Mary Beth Castle (Johnson Co.)

And then she said, ‘You are now prediabetic.’ And that kind of clicked with me. Because my Dad’s a diabetic; my Mom’s a diabetic; both of my siblings. And I went, ‘Okay, it’s time for me to do something.’

I’m Mary Beth Castle. I’m the Health Educator at the Johnson County Health Department, but I’m also the Diabetes Prevention Program Lifestyle Coach as well.

* * *

Most people who are prediabetic don’t know that they’re prediabetic. Because it’s not something that doctors will usually mention to them until it gets, really, to the point they are already type 2 diabetic. People don’t even know that there is such a thing as being prediabetic that can lead you into being a type 2 diabetic.

The Diabetes Prevention Program is set up to be 16 core classes. It’s one class per week; it lasts about an hour, sometimes an hour and a half— depends on your group.

Each of the classes are set up in different stages, we do talk about different things. Like, the first time they come in, we do talk about what your weight is, and where your weight needs to be. The program is not asking you to lose a lot of weight. It’s set up to lose 5-7% of your body weight. And so it’s not like we’re asking people to drop 50 pounds. Some people may have needed to lose 12; some people may have needed to lose 22. But, each individual, it’s set for them, based on what their weight is. So, that’s the first thing we do.

And then, we gradually start looking at what kind of foods that we’re eating. We look at labels— I bring in foods, we turn the labels over, we look what kinds of things are in those, as far as carbs and sugars and calories. We try to figure out a plan for them of what they want their calorie intake to be so that they can start to see some marginal weight loss.

I don’t expect them to come in here and have ten pounds’ loss, you know, in a week. Or maybe not even ten pounds in a month. If they’re moving the scale in the downward direction, that’s what we want them to do.

* * *

And then we gradually work from that into physical activity. And physical activity can be anything that they count during the day. I want them to get at least 150 minutes of physical activity in a week. So, that’s about 30 minutes for five days. It doesn’t have to all be done at one time; if they do 30 minutes a day, it could be 10 in the morning, 10 in the middle of day, 10 in the afternoon. But they get to count everything they do as physical activity: if it’s mopping, if it’s running the vacuum, if it’s taking the trash out. One little old lady washes her car all the time, she’s 82, I think she said, and she’s washing her car— she gets to count that as physical activity.

Our little saying as far as our process is— we are trying to be like the tortoise and hare, but we are the tortoise. We’re trying to be slow, but yet stay on a steady pace, to see some marginal weight loss, but yet get some physical activity in there. And I want them to feel good about it!

You know, and we always, when somebody in here, if they lost whatever weight, we always try to “yoo-hoo” and clap and, you know, always give them warm-and-fuzzies and pats on the back, per se. Because we all like that feeling, when we start to accomplish things.

* * *

I don’t tell them they can’t have anything. I don’t tell them they can’t eat this or they can’t eat that. I tell them they can have what they want to eat— they need to do it in moderation, and they need to look at portion sizes.

We live in an area where our Grannies and our Mommas want our plates to be full of food and they want us to eat everything on there. Trying to get them to get back to that, instead of three spoonfuls, start with two of green beans instead of three of the green beans. Even though that’s probably a better thing that you could eat. Because if they just cut back on portions alone, that’s going to make a difference.

But the group setting is awesome— sitting here around a table with other people that are going through the same thing that you’re going through, as far as looking at the foods they’re eating, getting physical activity, being accountable for their weight every week. Every week they come in, they weigh. They don’t have to tell the group their weight— they write it down, they give that to me, I keep that to myself. The only way that other people would know in the group what your weight is, is if you personally tell them. And most of our group, they’re pretty sharing. A lot of them don’t care to tell what their weight was, or if they gained— my little old ladies don’t care to say, ‘I gained a pound or two,’ or whatever!

Once it goes to once a month—and that’s where we are now, it’s a core maintenance, which is six months, we meet once [per month, for six months] after the first 16 weeks—they will tell you that they miss that once a week gathering. Because you’re going a whole month and not seeing those people. You’re not talking about what’s going on, you’re not talking about what struggles that you may have, or you’re not accountable for that weigh-in every week— you’re only having to weigh in once a month. And so, the weekly thing is really good for accountability.

And I never, ever, say anything negative to them if they didn’t lose weight. We talk about, okay, what do you think might have been the reason? And everybody bounces off of each other. Because what might work for LaDonna doesn’t work for Stony. And what didn’t work for Stony didn’t work for Mary. And it’s just— it’s all geared toward the personal individual.

* * *

It’s hard to get people to go out of their comfort zone. We’re all that way: we like to stay in that box; we don’t want to get outside of that box. And it makes it really hard.

I try to use myself kind of as a motivational piece, because I was right where they were. Before I started here at the Health Department, I had had my health checkup that we had to do for our health insurance. And they told me then that I was obese—which, I knew that, I’m 5’2’’, you can’t weigh 202 lbs. when you’re 5’2’… [I mean] you can, but it’s not good for you— and then she said, ‘You are now prediabetic.’ And that kind of clicked with me. Because my Dad’s a diabetic; my Mom’s a diabetic; both of my siblings. And I went, ‘Okay, it’s time for me to do something.’

So, I did what they’re having trouble with. I had to go outside my box. And I started walking. And that’s what I told them— you don’t have to walk far, and you don’t have to walk fast. Just some physical activity. And I’m now a runner, and I never was a runner. And now I do cardio kickboxing, and I never did do that either. But I pushed myself outside that box.

And that’s what I said to them. Because when I said I weighed 202, they went, ‘Yeah, whatever.’ And I’m like, ‘No, I did!’ And so, they’ve seen pictures of me, and I’m extremely overweight! But I said, ‘I’m 56. If I can do it, anybody can do it.’

But it is a mindset thing. You have to want to do for you. A lot of people can’t seem to get there because they still think they have to take care of everybody else. But you can’t take care of everybody else if you don’t take care of you.

* * *

And I’ve had so many people that will message me, or talk to me, and go, ‘What’s your secret?’ There is no secret. You have to be more physically active, and you have to start watching what’s going in your mouth. And they have to balance each other out.

I will eat things that I know are not necessarily healthy for me, and probably that I shouldn’t’ve eaten. But I make sure that if I had three pieces of pizza, that I’ve worked out that day. Or I’ve walked a little extra that day. Or tomorrow, I’m going to a little walk extra because I ate something the day before.

I think physical activity is the biggest thing right now for people. We get too sedentary. And so many families have children, and one has to be at A, and one has to be at B, and one has to be at C, and everybody’s in such a hurry. And we’re so quick to run through those drive-thrus, and we pick up something really quick. And so many of the things that are cheap for families are things that are not healthy for them. And we as adults, we’re sitting at a baseball field, or we’re sitting at a gym, or wherever we are— okay, your child is playing softball, or playing baseball. You can get up and walk around there while you’re there. I just think If you’re physically able to do it, you need to be doing the physical activity. Before you get the point where you can’t do physical activity.

* * *

I think it’s just become commonplace for people. Grandpa had diabetes; Granny had it; my Aunt-sister had it; my Aunt had it… and everybody just kind of is like, ‘Okay, I have diabetes now.’ I don’t think they see it as a huge health concern in this area.

I mean, and they can watch family members die because of it, or complications from it. But I think they think, ‘Oh, it’s not going to happen to me.’ And then if it does, it’s like, ‘Eh, it’s not that big a deal.’ They go to the doctor and they just expect the doctor to just give them a pill, and the medicine’s going to take care of it, and I don’t have to worry about it. And that’s not the way it is with diabetes. Yes, once you get it, there is medication that you can take, and it will help to help keep it in check. But there are still things you have to do for yourself. So, to keep from getting to that point, or maybe kicking that can, as I said, farther down the road and prolong it as long as we can— let’s do the things that’s good for us to help with that!

I’m not asking you to get out and run a marathon tomorrow. I’m asking you to start small. Walk just a little bit, and then in a week or two, increase your distance a little bit. And then in a week or two, increase that distance a little bit. We’re back to that tortoise: slow and steady. And the next thing you know you’ll be walking seven miles a day, or getting seven miles of activity a day. Or, me, who started out just walking, and now I run 5ks, and I do cardio kickboxing— but I started out just walking, like, 1/4 of a mile!

And that is hard. That’s hard for anything: just that first step, whether it be getting more physical activity, and going, ‘Okay, I’m going to start tomorrow— I’m going to get up, and I’m going to start walking.’ Or, ‘I’m gonna start with portion control.’ And that first time that you put food on your plate, and there’s all that food there, and you’re like ‘I’m only gonna put this, and this, and this [on my plate], and that’s all I’m going to eat’— that first step is hard! But once you get over that hurdle, I think it’s all downhill from there. It’s so much easier.

* * *

And I know, Eastern Kentucky, we’re at the top of, like, for everything: whether it be cancers, or smoking, or diabetes, or prediabetes. And I hear people in this area say, ‘Well, it doesn’t matter what you do, when it’s time for you to die, you’re going to die, no matter what.’ Kind of like that, ‘Oh, well, I’m already predestined to have type 2 diabetes, so I’m just going to have it, so I don’t need to worry about it.’

My comeback to that is, okay, maybe I am going to end up with type 2 diabetes later on in life. I mean, the possibilities for me are good. But— I’m willing to take the chances to try to prolong all of that down the road as long as I can.

I think just people knowing that the Diabetes Prevention Program is attainable. You talk about, oh, it’s going to be 16 classes, and it’s going to be 16 weeks, and we have to meet for an hour, I think people automatically turn that off. And they don’t realize how good of an experience it can be.

And that it is just about them. It’s not like you’re coming in here and you just have to deal with all of those people that’s in that session. Everything is geared towards the individual person. It’s about you, and it’s about you making changes for you. And to maybe stop this cycle of going from prediabetes to type 2 diabetes—it has to start somewhere. Why can it not start with me?