Diabetes prevention-maintenance programs specialize their services for truckers

TLA June Diabetes 1
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Kay Pfeiffer of TrueLifeCare conducted her first Mid-American Trucking Show seminar this year. She’s becoming a regular at high-profile trucking industry events, spreading the word about the growing problem diabetes poses to the trucking industry.

At MATS, she opened her presentation by listing several celebrities who have diabetes: Mariah Carey, Drew Carey, Billie Jean King, Larry King, Tom Hanks, Halle Berry and others. The subtext was that diabetes can be found in every walk of life and it doesn’t need to be a debilitating illness. Once she had the audience’s attention, she explained how TrueLifeCare helps truckers fight the disease.

Representatives from Omada Health were at MATS, too, giving diabetes screenings in conjunction with the Healthy Truckers Association of America (HTAA) and the American Association of Diabetes Educators (AADE) to deliver a diabetes control program offered free to qualified truckers through a grant by the Centers for Disease Control and Prevention.

They were two companies out of the thousand or so vendors at MATS, trying to get a common message across. These days sleep apnea, the opioid crisis and the obesity epidemic are the hot health topics. Diabetes is more of a golden oldie among medical issues, its seriousness sometimes muted by complacent familiarity. A few weeks after MATS, Pfeiffer spoke with The Trucker about the lack of diabetes awareness she’s observed.

“In the last year, all the trucking companies I’ve talked to, it’s seems like they don’t understand or they’re just in denial or they’ve never explored it,” Pfeiffer said. “It’s a huge safety issue.”

She comes to these conversations prepared with harshly enlightening statistics.

Diabetes cases have risen 700 percent in the last 50 years. In 2015, 30.3 million Americans had diabetes, and the number is growing by 1.5 million every year.

Unchecked, diabetes gives you almost a 70 percent chance of heart disease or stroke, about a 30 percent chance of blindness and about a 60 percent chance of needing an amputation.

It is also estimated that more than 84 million Americans age 18 and older are what is known as prediabetic – their blood sugar level is higher than it should be but falls below diabetic levels. Of this group, about 30 percent will likely become diabetic.

As usual when health statistics are cited, truckers come out on the short end of the equation. Diabetes rates among truckers are 50 percent higher than the general population. Of the 3.5 million truckers in this country, it’s estimated 600,000 to 700,000 have diabetes, of whom up to 150,000 have never been diagnosed.

What’s worse is that of the approximately 550,000 drivers who know they are diabetic, only about one in four are testing their blood sugar levels as recommended by their doctors.

“There’s an awful lot of people out there that are driving trucks that should not be driving because they’re not testing,” Pfeiffer said. “If you have diabetes and you’re not testing, you’re driving at night without headlights.”

Most diabetes is classified as either Type I or Type 2. With Type I, the immune system attacks the cells that produce insulin. It isn’t known why this happens and there is no way to prevent or reverse it.

With Type II diabetes, the body either fails to produce enough insulin or becomes resistant to it. Type II diabetes accounts for over 90 percent of diabetes diagnoses, and it is mostly brought on by lifestyle.

The bad news for truckers is that the stereotypical trucker lifestyle is the perfect formula for diabetes – too much stress, too little exercise, poor sleeping and eating habits and the obesity that comes with it. Although getting fat doesn’t automatically set you on the road to diabetes, it is a primary risk factor.

“Being overweight, having high blood pressure, having heart disease, all of those are co-morbidities,” Pfeiffer said. In other words, they aren’t necessarily tied, but where you see a lot of one, you see a lot of the others.

The good news about Type II diabetes is that what lifestyle choices create, lifestyle changes can fix. Type II diabetes can be controlled and even reversed. This where the programs offered by TrueLifeCare and Omada Health come in.

Although the programs differ in precisely what they provide, they are built on a similar premise.  As Pfeiffer put it: “Nobody changes behavior because you told them to. We wouldn’t have so many obese people in America if people did what they were supposed to do.”

When people are learning to combat diabetes, they need the tools, they need information and most of all they need consistent coaching. Both the TrueLifeCare and Omada programs are front-heavy when it comes to participant interaction. The reason is simple: Old habits are hard to break, new habits take time to take hold and managing diabetes usually requires some of both.

With TrueLifeCare, participants sign up through their company as part of their medical benefit package at no cost to the employee. They are assigned to a registered nurse who is trained as a behavioral health coach, and they receive glucose testing supplies. They also have access to meal planning and recipe resources, as well as diabetes educational materials.

During the first month, participants interact frequently with their coach as they get started. Too often, people won’t test if they feel OK, Pfeiffer said. People sometimes need a little extra prodding to get them to prick their fingers every day.

After the first month, participants who consult with their coach at least once a month continue to get their testing supplies for free.

Omada’s program is a digital adaptation of the Diabetes Prevention Program, which was borne out of a 2002 study by National Institutes for Health.

Adam Brickman, senior director of strategic communications and public policy for Omada, explained that after that study, the Diabetic Prevention Program was created, with the CDC promoting group meetings all over the country.

But for people like truckers, being able to attend regularly scheduled meetings is out of the question. With the surge in communications technology in recent years, that problem had disappeared. Omada began about seven years ago to create a program so that drivers can sign up and “attend” meetings anytime, anyplace.

The first step is to go to the Omada website, and take a simple quiz to determine if you have enough risk factors to be eligible for the program. Once accepted, participants are mailed a digital scale synched to an online health profile. They are also be assigned a health coach and to a group with about 25 statistically similar participants.

For 16 weeks, participants will keep track of their food intake, exercise and weight, and each week there is a new lesson about nutrition, exercise or improving on unhealthy habits. Participants can interact with their group or with their coach throughout the program.

Michele Geraldi is an Omada coach. She explained the program focuses on four lifestyle categories: nutrition, exercise, sleep and stress. Inadequate sleep and too much stress are often overlooked factors to overall health, Geraldi said, but both can be detrimental to the body’s chemistry, and either can prevent weight loss even if the person eats right.

“Everyone has different weak points,” Geraldi said. The Omada system is designed so coaches can look at a participant’s profile and tailor the program to suit their particular needs as they move past that initial 16 weeks.

Omada has been looking at ways to tailor the program specifically to truckers. For instance, when it comes to eating healthier, Geraldi said, “For a person who has a typical 9-to-5 job, we’ll talk about farmers markets.” But for truckers, information how to best navigate a fast-food menu board or convenience store options would be more useful.

The same goes for advice about exercise, Brickman added. After a long day behind the wheel, “Even when you stop, you’re probably not going to feel like, ‘hey, go for a run.’”

Instead, Geraldi explained, “We’ll talk about fitting little bits of exercise here and there that will add up – walking, lifting stuff.”

According to the Health Care Cost Institute, employers and employees combined spend an average $16,021 per diabetic employee enrolled in company health plans, compared to $4,396 for health plan members without diabetes.

All told, U.S. companies spend $237 billion per year on medical costs associated with diabetes. That’s on top of another $90 billion in lost productivity. Diabetics take an average of an extra five sick days per year, Pfeiffer said, and have another 15 days that qualify as what is referred to as presenteeism, which is when someone shows up for work even though they are not at their best.

Driving with a head cold is one thing, but considering that diabetes symptoms include unusual fatigue, tingling extremities and blurred vision, presenteeism becomes a dangerous proposition.

To find out more about TrueLifeCare, visit TrueLifeCare.com. for more on Omada Health, including their online quiz, visit Omadahealth.com.

“We’re saving companies hundreds of thousands of dollars and we’re saving people’s lives, and getting them to where they don’t need insulin, and don’t need medication and don’t need an amputation,” Pfeiffer said.

“It’s all your choice. If you choose not to manage your diabetes, your diabetes will manage you.”

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