WHITESBURG, Ky. - Local diabetes prevention programs in many eastern Kentucky counties are helping people stay healthy and prevent pre-diabetes and Type 2 diabetes during the pandemic.

Research has shown that diabetes can increase the risk of complications from COVID-19. It's estimated one in six Eastern Kentuckians has Type 2 diabetes, with many cases undiagnosed. Far more have pre-diabetes, with blood-sugar levels high enough to possibly develop diabetes.

Mary Beth Castle, Diabetes Prevention Program lifestyle coach at the Johnson County Health Department, said both can be prevented by lifestyle changes. And she said she's concerned the stress and increased time at home in the pandemic may be leading people to make fewer healthy choices.

"It concerns me, not that they're eating at home, which is a good thing, but maybe they're not eating as well and people are snacking more," said Castle. "And one of the things they suggest through our program is not to keep snack foods out on your kitchen counter, and to put them in a cabinet."

Castle adds many folks may not realize they have pre-diabetes because there are often no symptoms.

More information, including a list of of prevention programs searchable by county, is online at 'preventdiabeteseky.org,' a new website developed by Appalshop and the Kentucky Department for Public Health.

In 2008, Johnson County resident Marilyn Morgan was diagnosed with pre-diabetes. She's now part of her local prevention program and said she's managed to keep her blood sugar under control.

But Morgan said it's work to stay vigilant about what she eats and drinks.

"We've been at some of the local groceries that would hand out samples, and we would ask the lady handing them out, 'Does this have a lot of sugar in it?'" said Morgan. "And then when we told her no, we can't have it because of the sugars, she goes, 'I've got it too.'"

Morgan added that since the pandemic began, exercising has been more difficult, since she can no longer work with a personal trainer.

Castle pointed out that the Diabetes Prevention Program has virtual groups or individual phone sessions that guide and encourage participants to increase physical activity. She said it's important to keep moving every day.

"If you're sitting and you find yourself watching TV a lot," said Castle, "and I think a lot of elderly people have been watching a lot of news - that when commercials come on, get up. Walk through the house, walk down the hallway, walk in circles around in your living room. Do not sit in that chair all the time."

Diabetes prevention programs are being offered by the Cumberland Valley District, Johnson County, Kentucky River District, Lake Cumberland District, and Lawrence County Health Departments, as well as by the Barnstable Brown Diabetes Center for Knox and Whitley counties.

There are also online cohorts that can be joined from anywhere.

This story was produced with original reporting by Parker Hobson of Appalshop.


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United States Secretary of Health and Human Services Xavier Becerra and U.S. Rep. Yadira Caraveo - D-Thornton - recently paid a visit to Salud Family Health Centers' mobile clinic.

Each year, Salud serves up to two thousand migrant farmworkers who travel from other states and countries to plant and harvest leafy greens, corn, wheat, sugar beets, and other crops in North Central and Northeastern Colorado.

Director Deborah Salazar said her team always gets a very warm welcome.

"And it's usually the same guys that come to the same farms or greenhouses," said Salazar. "And so it's like seeing old friends. They know who we are, they know what we can do for them, and they trust us. There is trust because we have been doing this for a very long time."

In addition to its 12 brick and mortar health centers, and ten school sites, the mobile unit provides primary health services three to four evenings per week - primarily in rural areas.

They screen workers for diabetes, hypertension, cervical cancer, and anemia. Workers can also get lab tests, and flu and tetanus vaccines.

Salud is a federally qualified community health center that provides medical, dental, pharmacy, and behavioral health care services to all patients regardless of their ability to pay.

The first clinic on wheels was acquired in 1980, and Salazar said a brand new unit was rolled out in 2022.

She said her team works to build relationships with farm owners and supervisors to find the best time to plan a visit.

"If they need us to come out and start our visit on the mobile unit at 7 p.m, we can do that," said Salazar. "We are super flexible, because we don't want to interrupt their work day."

Salazar said the medical staff on the mobile unit might be the only people migrant workers see when they are not out planting and harvesting crops.

"These are the folks that put food on our table," said Salazar. "To give them quality, integrated health care - and go to them, so that they are taken care of - this is the least we can do."




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.