a nursing doctorate program she is doing at VCU, and partly funded by a grant from Virginia Diabetes Council, Moss Clinic is doing a trial of a questionnaire based on the American Diabetes Association Risk Test. This asks about history of blood pressure, family history of diabetes, amount of exercise as well as ethnicity, sex and weight to identify people at risk. Anyone scoring a 5 or more has their Hemoglobin A1c measured (an indicator of what the blood sugar has averaged over the preceding 90 days The Challenge These at risk pre-diabetics need to change their diet and lifestyle. A challenge that is taken on by YMCA explained Associate Community Health Director for the Fredericksburg branch, Nicole McGee. They run courses with classes consisting of 25 sessions run over a whole year. "People really benefit from being in a group and learning from each other" noted McGee. People do find this a bit daunting though, one of the teachers, certified Lifestyle coach Zakia Wichowki told me. But they "are motivated by concern about developing full -blown diabetes." She is motivated to teach others, Wichowki told me, being diabetic herself though she presumably practices what she preaches, as she told me "I've had no diabetes in the last 15 years."
Despite pre-diabetes being so common, people are still surprised and upset when they are diagnosed, she told me. And still find it hard "to give up their favorite foods like cheesy fries" - which she seems to see as the epitome of what you shouldn't eat. They also tend to feel ashamed, and uncomfortable about coming to a gym. "They'd much rather just take a pill" she told me.
Smart But Simple This is a work in progress to an extent, but the United States Preventive Services Task Force (USPSTF) - that expert panel that advises on what interventions are worthwhile - recommends screening all adults between 35 and 70 years for prediabetes - especially anyone overweight. In the US with its runaway development of ever more high-tech, expensive, interventions, it's gratifying to see a common-sense, low tech, highly effective - but unfortunately not particularly sexy - program, that has huge potential benefit to shine the light on this very common and potentially very serious problem.
Patrick Neustatter, MD is the Medical Director of the Moss Free Clinic
A Letter to Downtown
REFLECTIONS
by Ann Glave
Embrace the seasons and cycles of your life. There is magic in change . - Bronnie Ware
Eight years have passed since I was hired as Fredericksburg Main Street's first Executive Director. My, the time has flown by! It's been a project of love - and #LoveFXBG. This story starts with the City's Exploration Task Force investigating historic preservation, economic development and National Main Street. Richard Trembley, Karen Hedelt and the Economic Development Authority (EDA) were constant supporters. And two downtown business owners - Paul Cymrot of Riverby Books and Scarlett Pons of PONSHOP Studio - made it a reality after two years of dedicated work getting the buy-in from the downtown businesses. Without Andi Gabler's encouragement, I wouldn't be here today.
I would like to acknowledge the first official Board of Directors, who in 2013 worked tirelessly to bring the vision of Main Street to fruition.
And the story is not complete without mentioning Tom Crimmins. Tom was my mentor with the EDA. He is a gentle wise soul who guided me from the start.
I will miss connecting the dots. It's the collaboration that makes Downtown strong. My heart is happy when I can bring a buyer and seller together for a business sale, solve a business need or be an ear and brainstorm solutions.
There have been many accomplishments over the years resulting from dedicated volunteers working together: $266,900 in grants awarded to Main Street since I came on board. Over 23,000 volunteer hours. 24 planters with two seasonal plantings every year. A brand for Fredericksburg Main Street and Downtown. Don't you love the banners in Market Square Alley?! New promotions like #LoveFXbg, Thunder Alley, Scarecrows are Coming, Treats on the Streets, and Small Business Saturday. Downtown Gift Cards. Open Late initiative. Scan & Love, creative storytelling about our historic buildings using QR codes, is the winner of both Virginia Main Street' s Best Business Promotion Merit Award and Pitch Award. A Downtown Affair, a community dinner celebrating our historic and vibrant downtown, winner of Virginia Main Street' s Outstanding Fundraising Effort Award. Our first text to donate Power of 100 campaign which raised over $15,000 for more bike racks, trash cans and planters. Two bike repair stations and a water bottle filler for Riverfront Park resulted from the selling of raffle tickets to win the City of Fredericksburg's box for a Fred Nats game. " The Otter-l ly Amazing Public Art Project, a series of bronze otters cast by local artists Steven and Stuart Wegner of Wegner Arts Foundry, to be installed in various downtown locations. The companion Otter-l ly Amazing Board Game, designed by Pete Morelewicz of Print Jazz, to raise monies in support of the otter installations.
There is a strong love for Downtown. And you came out in droves to support Downtown in the midst of the pandemic and civil unrest. The City of Fredericksburg - the Departments of Community Planning and Building; Economic Development and Tourism; Parks, Recreation and Events; and Public Works - the Economic Development Authority and our numerous community partners, along with our downtown stakeholders, have been instrumental in the success of Fredericksburg Main Street over the years.
Now it is time for a new leader. The friendships and memories I have will always be a bright spot in my time here. I wish Fredericksburg Main Steet the best as the Board of Directors embarks in a new direction.
Warmly, Ann
Photo of Ann & her son by Dirt Road Photography
907 Princess Anne Street, Downtown Fredericksburg
www.donatelifevirginia.org
