NEWPORT, Ark. – This is the most diabetic place in America.
None of those interviewed knew that. Not even the mayor.
“I didn’t know it until you told me,” Mayor David Stewart said.
And therein lies the problem, said Dr. Bala Simon, state chronic disease director for the Arkansas Department of Health.
Diabetes attacks victims silently, sometimes doing years of long-term damage before the disease is discovered, he said.
Overall, the disease affects 1 in 10 Americans, but here, it’s nearly 1 in 3 — the highest rate in the nation.
The mayor didn’t know that Jackson County, where Newport is the county seat, had the highest rate of diabetes in the nation, according to the Centers for Disease Control and Prevention. He didn’t even know the county had the highest rate in Arkansas.
What he wishes he did know is why.
Rise in obesity in the Mississippi River Delta
Simon said the main culprit for the skyrocketing rate in diabetes (10 times higher today than in 1958) is the corresponding rise in obesity. Over the past 60 years, the percentage of Americans 20 and older battling obesity has tripled from 14% to 42%.
Other factors also increase the risk of Type 2 diabetes, including smoking, binge drinking and lack of physical activity, he said. “The primary reason is the poor diet. A lot of that is the socio-economic status.”
Jackson County is part of the Mississippi River Delta, which has some of the world’s richest soil and some of the nation’s most impoverished people. The poverty rate here is more than twice as high (23%) as it is nationally (less than 11%).
“Processed food is a lot cheaper than fresh fruits and vegetables,” Simon said. “You can stretch your dollars compared to fresh food.”
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According to a Harvard School of Public Health study, eating healthy costs about $1.50 more a day.
The Delta, which includes Arkansas, Louisiana and Mississippi, includes many food deserts.
Convenience stores are closer and cheaper, which “leads to consuming more processed food, which are high in calories,” Simon said. “That leads to putting on weight, which leads to obesity. That, in turn, leads to diabetes over a 5- to 10-year period. It’s a complex societal problem.”
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To battle the problem, the Arkansas Department of Health is promoting prevention, management and treatment of diabetes, working with registered dietitians, pharmacists and lifestyle coaches, he said. Since the pandemic began, those programs have had to go online.
Losing weight can help reduce the risk of Type 2 diabetes and even reverse it in some cases, he said. “Losing about 5 to 10% of body weight can decrease the risk of diabetes by 50%.”
That’s important, he said, because the risk of diabetes increases with age. In the U.S., 27% of Americans 65 and older have diabetes.
This town of less than 8,000 has more than 20 churches, two grocery stores, two franchise dollar stores, three second-hand stores, a medium security prison and a medical supply store stocked with products for those battling diabetes.
“We do well financially compared to towns our size around the state,” Stewart said. “We’re just an old Delta town. People will come in for a few years to work … and they’ll say, ‘I’ve been to a lot of towns, but I’ve never been to one like Newport. Everybody’s friendly. It’s like you’re their best friend.’”
Medicaid expansion gave patients health insurance coverage
Between 2009 and 2013, Dr. Guilford Dudley, an internist, and his wife, Retha, a nurse practitioner, ran a free medical clinic with others here through the First United Methodist Church, testing blood sugar, blood pressure and the like.
“Not one person was paid for working,” Retha Dudley said. “Where there was a need, God met that need.”
What they saw stunned them. “We were seeing with people, even end-stage kidney disease, as a result of their diabetes that had never really been treated,” Dr. Dudley said. “That’s when I changed and realized we needed socialized medicine, because people weren’t getting treated.”
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The couple shut down the clinic after Medicaid expansion took place in Arkansas, making it possible for their patients to receive health insurance coverage.
Nationwide, more than 34 million Americans are battling diabetes, but more than twice as many – 88 million – have prediabetes, which is higher than normal blood sugar that has yet to develop into diabetes.
The couple said they would like to see healthcare providers be more aggressive with the diagnosis of prediabetes. “People think when you say that that they’re not diabetic, they’re OK,” he said, “but if you say they’re prediabetic and you start managing that, that gets their attention.”
Half of those who have prediabetes develop Type 2 diabetes in five to 10 years. Prediabetes can bring long-term damage to the heart, blood vessels and kidneys. A study last year showed an increased risk of cardiovascular disease and death.
Physician describes own diagnosis of prediabetes
“Both of my parents were diabetic,” Dr. Dudley said. “This is what motivated me.”
Three decades ago, the physician, then 260 pounds, learned he was headed down the same path as his parents.
The diagnosis of prediabetes woke him up, and he began to eat healthy and exercise. Today he weighs 175 pounds.
He began taking Metformin. “It’s a very safe drug,” he said. “I started on that, and I’ve never developed diabetes.”
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Retha Dudley, whose mother died of complications from diabetes, said what they saw in their free medical clinic was heartbreaking. “By the time they came in, they’d already been a diabetic for two, three or five years,” she said.
She warned those diagnosed with prediabetes that diabetes could happen to them if they refused to change. That frightened plenty of them.
“They didn’t want to get diabetes,” she said. “They connected that with losing a leg or taking insulin.”
She put them on a program to change lifestyles. “We were motivated,” she said. “I took care of them the way I took care of myself.”
The clinic also prescribed Metformin in some cases, she said. “We would tell people, ‘I’ve got a drug that will keep you from being diabetic, and it will help you lose weight,’ and they would say, ‘Give it to me!’”
The couple said that even after prediabetes is diagnosed, some healthcare providers fail to discuss the serious health problem with their patients.
As a result, many remain in the dark, a problem made worse by the lack of diabetes educators in this small town, she said.
To stem this rising tide of diabetes and prediabetes, this town needs a free preventative screening clinic, she said. “The only way to get ahead of this increasing rate of diabetes is to identify prediabetes and be aggressive in addressing it through lifestyle changes and medication.”
‘I’ve hit a brick wall,’ former athlete with Type 2 diabetes says
In his 30s and 40s, Steve Reid, a 6-foot-7-inch respiratory therapist, became a triathlete, swimming, biking and running marathons, he said. “I’ve never felt better in my life.”
He weighed 210 pounds, he said. “I was lean and mean. I was in better shape as a young adult than I was in high school.”
But that was then, and this is now. Reid’s weight is nearly 300 pounds, down from 360, and he is 66 years old.
“I’ve hit a brick wall,” he said. “I’m trying to get back into the 270s. It’s just…
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