TAMA, Iowa - Six years after the Special Diabetes Program for Indians (SDPI) was established by the federal Department of Health and Human Services, the Meskwaki Settlement in central Iowa has its own wellness center to combat this disease.
Using their $35,000 grant, the Meskwaki opened the center this past May after renovating an unused commodity distribution building. The cost of the reconstruction was kept to a minimum because local labor provided its services for free. Ten pieces of equipment including treadmills and stationary bicycles occupy half the space with the rest of the center's floor allocated for an aerobics area.
Health Director for the Meskwaki, Mark Merrick said the purpose of the center is to encourage residents to take control of their own health and fitness. With more than one-quarter of the settlement's 650-member population having Type 2 Diabetes - a percentage about three times the national average - this ailment affects everyone both directly and indirectly.
While diabetes can be hereditary, both Merrick and Kim Van Rheenen, the Diabetes Program coordinator, concur that diet and lifestyle are significant contributors to diabetes prevention. The consumption of too much sugar without proper exercise can lead to excess sugar in the blood cells causing poor circulation. In turn, this causes infections to improperly heal, which in severe cases can result in amputation.
"The foods that they eat are high in carbohydrates plus less activity leads to high obesity rates," Van Rheenen said. She pointed out Indians are more susceptible to diabetes than other segments of the population due to genetics.
At the center, participants have the benefit of a climate-controlled environment with the added bonus of television and music to stimulate an aerobic routine. Merrick acknowledged that exercise can be obtained by walking vigorously around the neighborhood without the need of equipment though the center provides more than bikes and machines.
"Nowadays people want some type of support (from people) who have knowledge of diabetes and nutrition," said Merrick displaying the numerous brochures and reading material to inform the clients about proper health care.
If the center is designed predominantly for use by adults and seniors, there are steps the settlement is taking to prevent the spread of the disease with the children. From as early as three-years-old, pre-schoolers are being screened for Acanthosis Nigricans, visible scars and brown marks throughout the body - warning signs the child can be vulnerable to diabetes.
For the children, there are plans to conduct a second week-long getaway that promotes a healthy lifestyle. Combining a balanced diet with regular exercise, the message that was almost indoctrinated during the 2002 camp with 43 participants was the spread of diabetes is preventable and can be controlled.
"Today, people don't use their feet and walk," criticized Merrick about the general state of physical fitness leading to obesity and the rise of ailments. "Kids are riding their ATVs around here."
Merrick mentioned how the participation at the center has been slower than expected because of the summer season and how local politics have curtailed funding leaving the building open only 40 hours per week with just one staff member. This winter will provide a telling sign about the center's usage, he pointed out, as the colder weather will force people indoors and more money should be available for increased staff and hours of operation.
Comparing diabetes to an overheating car, Merrick said prevention is much cheaper than an overhaul. Yes, the thermostat under the engine can run hot for awhile as the vehicle continues to operate but eventually, if the problem isn't rectified the damage can be severe. This comparison, he said, would be an appropriate metaphor for those with the disease.
"People take it for granted because they can run on hot for awhile," Merrick said about how it's easy to ignore the symptoms of diabetes, including dehydration and tiredness.
"But once it's cracked, it can't be reversed," Van Rheenen added.