1.The Diabetes Wellness Center, Inc. A Model for Engaging-In and Sustaining a Healthy Life How to Juggle Body, Soul, and Mind

2. Preface: Acknowledgements Medical care is integral to living with diabetes. The Diabetes Wellness Centers purpose is to supplement the care the DWC members receive from their medical practitioners. More specifically, the objective of the DWC is to meet the needs that are not addressed in the diabetes medical model. The Diabetes Community, as a whole, owes a debt of gratitude to all of those, with and without diabetes, who dedicate and have dedicated their lives to improving the treatment of diabetes. Where would we be without Dr. Banting? 3. Preface: Acknowledgements The tremendous efforts in science and medicine are truly admirable; however these are not the only aspects that can be addressed in order to improve the lives of people with diabetes. The DWC will work closely with the medical and scientific communities to maximize the breadth of opportunities for DWC members, in addition to working collaboratively to study the benefits of the DWC program. 4. The Premise for a NewDiabetes Model 5. Premise for a New Diabetes Model Diabetes is much more than just a health condition. It affects nearly every area of an individuals life. Current methodologies focusing primarily on the medical components of diabetes are missing tremendous opportunities to generate desired sustainable changes for the individuals, families and communities living with it. The vast majority of efforts attempting to positively affect the plight of individuals who have diabetes, has been and continues to be, based on the same paradigm: a medical paradigm. 6. Premise for a New Diabetes Model It is unrealistic to expect that programs based on strikingly limited efforts to assist people in changing the way they live their lives will ever demonstrate results much better than what we see now. While technologies and pharmaceuticals have improved and become more specialized; the average life with diabetes continues to be fraught with microvascular and macrovascular complications, in addition to frequently unrecognized and unaddressed senses of fear, trauma, shame, depravity, depression, judgment, as well as many of the other things experienced during the individuals life. 7. Premise for a New Diabetes Model Solving the diabetes epidemic is proving to be much more challenging compared to other epidemics. The reality is that over 95% of diabetes care is done by the person who has it. If that person is disenfranchised, lacking in resources, overwhelmed, in denial, or dealing with any other confounding issues, then the majority of diabetes-care is likely ignored. Attempts to change the plight of the diabetes epidemic will fail, without focusing the majority of efforts on helping individuals living with diabetes to help themselves. 8. Premise for a New Diabetes Model The Diabetes Wellness Center offers a revolutionary grassroots response to address this ever expanding epidemic and potential threat to the security of this great Nation. Something must change; we, as individuals, communities, nations, and world, can not afford to continue to stay the current course of diabetes. Its time to stop pressing the button for the elevator, which is not coming, and take the life-preserving stairs! 9. Mission Statement of the Diabetes Wellness Center, Inc. 10. Mission Statement of DWC The Diabetes Wellness Center is a nonprofit community-based diabetes center dedicated to empowering individuals living with diabetes to identify, address and overcome the physical, psychological, social, financial, and environmental obstacles and barriers to living well with diabetes. 11. Goals of the Diabetes Wellness Center 12. Goals of the DWC A primary goal for the DWC is to create a community where currently there virtually is none. Community development is integral to the success of this Diabetes (R)Evolution. An integral element of human evolution was the development of community. Our species may very well not have survived if not for this evolutionary tool. Yet, in the U.S. today, communities are becoming a relic. Hence, it is no wonder why so many are struggling through their existence. Humans need each other! 13. Goals of the DWC Other goals are to educate and empower all members so they will be more inclined to choose healthier options, and join together to in order to achieve workable homogeneous solutions, thus creating a sense of belonging for all of those who live with diabetes. These experiences of feeling a part of can be beneficial in addressing feelings of isolation, which can be extremely detrimental to making and sustaining life-long changes. 14. Goals of the DWC One of the long-term objectives is for people across the United States and World to have DWCs in each of their communities. Ultimately the Diabetes Community, once organized, will be the largest single-interest voting sector in the United States. The Diabetes Community has the potential to make the political and legislative changes necessary to solve many of the virtually insurmountable challenges that people living with diabetes face today. 15. The Diabetes Wellness Centers Target Audience 16. DWCs Target Audience Everyone is welcomed to be a member of the DWC! The DWC strives to engage most, if not all, people living with diabetes. Living with diabetes, for all intents and purposes, is defined as: having diabetes, being related to someone with diabetes, as well as being connected to someone with diabetes whether it is a friend, boss, or bus driver. It seems that ALL of us are living with diabetes, whether we know it or not. 17. Why the Diabetes Wellness Center Model Differs fromOther Medical Models 18. Why the DWC Model Differs Poorly controlled diabetes is the leading cause of adult blindness, end-stage renal disease and non-traumatic lower-limb amputations. It also doubles the risk of stroke and heart disease.1 This remains true despite all of the amazing technological and pharmacological advancements made over the past 30 years.1. American Association of Diabetes Educators, Diabetes Fact Sheet 19. Why the DWC Model Differs A primary component of these failures is the standardized efforts to address diabetes solely from an interventionist medical model, when the reality is diabetes is much more than merely a medical issue. Another contributing element is continuing to use trickle- down models as a means to change this health crisis. 20. Why the DWC Model Differs The current trickle-down model of academics and scientists determining standards of medical care, medical professionals doling out treatment plans, and insurance companies determining accessibility and availability of resources leaving the individual with diabetes at the bottom struggling just to navigate this maze, much less make it all happen within the confines of their life is insufficient at best. Is it any wonder why it hasnt worked?! 21. Why the DWC Model Differs The solutions we are looking for lie with the individuals who live with diabetes. They know (or with some help will know) what limits their motivation and desire to employ daily efforts of self- care. The foundation of all diabetes management must be the individual in order to sustain the necessary lifelong efforts. This is precisely why the DWC is dedicated to extensively educating, offering resources, and vitally empowering each individual to be a competent center of self-care. The DWC model uses and expands upon the successful components of current paradigms. 22. How the Diabetes Wellness Center Model Differs fromOther Medical Models 23. How the DWC Model Differs The Diabetes Wellness Center is a concerted effort to change the ways and means of which diabetes is addressed, as an individual, a community, a country and world. The DWCs distinct efforts are specifically designed to diverge from the lunacy of continuing to deal with diabetes - using the same methods that continue to perpetuate negligible hope for people living with diabetes. 24. How the DWC Model Differs Diabetes management is typically isolated from almost every other aspect of life. This compartmentalized approach is often futile over the long haul, and diabetes is hauled for the rest of ones life. What is desperately needed are; livable-treatments for livable- conditions. It is with this notion that the DWC is helping individuals, not just treating diabetes. 25. How the DWC Model Differs For most living with diabetes, they are told what not to do and what not to be like. It often goes something like this: See that person who went blind from not taking care of his diabetes? Dont be like them. This approach is ineffective in attempting to improve peoples desire, ability and motivation to take better care of themselves. The DWC advocates a different means to invoke behavior changes. 26. How the DWC Model Differs Humans learn by modeling behavior, so the DWC will offer examples of how to live well. Members will have the opportunity to participate in a mentorship program. This programs benefits transcend the individuals involved. The mentee will have a person, who lives with diabetes, to assist in understanding how to maneuver the numerous challenges and barriers to living well with diabetes. 27. How the DWC Model Differs The mentor receives the benefit of living a life as an example. There are times when self-care can be difficult to muster the energy for, and in those moments it can be beneficial to have the knowledge that people look to you for your example of self-love and self-care. The DWC will staff therapists who offer one on one sessions, family sessions, as well as group sessions. The DWC also offers potential solutions to address and overcome the under-recognized and under-treated depression that is associated in living with a chronic condition. 28. How the DWC Model Differs Some 85% of people living with type 2 diabetes are overweight, obese or morbidly obese. A pertinent question to ask is: how do people care for themselves, if they dont care about themselves? The simple answer is: they dont. For many people it is nearly impossible to get a handle on weight management without also addressing any coexisting psychological issues. 29. How the DWC Model Differs One of the greatest challenges people living with diabetes face is without a doubt getting sufficient physical activity. The DWC will staff exercise physiologists who give personalized physical assessments, as well as individualized activity programs. The center will host activity classes on-site, through-out each day. The classes offered will depend on the interests of the community. Some possibilities include: Pilates, yoga, tai-chi, kick boxing and salsa dancing. 30. How the DWC Model Differs Many people living with diabetes are not able to afford to take care of their diabetes. Financial problems pose many risks and challenges for the individual, the family as well as the diabetes community. Financial constraints force individuals to make seemingly impossible choices. Do you pay rent or buy your test strips? This is a question which should not have to be asked, and yet is asked by far more people than anyone realizes. 31. How the DWC Model Differs The DWC will staff advisors to assist members in identifying, applying, and sustaining eligibility for programs available to assist with the financial challenges of living with a chronic condition, such as diabetes. It is in the interest of all Americans to have people living with diabetes succeed and live well. The social, financial, and political implications of perpetuating the circumstances that fuel the diabetes epidemic are dismal for everyone, whether they have diabetes or not. 32. How the DWC Model Differs It is imperative to consider the long-term implications of this national diabetes epidemic and international pandemic, when thinking about where, when and how to spend the limited resources available to improve the state of diabetes. Funding for the DWC is seeding for change. 33. How the DWC Model Differs The financial implications of the diabetes epidemic may very well be the final straw that bankrupts the United States. Income tax is the financial basis for most Federal and State programs. Where will be when people who have diabetes and did not get the adequate care, resources, and empowerment needed to live well; end up suffering preventable end-stage complications of uncontrolled diabetes, loose their jobs and then rather than contributing to the tax system, they are positioned to necessitate tax-funded services like Medicare and Social Security? 34. There Is Hope! 35. There Is Hope! The Diabetes Wellness Center is dedicated to changing the course of diabetes in our lifetime. With the power of the people living with diabetes, anything is possible. Together we can change the World! 36. The Diabetes Wellness Centers Model Program 37. The DWC Model The DWC program includes, but is not limited to, the following: Diabetes Education: Registered Dieticians, Certified Diabetes Educators (R.D.,C.D.E.) and Registered Nurses, Certified Diabetes Educators(R.N., C.D.E.) will teach one and one, groups, and familysessions. Comprehensive, on-going diabetes education is integral toliving well with diabetes. 38. The DWC Model Counseling: Therapists will hold one on one, groups and family sessions. Groups will develop to support varying aspects of life with diabetes including; women's, men's, teens, parents, spouses, walkers, jokers, spiritual groups in addition to many others. Each member will be asked to share their experience, strength and hope. 39. The DWC Model Physically Active: Exercise physiologists will assess each members ability to do physical activity and will give recommendations tailored to each individuals needs and wants. On-going activity classes will be held on-site, through out each day. These classes will be chosen by members, as to give the people what they want, whether it is Yoga, Tai-Chi, Salsa Dancing, or Line Dancing. 40. The DWC Model Programs Advisors: Caseworkers will assist members in maximizing their ability to utilize any and all programs available to them including but not limited to: Federal, State, County, and Private Programs. 41. The DWC Model Volunteering: Members will be asked to offer their services to the membership. Mentoring will be taught to members who will in turn mentor others, which will create tremendous opportunities to keep people engaged. Other opportunities include: Offering rides to the center as to alleviate concerns of people who arelimited by transportation, Taking care of children in activity area so parents can freely attendclasses, groups or sessions, Donating others services. 42. The DWC Model Diabetes Outreach Ambassadors: Members will be trained to do outreach efforts of teaching the basics of diabetes care in order to reach as many people as possible. Such efforts are hoped to reign-in and engage those who are not being seen by the medical community. Members are encouraged to do such outreach efforts at their churches, book clubs, or other groups. 43. The DWC Model Healthy Eating & Cooking: The Center will offer healthy eating classes instructed by Registered Dieticians. The DWC hopes to partner with local farmers and growers to host Farmers Markets on site. One goal is to increase opportunities for members of the center to choose healthier, economical food choices. 44. The DWC Model Healthy Eating & Cooking (cont): The Center will include Nona Bellas Cucina; a kitchen where members will learn, and then teach, how to cook nutritious, cultural, and frugal meals. A potential partnership may arise out of a proposed Healthy Eating effort. Registered Dietician will work with local grocery stores to host on-site: Living Well- the Art of Grocery Shopping 45. The DWC Model Stress Management: The DWC will offer many different tools to assist members in managing stress, which is paramount to sustaining a life- long healthy approach to life. The Center will offer courses on meditation, in addition to other techniques. One such technique to be offered is art therapy. Members will be invited to create art using a space set-aside for such activities. They will also be encouraged to donate some of their works of art for an annual fundraising event, in which pieces will be auctioned off to patrons of the Diabetes Wellness Center. 46. Closing Comments from theFounder 47. Closing Comments During my 30-year experience of living with diabetes, I have come to realize that the challenges I face in trying to juggle body, mind, and soul with diabetes are ever present for most people living with this condition. I, like many of those living with diabetes, spent vast amounts of time being angry and defiant about having to live this life with diabetes. I had not asked for diabetes, I resented having it and therefore did not want to manage it. I was on the verge of being ravaged by the complications of uncontrolled diabetes, when I finally learned to embrace myself, my life, and my diabetes. 48. Closing Comments I believe this transformation is possible for most individuals who are struggling to live well with diabetes, but there must be a catalyst to spark a desire and structure to sustain the changes. The Diabetes Wellness Center hopes to provide the sparks and structure for all of those who wish to live well with diabetes. ~ Heather Jacobs, Founder and President 49. Questions? 50. Thank you! 51. The DWC Executive Board Heather Jacobs: Founder, and President Chesney Hoagland-Fuchs, RN, CDE: Chief Financial Officer Isabel Estolano: Vice-President and Secretary Francine Genta, RD, CDE: Board Member Javaier Carillo, MPH: Board Member Tim Aquino, Pharm D: Board Member Chandra Ziel RD, CDE: Board Member