RICHARD WALKER / RWALKER@STARBULLETIN.COM
Irene Takeshita and her husband, Carl, take the message of diabetes prevention to local schools. Above, Irene talked to fifth-graders at Ala Wai Elementary.
Diabetes education starts in the schools
A husband-and-wife team has developed a program that helps kids learn about prevention
ASK FIFTH-GRADERS IN Lori Maihui's Ala Wai Elementary School class what diabetes is and they'll tell you: "Too much sugar in the blood."
They learned that and a lot more about the disease this week from retired teachers Irene and Carl Takeshita.
The couple uses interactive games to get their messages across in a popular "Diabetes and You" program.
"Why aren't we doing this all over the country?" asked Lynn Nicholas, chief executive officer of the American Diabetes Association, impressed with what she saw during a school visit.
"I'd like to take this nationwide," she said. "It's so informative and simple. The children are so engaged."
She said the program is a low-cost way of trying to deal with a devastating disease that's reached epidemic proportions nationally with a high human and economic toll.
"I see an opportunity to find sponsors for this and try to do this nationally. I think it would be effective and get them (children) at an early age."
Irene Takeshita retired in 1995 from Waimalu Elementary School after 28 years of teaching sixth grade. Her husband retired as the Department of Education's specialist for the at-risk program.
She developed the diabetes program in 1999 for the DOE, state Department of Health and ADA in Hawaii.
Before doing their first teacher workshop three years ago, she shed 45 pounds and her husband dropped 15 through diet and exercise.
"I wanted to be a role model, not only for the children but the teachers," Irene said. "I couldn't stand in front of them and be overweight ... It became my goal, to be a role model like all teachers are."
"It just became so much of a passion," her husband said.
The couple has presented the program to about 2,500 children and adults statewide. They've gone to more than 200 school classes. While fourth- and fifth-graders are their target group, they've also been to other grades and to organizations to talk about diabetes and a healthy lifestyle.
Irene said she adapts the program for adults but they enjoy its simplicity. "The message is easy to understand, not like from a doctor."
They present it in two or three classes. After the first class at Ala Wai Elementary School Wednesday, they gave the students "homework" to share what they learned with their parents. They returned Friday to discuss "really heavy duty" complications of diabetes.
THE KIDS were captivated from "Mrs. T.'s" first question: "How many of you have heard of this illness?
"It's because of all these hands going up of people knowing someone who has diabetes that we were asked to present this curriculum," she explained, "so you don't get the illness, or at least not until you're very old."
Irene said she designed the program to be "teacher and student friendly" with repetition of the material in different ways so children will grasp it and remember it.
The couple demonstrated with simple pictures what happens in the body to cause diabetes, the symptoms (frequent thirst and urination) and risk factors.
They described the two types of diabetes: Type 1, known as juvenile diabetes, and Type 2, which used to affect mostly adults but now is occurring in children.
Since Type 1 can't be prevented, the Takeshitas focus on Type 2. Some people have a higher chance of getting it because of ethnicity or family history, but risks can be reduced with exercise and a healthy diet, they stressed.
Sheets of paper were handed out to the students and, following instructions, they folded them into booklets with information about the characteristics of diabetes, symptoms, risk factors, complications, a food guide pyramid and a puzzle.
In sharing the booklet with their parents, sometimes the children learn that diabetes runs in their family, Carl said. And on some occasions, he said, parents looking at the booklet realize they have some of the symptoms and will check to see if they have diabetes or pre-diabetes.
He said he and his wife constantly revise the curriculum as they "practice what we preach" with daily walks.
"Even though we don't have diabetes ourselves and it's not in our immediate family, as educators we feel we are making a difference," he said. "It's an important message and fortunately we came up with a tool to help spread that message."
ADAH Executive Director Majken Mechling said the program is underwritten by various foundations and agencies, such as the City and County of Honolulu Public Health Fund, and it's free to classes.
The Takeshitas also train teachers to conduct the program.
They recently presented it to a fourth-grade Latino class in Los Angeles after attending a conference there for health educators.
"It went really well," Irene said, adding that eventually she and her husband would like to teach it to native Americans, who have the highest diabetes rates in the country.
But Mechling said, "She has to stay until we find a cure."
RICHARD WALKER / RWALKER@STARBULLETIN.COM
Majken Mechling, director of the American Diabetes Association in Hawaii, left, and Lynn Nicholas, chief executive of the national group, sat in on the session at Ala Wai.
ADA chief sounds the alarm against the disease
DIABETES is "on the march" across the country with a 14 percent increase in incidence since 2003, says Lynn Nicholas, chief executive officer of the American Diabetes Association.
The number of islanders with the disease is up to 111,000, with an estimated 39,000 undiagnosed, she said in a talk and an interview this week at a Healthcare Association of Hawaii membership meeting.
One in three children born in 2000 nationally will develop diabetes in their lifetime, and in Hawaii it's one in two children, she said. "That is unconscionable."
Native Hawaiians, Filipinos and Japanese populations have the highest risks for the disease here and native Hawaiians have the highest death rate, she said.
The latest U.S. Centers for Disease Control and Prevention figures show 20.8 million Americans have diabetes -- 1 million with insulin-dependent Type 1 diabetes (known as juvenile diabetes) and 19.8 million with Type 2 diabetes, Nicholas said.
An additional 41 million people have higher than normal blood glucose levels, putting them at risk.
Increasing numbers of people with Type 2 diabetes reflect active screening, longer life-spans and more people in higher risk groups because of age, ethnicity and less healthy lifestyles, Nicholas said.
About 90 percent of people diagnosed with Type 2 diabetes are overweight, she said.
There is no known prevention for insulin-dependent Type 1 diabetes, she said. However, Type 2, affecting 90 percent to 95 percent of those with diabetes, is avoidable, she said. It once affected mostly adults but younger people are being diagnosed, she said.
Nicholas agreed with Rep. Josh Green, (D, North Kona-Keauhou-Kailua-Kona-Honokohau) a family and emergency doctor and chairman of the Health Care Task Force, that there is a correlation nationally between the uninsured population, poverty and diabetes.
"A person has to have affordable care and drugs so they don't land in the hospital," said Green, also addressing the healthcare association.
He said Hawaii's uninsured population rate of 10 percent is "better than so many places." But the number of people with diabetes is almost as high as Hawaii's 112,000 medically uninsured residents, he said.
He asked the association for support to get primary care for people who can't afford it to prevent catastrophic events.
Nicholas said it costs $11.11 a day for a 40-year-old to manage Type 1 diabetes; $11.23 a day for a 55-year-old with Type 2 on oral medications only, and $23.24 a day for a 65-year-old with Type 2 on insulin and oral medications.
A typical person with Type 2 diabetes using insulin spends more than $700 a month on medications and diabetes supplies, she said.
Direct costs for medical expenses and treatment nationally for diabetes and related complications total about $91.8 billion, she said. Indirect costs of disability and mortality total $40.8 billion.
Nicholas said the return is enormous on investments for research in intervention and treatment of diabetes. But research funding is "not in sync" with prevalence of the disease and it's getting worse because of expenses for the Iraq war and the hurricane disasters, she said.
Diabetes patients can self-manage their disease but they must have education to do it and reimbursement for that is difficult for doctors to obtain, she said.