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November is American Diabetes Month – Here Are 3 Things CHWs Can Do To Help Prevent The Disease

Nearly every day, a new study shows that healthy habits are the ticket to living longer and feeling better while you do live by avoiding diseases like diabetes. Eating well, exercising often, stopping smoking, keeping to a healthy weight, and limiting alcohol pays off.

Diabetes among your community members and patients is probably one of your biggest concerns. The burden of diabetes is staggering, and it continues to climb. The total costs of diagnosed diabetes have risen to $327 billion, when the cost was last examined, according to research from the American Diabetes Association.

The largest components of medical expenditures are:

  • hospital inpatient care (30% of the total medical cost),
  • prescription medications to treat complications of diabetes (30%),
  • anti-diabetic agents and diabetes supplies (15%), and
  • physician office visits (13%).

Diabetes affects the body’s ability to fight off infections, leading to skin conditions and other complications. Diabetes also makes circulation a challenge and takes a toll on the cardiovascular system. By now it’s also known that preexisting conditions like diabetes and hypertension increase the risk of getting infected with COVID and its severity.

With over 34 million Americans dealing with diabetes and up to 1 in 3 adults facing prediabetes, it’s clear that resources to prevent and treat this chronic disease are much needed. Community health initiatives can educate and help individuals keep diabetes at bay by promoting healthy lifestyle changes like regular exercise, a balanced diet with lots of produce, and limiting substance use, including tobacco and alcohol.

Providing this kind of diabetes education and motivating people to make lifestyle changes is exactly where community health workers (CHWs) excel. Health initiatives targeted at reducing incidence of diabetes are creating more CHW jobs, because it’s proven that CHWs help patients manage diabetes. It should be part of any CHW core competencies program.




Your program can be key in preventing diabetes and improving health outcomes for patients by training your team in outreach, peer education, and chronic disease management. The first step in training your team for diabetes interventions is identifying which skills you need to develop. From there, you can set up a training plan to best position CHWs for helping people to make changes.

The following three areas are a must for any diabetes education program:

[Add Diabetes and Prediabetes to any subscription—read more]

1. Tobacco cessation

CHWs need skills in tobacco cessation—including Motivational Interviewing—to address many health problems caused by smoking and using tobacco. Tobacco cessation skills are also critical for diabetes prevention and control programs.

Smokers are more at risk for developing type 2 diabetes than nonsmokers, and that risk goes up along with the number of cigarettes smoked. Smoking damages cells in the body by increasing inflammation and mixing chemicals in cigarettes with oxygen, called oxidative stress. Smoking can also lead to more belly fat, itself linked with diabetes.

Smokers who already have type 2 diabetes have more serious health problems. Nicotine can make insulin less effective. They’re also more likely to have heart and kidney disease, poor circulation in the legs and feet, and blindness.

2. Physical activity

Americans sit too much and exercise too little, so CHWs who know how to get people up and moving are helping prevent a host of health problems in addition to diabetes. According to studies, moving around shows immediate health benefits, including reducing anxiety, improving blood pressure and insulin sensitivity.

Read more: How I Started a Community Health Initiative and How It Can Make Your Clients Healthier

Physical activity fights diabetes on several fronts. It makes a body more sensitive to insulin and helps people lose weight and maintain a healthy weight. It also helps control blood sugar levels.

CHWs who are trained in physical activity and active living are in a better position to make recommendations to people, no matter what their barriers are (physical, geographical, financial, etc.). They can also help patients and clients set and stick to goals and maintain an activity program that works.

3. Healthy eating

Finding a healthy eating strategy is probably at the top of a diabetes prevention and control program, and it may be one of the toughest strategies for people to follow. Following a diabetes diet means eating a plant-heavy diet that’s rich in nutrients and low in fat and calories. People should add more fruits, vegetables and whole grains to their plates. That helps with weight loss and also controlling blood glucose.

Many people with diabetes work with a dietitian to develop a healthy eating plan, but CHWs can work with them to make food choices that work for each person’s preference, location and culture.

Training in healthy eating can also be matched with training in physical activity to offer more comprehensive support to clients.

Read more: Your Agency Needs Training for Food Insecurity

Suggested training curriculum

A comprehensive CHWtraining curriculum for a team of CHWs looking to control diabetes should start here:

  • Diabetes and Prediabetes
  • Supporting Tobacco Cessation
  • Promoting Healthy Lifestyles
  • Motivational Interviewing: Peer Support for Behavior Change

A useful expansion pack of diabetes education resources includes options for supporting clients on their journey:

  • Providing Social Support
  • Health Literacy: A Start
  • Substance Use

During National Diabetes Month, you can add Diabetes and Prediabetes to any subscription on CHWTraining. If you’re interested in building a diabetes education program for your team with these or other courses, click the button below to learn how to add certified training to your program. Our team will be in touch ASAP to schedule a time to chat.

Originally published November 15, 2019, updated November 20, 2020.

What’s New for Diabetes and Prediabetes

CHWTraining launched its Diabetes and Prediabetes more than six years ago, and it remains our top requested course. It’s not hard to understand why, as diabetes continues to grow in the U.S. and trigger a host of other chronic diseases.

Adults in the U.S. need diabetes support, especially now when the coronavirus brings new threats to communities and people who already have the disease. Without the proper education about diabetes, patient populations will only decline if trends continue on the path they’re on.

CHWs, Diabetes and Prediabetes

Community health workers, community care coordinators, health promoters and others are more important than ever in helping people understand their diabetes or prediabetes diagnoses and control it.

CHWs can advise on what diabetes is, how to interpret blood sugar levels, share healthy eating ideas and recipes, and give ideas for physical activity. They can also connect clients to professionals who can provide more support beyond a physical, such as dental workers and dietitians. They can also help vulnerable and minority communities who have statistically worse health outcomes from diabetes.

That’s why we created Diabetes and Prediabetes (and the Spanish language Diabetes y prediabetes) included it as part of our chronic illness learning track. As part of our latest updates to the course, we took a careful look at how things have changed with diabetes.

[Related: Add Chronic Illness training to any Learning Track]

Diabetes is on the Rise

The number of people with diabetes in the US is up. In the United States, an estimated 34.2 million people of all ages have diabetes. That number continues to rise. In 2018, about 1.5 million adults in the United States were newly diagnosed with diabetes, according to the CDC’s National Diabetes Statistics Report 2020.

[Source: CDC]

Diabetes is the seventh leading cause of death in the United States.

African Americans, Hispanic/Latino Americans, and Native Americans are at a higher risk for both type 2 diabetes and gestational diabetes. These health disparities gain an alarming momentum when you see that more African-American and Hispanic people are testing positive for COVID-19 and are being hospitalized at higher rates than whites.

Diabetes and COVID-19

Scientists and officials have revealed that most cases of the disease are mild. Most serious cases are in patients with underlying health conditions, such as hypertension, obesity, and diabetes.

This is a serious consideration in the US, because the CDC reports that 60 percent of U.S. adults have a chronic condition. More people in the ICU for COVID-19 had diabetes than any other condition.

Diabetes makes outcomes worse by weakening the immune system, especially if the infected person’s diabetes is not well managed.  This means that their bodies have to work even harder to fight off the infection.

Stress can cause another problem with immune defense systems and blood sugar levels. It can cause both to grow out of control. This can make diabetes even worse. The American Diabetes Association has more information on How COVID-19 Impacts People with Diabetes.

This is an opportunity for community-focused health workers to step in and help. By helping patients understand how to interpret their blood sugar readings and helping them eat nutritiously, they can both help them manage diabetes and boost their overall immune system.

Diabetes and Oral Health

The relationship between oral health and diabetes is more pronounced than many people realize. Good dental hygiene is associated with a lower diabetes risk, according to a study. On the other hand, people with a dental disease, such as periodontal (gum) disease, are at a higher risk of developing it. One surprising statistic says “In individuals missing 15 or more teeth, this risk increases to 21%.”

CHWs can help by educating clients and caregivers on good oral health habits, including frequent brushing, daily flossing, and avoiding sugary snacks. Many people are not seeing dental workers because of cancellations and coronavirus risks, which means they need to be extra vigilant with their oral hygiene to avoid the need of seeing a professional.

More information on oral health and its relationship with other chronic disease is in the course Oral Health Disparities.

Diabetes is bad for people in the U.S. more than ever before. Community health workers are more important than ever when it comes to avoiding and managing diabetes and prediabetes.

If you’re not including training about diabetes in your CHW workforce, start now. If you’re interested in building a diabetes education program for your team with these or other courses, contact us to learn how to add certified training to your program. Our team will be in touch ASAP to schedule a time to chat.

Image by Myriam Zilles from Pixabay