Combatting Diabetes by Casting the Net Wide

Every time Angelo Restrepo would overeat, he’d feel a sharp pain in his head. Driving to work last July, his headache was so intense that he struggled to focus on the road. Pulling over, the 45-year-old Midvale resident spotted the Wellness Bus—the 40-foot RV that he passes on his way to work. This time, he drove closer and noticed a sign for free blood pressure, blood glucose, and cholesterol screenings. “I decided to get on the bus, hoping to find out why I was feeling so lousy,” Angelo says.

It turns out that Angelo had serendipitously stumbled upon a mobile health clinic with a focused goal: to empower patients struggling with or predisposed to diabetes. Carmen Ramos, MS, RDN, a registered dietitian and health coach at University of Utah Health, greeted Angelo at the door. After testing his blood glucose level, she delivered some life-changing news: it was high enough to trigger a headache and within a range that indicated he was likely living with type 2 diabetes.

She then helped Angelo develop a plan for regular blood glucose testing, nutrition monitoring, and exercise. Urging him to visit his physician for advice on medications that might lower his blood glucose, she also invited him to come back to the Wellness Bus once a month.

The Wellness Bus is part of Driving Out Diabetes, a Larry H. Miller Family Wellness Initiative. Launched in 2017, the $5.3 million project represents collaborative work between the Larry H. & Gail Miller Family Foundation and U of U Health. Making the rounds of neighborhoods in South Salt Lake, Midvale, Glendale, and Kearns, the bus provides private, confidential consultations and customized nutrition and exercise plans for patients who don’t have access to the care—and the information—they need. Race, class, and education level all play a role in who the disease affects. Pacific Islanders and American Indians/Alaska Natives are twice as likely to have diabetes as Whites. Those without a high school diploma are twice as likely to have diabetes as those with a college education.

Eliminating these disparities and tackling health inequity is part of Driving Out Diabetes’ goal. Health coaches, screeners, community health workers, registered dietitians, and student volunteers work with patients to treat diabetes—and to help them prevent it from developing in the first place. “Sadly, more than 84 percent of those with prediabetes don’t know they have it,” says Robin L. Marcus, PT, PhD, OCS, professor and former chief wellness officer at U of U Health. Prediabetes is defined as having a higher-than-normal blood glucose level. Without intervention, approximately 70 percent of those individuals will eventually develop diabetes.

While the Wellness Bus is focused on improving access and education, researchers across U of U Health have an even more ambitious goal: to turn diabetes into yesterday’s memory, not today’s crisis. More than 100 faculty members across 26 departments are investigating the causes of diabetes, new drugs to treat the disease, and the best ways to manage it. Scott Summers, PhD (right), co-director of the Diabetes and Metabolism Research Center, leads the brilliant minds working on these questions. But the reality is that they are difficult to answer.

No one understands that better than Summers. When he was 14 years old, his father, an avid runner and fit 41-year-old, was unexpectedly diagnosed with diabetes. Shortly after, young Scott made his father, Jerry, a bold promise: He would find a cure. However, 34 years later, Jerry, now almost 80 years old, told his son that “time was running out.” Scott admits he probably won’t cure diabetes in his father’s lifetime. “The body is much more complicated than we realize, and our understanding is still juvenile,” he says.

The complexity notwithstanding, exciting progress is being made. Researchers like June Round, PhD (right, holding research module); William Holland, PhD; and Michelle Litchman, PhD, FNP-BC, FAANP, are working on innovative studies linking gut bacteria, regenerated insulin-producing cells, and social determinants of health to diabetes care. Scientists like Marcus Pezzolesi, PhD, MPH (right), are also tapping into the Utah Population Database to track genetic drivers of diabetes. And clinicians are discovering new ways to deliver information so that patients and providers can collaborate more effectively on disease management.

That diversity of work underpins the holistic mission of the Driving Out Diabetes initiative, translating the knowledge discovered in research labs into transformative care delivered in clinics and education shared with the community.