Author: Marlayna Bollinger, Executive Director of the Skinny Gene Project

After 10 years of championing for diabetes prevention services in San Diego, the Skinny Gene Project is looking at the growing epidemic of type 2 diabetes from a different lens. According to the UCLA Center for Health Policy Research, Californians could experience a growth of up to 30% in new diabetes cases within the next 5 years. However, an evidence based solution already exists that can prevent diabetes by 58% and up to 70% for those age 60 and older. The problem lies in the fact that the solution is not readily available or accessible to many of the people in our community. Our challenge, is connecting those who want to learn how to prevent type 2 diabetes to the lifestyle modification programs that can make prevention possible.

At first, it seemed like it would be an easy match up. We have a problem where 46% of San Diegans have a condition known as prediabetes. Without intervention, there is a 70% likelihood they will develop type 2 diabetes in their lifetime. A solution to this problem is the Diabetes Prevention Program (DPP). This evidence-based program is backed by over 15 years of research showing that making small lifestyle changes can reduce your risk of developing type 2 diabetes by at least 58%.

At first, the path to prevention seemed simple – identify those with prediabetes and connect them to the proper program. We quickly learned, it wouldn’t be that easy. The DPP is not a diet; it’s a lifestyle change. It requires collaboration and support from multiple members of a person’s care team (e.g. community and clinical), each interested in seeing them succeed.

We knew that access does not equal success, so in addition to ensuring a person’s healthcare needs are being met, we also wanted to address their social needs (i.e. social determinants of health), too.

The Skinny Gene Project worked with Unite Us to build a bi-directional referral system with DPP case management capabilities. Then we collaborated with the YMCA of San Diego County, Champions for Health, 2-1-1, and other health champions to create a person-centered wellness network to support the clinical and social needs of participants enrolled in a DPP.

We changed our perspective, identified a need, and began working on a solution. The use of technology is crucial to scaling our efforts, but the key to our success is collaboration on federal, state and local levels.

At the Federal level, the Center for Disease Control and Prevention (CDC) designed the Diabetes Prevention Program to be provided within the community. The American Medical Association worked diligently to create awareness among physician and care teams, urging them to screen, test, and refer patients to DPPs. 

Statewide, our CA Department of Public Health worked to align stakeholders to create an Action Plan to roll out the DPP, while Public Healthcare Advocates wrote a bill to ensure Medi-Cal joined Medicare and many commercial insurers in covering DPP as a member benefit.

Locally, Kaiser Permanente is supporting our work with 2-1-1 to further develop and integrate our technologies. Alliance Healthcare Foundation is funding the creation of a Prevention Alliance with an objective to use proven prevention programs (e.g. DPP) to garner economic stability among multicultural community organizations.

Yes, there are a large number of people with pre-diabetes, but we also have a coalition of organizations working to ensure San Diegans that choose to make the leap to improve their health, will have the support and resources to live well.

We can’t prevent diabetes overnight, be we can accomplish this by focusing on one success story at a time.

Meet Henrietta

Henrietta enrolled in our Skinny Gene DPP in March of 2017. With the help of her coach, Nadin, Henrietta began making small sustainable changes to her lifestyle. She stopped skipping meals, began eating smaller portions, increased her exercise and water intake, and took photos to track her food.  Her fifth week into her program, Henrietta set a goal of walking 3 times a week, and began interval training to start running. By the completion of her 12-month program, Henrietta was running 7 miles! In addition to losing 62 pounds, 28% of her body weight, she lowered her blood pressure from 220 over 110 (at 6 months) to 111 over 67 (at 12 months).

Most importantly, she is no longer at risk of developing type 2 diabetes.

Henrietta transformed from being a health seeker into a health care hero. With access to a DPP and a supportive environment to help her succeed, the onus was on Henrietta to take the first step towards living a healthier lifestyle. In doing so, she not only acquired the knowledge needed to improve her own health, but enrich the lives of her family and surrounding community.

The Skinny Gene Project has been providing the DPP in San Diego County since 2014. Our third consecutive award from the CDC has placed us among the top 3% of evidence-based diabetes prevention programs in the country.  Through person-centered care and collaborations, we intend on improving the health of our community, one success at a time.

November's Diabetes Awareness Month is an opportunity to learn about how we are evolving to meet the growing needs of our San Diego community. Whether you are a health seeker interested in preventing type 2 diabetes, health champion, or a person who wants to see San Diegans live well, we encourage you to get involved in our lifestyle movement.

See yourself as a part of the solution in creating a “diabetes-free SD.” Visit the Skinny Gene Project’s website to learn more.