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were still in place, so classes were held online. She liked the convenience of the virtual setting. It also helped that she had a great program facilitator, Jodie Block, a diabetes health educator and a registered dietitian. Butsumyo credits Block for her expertise with nutrition, the real-life examples she infused into her curriculum and her insistence that the process was a lifelong experience, not a quick fix. This, Butsumyo says, helped her stay with the program and make lifestyle changes necessary for long-term health. “I was worried going into the program that it was going to be hard for me because I’m a social eater,” she says. “Thanks to Jodie, I learned not to beat myself up about that. If I’m at a social gathering, I don’t have to eat something just because it’s offered to me. Or I can take something to be polite, but I don’t have to eat it. I can go out to restaurants and just look for healthier choices—not avoid the restaurant altogether. And even though I’m not a cook, Jodie and my other classmates all had suggestions for ways to eat healthy. The accountability to other people really helped.” Scripps’ Diabetes Prevention Program focuses on “baby steps,” small changes that patients are comfortable sustaining for the rest of their lives. Facilitators like Block work with each patient to establish an action plan that includes realistic ways to overcome any obstacle that may hinder progress. “Most people who join the program have been good at losing weight, but keeping that weight off is the problem,” Block says. “We know that when people lose weight and gain it back, they often gain even more than they lost, and they aren’t regaining the muscle that they also lost. That’s why I emphasize that this is not a diet, it’s a lifestyle.” Under Block’s instruction, no food is entirely off limits, but she counsels patients to avoid foods that are high in fat, sugar
make. Empowering them early on with all the resources we have available at Scripps can make a big difference. It’s not inevitable that the train is going to keep going down the track to diabetes.” Butsumyo, for one, was motivated to take the news of her prediabetes and run with it—directly to the Scripps Diabetes Prevention Program, a year-long program that is part of the National Diabetes Prevention Program. Using a curriculum developed by the CDC, the program has been shown to cut participants’ risk of developing diabetes by more than half. “I was surprised when Dr. Cheon told me I had prediabetes, even though I knew my weight had been creeping up,” Butsumyo says. “It was the wakeup call I needed. I tried to lose weight on my own, but three months later, my levels were still the same. That’s when I really started paying attention.” Usually, Scripps Diabetes Prevention Program groups meet with certified lifestyle coaches and registered dietitians weekly for the first four to six months, then twice a month for the remainder of the year to maintain
he normal range for fasting blood sugar is less than 100 mg/dl;
prediabetes is from 100 to 125 mg/dl; and diabetes is above 125 mg/dl, though several factors can influence these numbers, including genetics, weight and age, explains Athena Philis- Tsimikas, MD, medical director, Scripps Whittier Diabetes Institute, and an endocrinologist, Scripps Clinic. “Diabetes is a continuum, and prediabetes is one of the points on the diabetes spectrum,” she says. “People need to pay attention to the numbers creeping up. That’s an indicator that they’re heading in the direction of diabetes.” According to the Centers for Disease Control and Prevention (CDC), an estimated 96 million American adults—more than 1 in 3—have prediabetes. The vast majority are unaware they’re living with the condition. There are no telltale symptoms of prediabetes, so routine lab work is required to assess blood sugar levels. Fortunately for Butsumyo, her longtime primary care doctor, Isabel Cheon, MD, an internal medicine physician with Scripps Clinic, knows to screen for the condition. She uses a prediabetes diagnosis as a teaching moment to help her patients get on a path to good health.
Athena Philis-Tsimikas, MD, Medical Director, Scripps Whittier Diabetes Institute, Endocrinologist, Scripps Clinic
SCRIPPS HEALTH IS A NATIONALLY RECOGNIZED LEADER IN DIABETES CARE. Scripps’ specialists diagnose, treat and help patients learn to manage diabetes and prediabetes. Scripps also offers a comprehensive range of diabetes services, plus programs, such as the one Butsumyo participated in, to help people at risk of diabetes prevent the chronic condition from developing in the first place.
healthy lifestyle changes. Patients learn to eat healthy via nutritional counseling, increase their physical activity (like many people, Butsumyo’s activity level waned in the early days of the COVID-19 pandemic), manage stress and make healthy choices when eating out. Butsumyo began the Diabetes Prevention Program while pandemic-era precautions
“In general, when we do routine labs and people receive the prediabetes result, they’re surprised and upset, but I like to frame it as an opportunity to be proactive, to address the situation and improve their lifestyle so things don’t progress to diabetes,” Dr. Cheon says. “Often people are really motivated to make the changes they need to
16 SAN DIEGO HEALTH | FALL 2023
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