When Jean Wilson learned she had prediabetes, she recalled seeing information about a national diabetes prevention program called Change Your Lifestyle. Change Your Life. (CYL2) on her neighborhood block club’s website. She joined the evidence-based program in September 2016 to address this serious health condition, which affects 86 million Americans and increases their risk of developing type 2 diabetes and other chronic diseases.
Currently, people with type 2 diabetes account for about 90 to 95 percent of all diagnosed cases of diabetes. This blood sugar disorder occurs when the body can’t effectively use insulin, a hormone that controls glucose levels in the blood.
According to the Centers for Disease Control and Prevention (CDC), prediabetes occurs when your blood sugar level is higher than normal but not elevated enough to be classified as type 2 diabetes. Still, prediabetes can kick-start the long-term damage diabetes causes, especially to your heart, blood vessels and kidneys. But lifestyle changes can stop prediabetes from progressing to type 2 diabetes.
The Los Angeles–based CYL2 is a national program offered to men and women who meet the CDC’s eligibility standards for prediabetes and are at high risk for developing type 2 diabetes. CYL2 originated from a partnership with Black Women for Wellness (BWW), a Los Angeles–based nonprofit community organization, as a way for individuals to develop healthy habits while participating in a structured, yearlong intervention that could cut their risk of developing type 2 diabetes by as much as 58 percent, according to the CDC.
Before people join CYL2, their health care providers use blood sugar tests to determine their score on the CDC prediabetes risk test and confirm that they have prediabetes.
“Evidence-based factors that were used to structure the regimen are based on the results of research that showed that if people lost 5 to 7 percent of their body weight through healthier eating and by engaging in 150 minutes of physical activity a week they delayed or reversed the onset of type 2 diabetes,” explains Willie Duncan, the senior manager of programs, administration and operations at BWW.
The goal of CYL2 is to help participants make better food choices, increase their level of physical activity and maintain the goals they meet. The program introduces individuals to information and tools, such as guest speakers, field trips and group activities, to complement the curriculum. “For example, BWW’s Kitchen Divas program uses a plant-based approach to encourage our community to eat more vegetables, fruits and plant foods to lower the incidence of chronic diseases,” Duncan says.
During a typical program meeting, trained coaches might lead a discussion about lifestyle change and direct members to share information, resources, challenges and successes with the group. “Participants are weighed in privately at the beginning of the meeting, as weight loss is tracked throughout the programs,” Duncan explains. “Food trackers and physical activity minutes for the week are also reported to the lifestyle coach.”
According to Duncan, how regularly participants track their food is a key indicator of the program’s success because this shows that people are actively thinking about what they put into their bodies.
Most of the time, meetings are fun, energetic and reflective. Sometimes, lifestyle coaches lead the group through warm-up exercises at the beginning of a session or call for a few moments of meditation. Many people find these activities to be “deeply moving and life-changing,” Duncan says.
Certainly, Wilson believes the program altered her life. “The class discussions and printed materials make me realize I’m not alone in this health challenge,” she says. “I’m very aware of what I’m eating, and I have learned to make healthier choices. Now, I’m working on continuing to modify my behavior.”
CYL2 recruits participants through grassroots outreach. Program coordinators distribute flyers at community centers, schools, libraries and local businesses. In addition, workers send out email announcements and spread the word on social media, the BWW website, in resource guides and by word of mouth. “Former participants often tell their families, friends and coworkers about the program after experiencing CYL2 for themselves,” Duncan says.
Emmitt Sanders learned about the intervention through a lifestyle coach. “She told me I should do it because I had recently been diagnosed as prediabetic, and she felt the program would help me,” Sanders says. “At first, changing my eating habits was a challenge. For me, the hardest thing was giving up bread and also becoming more physically active. But I’m losing weight, so when I look in the mirror and see where I am and know where I want to be, I got over those challenges.”
Christine Johnson heard about CYL2 from her primary care physician who encouraged her to join so she could prevent or delay type 2 diabetes. After participating in the program for seven months, Johnson found that she enjoyed the lectures on different topics. In addition, she appreciated the easy, nonjudgmental attitude of the coach guiding her through the program.
“The big challenge I encountered came during the holidays, and, unfortunately, I failed to achieve my goals,” she says. “But I learned not to despair and to get back up and move forward. So far, the program has helped me reduce my body weight, better understand food labels, and, most importantly, CYL2 reduced the chances I’ll develop diabetes.”
Like Johnson, many participants enjoy interacting with other people who share common goals. In particular, they like sharing information and the support they get in the program’s community-style setting.
“The coaching and group environment are critical components, as they aid in behavioral change by showing folks how to work through obstacles while encouraging them through stumbles to eventually celebrate and share their successes with each other,” Duncan says.
Wilson says there’s nothing she dislikes about the program. But Sanders has one big complaint. “Sessions go by too fast,” he says. “I wish they were longer than one hour.”
At the end of their year in the program, participants’ success is measured against the amount of weight they lose, the number of minutes they add to how long they’re physically active each day and their attendance throughout the year.
One man named Andrew who attended CYL2 lost almost 7 percent of his initial body weight during the program. “My family has a history of diabetes, and I have seen personally what the illness does when it ravages the body,” he says. “I don’t want that to happen to me, and I will do whatever it takes not to get the disease.”
So far, 297 participants have gone through the program in California. Four other providers in Indiana, Iowa, Tennessee and Michigan also offer individuals a chance to change their lifestyles, lead healthier lives and close the door on type 2 diabetes.