Preventing Type 2 in the Age of COVID-19


A still from a recent Zoom meeting of the Diabetes Prevention Program at the Johnson County Health Dept. At bottom left is Marilyn Morgan, a DPP Participant. (Photo courtesy of Mary Beth Castle)

Avoiding type 2 diabetes is, of course, always a good thing for your health. But health professionals say that diabetes is also one of several underlying health conditions (along with obesity, COPD, and black lung disease, among others) that could make the symptoms of COVID-19 more severe, if you were to happen to get it. So, if you can prevent diabetes, you are also lowering your risk of more serious complications from the coronavirus.

That’s not to say it’s always easy to make the changes that can help prevent type 2, though. Especially in a global pandemic, with so many of us spending more time at home. But in this piece, we meet two Kentuckians who, despite the difficulties, have met the challenge head-on: Marilyn Morgan, of Johnson County, and Connie Godsey Duvall, of Cumberland County. Both have been participating in their local version of the National Diabetes Prevention Program (DPP), and both say the program has helped them not just lose weight, but also keep it off.

We also hear in this story from Mary Beth Castle, DPP Lifestyle Coach at the Johnson Co. Health Department, about what it’s been like to guide participants through the DPP process amidst the unique circumstances posed by the coronavirus pandemic.

Music in this story (“Across the Tappen Zee” and “Like a Sick Eagle Looking at the Sky”) was performed by Glenn Jones & Laura Baird, and can be found at the Free Music Archive.

Click here for the full transcript of this story:


NARRATOR: The pandemic has of course changed life in massive ways for so many of us— some losing jobs, others working from home, schools and businesses closed, or using drastically different procedures. But it’s also had smaller, more everyday effects.

{Mary Beth} Actually I had gained five pounds, I was about to die. But I got those five off, so all is good! (laughs)

NARRATOR: This is Mary Beth Castle, of Johnson County, Ky. Mary Beth is a lifestyle coach for people trying to prevent type 2 diabetes, and a big part of her job involves working with people’s eating habits, and trying to help with weight loss. So, the pandemic has hit home. Literally.

{Mary Beth} You know, Corona’s got us all in our homes, and I think that we are eating more and not getting as much activity as if we were, you know, going about our normal day.

NARRATOR: Mary Beth leads the Johnson County Health Department’s version of the national Diabetes Prevention Program, or DPP for short. The DPP is a lifestyle change program, with the ultimate goal of helping people prevent type 2 diabetes.

Even before coronavirus, type 2 was already a national epidemic, according to the CDC. And eastern Kentucky has rates of type 2 that are higher than the state and national average.

{Mary Beth} This is an area where diabetes is very prevalent. And unfortunately, it typically runs in families, and so a lot of people have just have taken that for granted that that’s just something that’s going to happen to them. But there are things we can do maybe prevent it, or maybe prolong it.

NARRATOR: Unchecked, type 2 diabetes can lead to serious health problems, including: damaged eyesight and kidneys, the loss of feeling in parts of the body and even the loss of limbs, and it also carries a large risk for cardiovascular disease, among other issues. So avoiding type 2 has huge benefits on its own. But Mary Beth says there’s a connection with the coronavirus, too.

{Mary Beth} We do know that there are underlying health conditions that can cause greater concern if you are positive for coronavirus. And, of course, diabetes is listed; heart disease, of course; high blood pressure; asthma; COPD; all of those underlying issues can all cause lots of other health issues added to having the coronavirus as well.

NARRATOR: So if you can prevent type 2 diabetes, you’re also reducing your potential risk of more serious symptoms from Covid-19, if you were to happen to get it.

* * *

{Marilyn} It’s one of those things that— you’ve got to take a hold of it. You can’t let it decide what it’s going to do for you.

NARRATOR: Marilyn Morgan lives in Johnson County, and she’s currently a participant in Mary Beth’s DPP group.

{Marilyn} We’ve been at some of the local groceries that would hand out samples. And we would ask the lady handing them out, ‘Does this have a lot of sugar in it?’ And then when we told her, ‘No, we can’t have it, because of the sugars,’ she goes, ‘I’ve got it too,’ but she throws up her hands and says, ‘The Lord will provide, and take care of me.’ Sometimes, he needs a little help!

NARRATOR: Marilyn has prediabetes, a condition which, basically, means your blood sugar is high enough that you’re at real risk of getting type 2 diabetes soon, unless you can make some lifestyle changes.

When she was first diagnosed with prediabetes, Marilyn knew about type 2, because her husband George had been dealing with it for years. But she said she herself wasn’t showing any symptoms, apart from just fatigue.

{Marilyn} I was a little bit in shock. You know, it’s always fine in general when you’re talking about somebody else. But when it comes about you, it’s a whole different ballgame. It can be earth-shattering. But I was diagnosed in 2008. And I’ve kept it under control ever since.

NARRATOR: And keeping prediabetes from becoming type 2 is exactly what the DPP is about.

In her DPP classes, Mary Beth says there are two big things anybody can do to help their diabetes risk: changing what you eat, and how much you move your body. This does mean some weight loss, but Mary Beth says losing just 5-7% of your weight can make a huge difference in preventing type 2. And so in the DPP, everyone gets their own weight loss goal, and then classes focus on things like: healthy recipes, counting fat grams and calories, eating smaller portions, and finding ways to get exercise in.

Normally, a group meets in person over the course of a year— first weekly, and then monthly. But, well, here’s Mary Beth again.

{Mary Beth} That’s all went great— for awhile. And then Corona reared its ugly head, and we had to make some changes, because we could not bring people together, you know, face to face, in person.

NARRATOR: Everyone in Mary Beth’s group had access to a device that could use Zoom, the video conferencing program, so they started having meetings virtually. And while they’ve been adjusting to the technology, changing habits is something that can always be tricky, especially around food. And the pandemic has added some extra wrinkles on top.

{Mary Beth} It concerns me, not that they’re eating at home—which is a good thing—but maybe they’re not eating as well, and people are snacking more.

And one of the things they suggest through our program is not to keep snack foods out on your kitchen counter, and to put them in a cabinet. And so I finally had to do that, I finally had to put all of the snack goodies in that cabinet. So if I get something out, then I am making a conscious decision to go in there and get out whatever it is that I think I want.

If you’re going to keep something on your counter, let’s go with fresh fruits. So that if you go in there and think, ‘Oh I want that cookie,’ I’ll eat a banana instead.

NARRATOR: And especially if you’re spending more time at home these days, it can also be easy to just feel a little more lethargic, and to be moving around less.

{Mary Beth} If you’re sitting and you find yourself watching TV a lot—and I think a lot of elderly people have been watching a lot of news, which is not a good thing, because it’s so depressing—when commercials come on, get up. You know, walk through the house, walk down the hallway. Walk circles around in your living room. Do not sit in that chair all the time.

* * *

NARRATOR: For Marilyn, the pandemic hasn’t been all bad for her DPP goals. Especially around food.

{Marilyn} I’ve been eating at home a lot more. And so that way I can control the amount of sugar that’s in the food and the sodium that’s in the food. If I’m making a pizza, I’ll make my own pizza crust, so I can control the sugar in that. I’ve even gone as far as taking some of my mom’s old recipes and converting those over to sugar-free.

If you have your choice of either eating healthy like this, or just eating like you normally would, and you lose your sight, or some fingers and toes, it might be too late then.

NARRATOR: For Marilyn, the exercise side of the coin has been a little tricky, though. For the past year or so, she had been working out with a professional trainer, but that stopped with the pandemic.

{Marilyn} Well, since COVID set in, it’s harder to get out and exercise, especially in this heat. But I go over to the local community college, and walk around their track. And the rest of the time it’s just, maybe running the vacuum, or mopping the floors, or just getting up and moving within the house.

Just knowing you’re going to have to turn into Mary Beth how many minutes did you exercise and what your weight is, you try to stay on track to be motivated to get that accomplished.

NARRATOR: Marilyn says switching to zoom has been a bit of an adjustment, too.

{Marilyn} In some ways, like seeing the group all together in person, makes… you know, you have camaraderie there that you support each other. But even though we do it on Zoom now, because of COVID, we still can talk and see each other, and still have that camaraderie to it.

{Mary Beth} When somebody doesn’t make it to the meeting, they’re like, ‘Where is so and so?’ I mean, we kind of keep each other accountable. But we also have become friends, and we’re concerned about one another. And we are all smiles when we get on Zoom; we can’t hug each other, but we get to see each other!

{Marilyn} And when somebody hits a goal, or something like that, everybody gives them a round of applause, that makes you feel so much better.

NARRATOR: And so the DPP is now part of how, for 12 years now, Marilyn has kept her prediabetes from becoming type 2. In total, over the past year, including her time with a trainer and then starting DPP…

{Marilyn} So far, I’ve lost about 25 pounds. I’ve met my first goal, which was lose 7% of my weight; now I’m on my second 7.

So, as long as you stay on top of it and keep a positive mind, you can do anything.

* * *

{Connie Duvall} The young lady—that’s, I call her young, ‘cause she’s younger than me, that’s 51—she was a secretary at the Kentucky Farm Bureau office. And I went in one day, and she saw me, and she said, ‘Connie, what have you done? You’ve lost so much weight!’ And I said, ‘Well, I’m doing a diabetes prevention program, through the health department!’

NARRATOR: Connie Godsey Duvall lives in Cumberland County, Ky., in the Appalachian foothills along the Tennessee line. She’s also a DPP participant—she started the program last summer, and says she lost about 25 pounds, and that’s weight she’s been able to keep off. Type 2 runs in her family, and she says preventing it also has a special urgency right now.

{Connie} I even went back to the radio station—they have a Talk Around Town program, and I actually shared this DPP, the basics of it. And I said, ‘You can do this at home. Start counting your calories and your fat grams. Start moving.’ The Governor was saying, ‘Stay Healthy at Home,’ but my thing was, ‘Get healthy!’

Especially in the middle of this pandemic, if you were to actually contract it, when it affects your lungs, and you’re already struggling with extra weight— just like me carrying that extra 25 pounds, that was harder, to me, to breathe! So definitely, I think getting healthy right now is even more important. Make those choices.

* * *

NARRATOR: And for the moment, with so many people in eastern Kentucky having the sort of underlying health issues, like diabetes, that could make COVID-19 even worse, Mary Beth says she’s committed to keeping herself and her neighbors safe.

{Mary Beth} I do advocate the wearing of the mask; I know that’s a very controversial issue. But I have elderly parents. And so 30, 40 minutes, when I’m in the store, of wearing the mask, is not that difficult of a task for me to do if it’s going to keep someone else healthy. I could be asymptomatic— I don’t know that!

And I think that’s important because there are people that already have underlying health conditions; this is going to keep them safe, I hope. It’s not just about me, it’s about everybody else out there around me.

NARRATOR: Mary Beth is taking sign-ups for a new DPP class, and if you’re interested, you can get in touch with the Johnson Co. Health Department. The DPP is also offered in small groups at: the Kentucky River District Health Dept., Juniper Health, the Clay County & Lawrence County Health Departments, and all across the region online. For a short quiz to see if you might be at risk for prediabetes, check out For WMMT, I’m Parker Hobson.