Diabetes Reversal Outcomes Program (DROP): An Intervention Tailored for Rural Communities

Diabetes Reversal Outcomes Program (DROP): An Intervention Tailored for Rural Communities Approximately 34.2 million adults in the US have type 2 diabetes (T2DM). The prevalence of T2DM is 17% higher in rural dwellers compared to their urban counterparts. As of 2018, Kentucky ranks 7th in diabetes with a rate of 13.8%, and Kentucky ranks 5th in obesity with a rate of 36.6%, which is a major contributing risk factor for T2DM. Furthermore, appropriate self-care is necessary for optimal clinical outcomes in T2DM and variability in self-care accounts for 90% of the variance in glycemic control. Yet, T2DM self-care is consistently poor in general. Rural dwellers are exposed to challenging social environment factors, including high rates of poverty, limited access to needed healthcare services, limited access to healthy foods, and social support that may not promote beneficial decision-making, which are barriers to self-care and optimal clinical outcomes. In an effort to address challenges faced by rural dwellers who are currently living with T2DM, the 6-week Reversing Diabetes Program was developed. This program was originally developed to accommodate the unique limitations and address the recidivism rate observed in the private patient programs to address T2DM management for residents of Grundy County, Tennessee. The goal of the program is to empower participants with the knowledge necessary to make wise decisions regarding their health at a low financial cost. Participants are encouraged to adapt the lessons to their unique financial and temporal situations, allowing them to make health changes that are personally sustainable and feasible. What is also unique about this program is that it is open to those in the community who are prediabetic in an effort to address T2DM-related risk factors, including obesity. The challenges faced by those in Grundy County are very similar to those in Appalachia Kentucky. Thus, the purpose of the proposed pilot study is to collect data on the preliminary feasibility of the Diabetes Reversal Program when administered in rural Kentucky. Though the program has been administered in 17 states, there has not been any objective data collected to determine the program’s effectiveness besides anecdotal accounts of improvements in clinical and lifestyle changes by participants. To efficiently collect the needed data, it is proposed that the services of the Vanderbilt Diet, Body Composition, and Metabolism Core be enlisted to collect food intake, body composition, and glycemic control data. Data will be collected at baseline and at 3,6, and 12 months post-program.