Jay Shubrook, associate professor of family medicine, treats patient John Carsey at the Diabetes Clinic.

Photographer: Victor Blue


Shubrook treats patient Clarence Sams at the Diabetes Clinic.

Photographer: Victor Blue

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Appalachia Rising: Free services fight diabetes scourge

This special Compass series features the programs and initiatives through which Ohio University students, faculty, staff, alumni and friends are realizing their promise as they elevate lives across the region. These people-focused success stories take you behind the scenes and highlight the many meaningful ways OHIO serves society by supporting educational, economic, creative and wellness endeavors, as well as other humanitarian efforts.

A version of this article originally appeared in the spring 2010 issue of “Ohio University Medicine,” the official magazine of the Ohio University College of Osteopathic Medicine (OU-COM).

Six years ago, Robert worked as a plant supervisor in Meigs County. Although he and his wife, Amy, are both diabetic, his company insurance eased their health concerns.

“It was good coverage, paid almost all (medical) costs. We didn’t really worry about it,” he said.

When the plant laid him off, Robert and Amy, whose names have been changed here to protect privacy, had to use retirement funds to pay for COBRA insurance. Then COBRA ran out. With their diabetes, individual insurance would have cost them nearly $3,000 a month.

“It felt like the world turned upside-down,” Amy said.

Then in August 2005, Robert and Amy read about a mobile health van run by Ohio University College of Medicine’s Community Health Programs, which offer free health care to uninsured Appalachian citizens. There, nurses connected the couple with the college’s monthly Diabetes Clinic.

Now, every three months, they return to the Diabetes Clinic, located in Parks Hall in Athens, Ohio, for free check-ups.

“I thank God for that place,” Amy said. “When we hardly have money to pay the bills, they take us for free; they supply the medicine—the insulin. It’s helped us so much.”

The Diabetes Clinic began in November 2006 when local demand for diabetes care led OU-COM to specialize their free community health care. It is open the first Tuesday of every month.

“We saw a need for diabetes specialists during our regular free clinic hours,” said Kathy Trace, director of OU-COM Community Health Programs.

According to the American Diabetes Association* (ADA), diabetes is a group of diseases characterized by the body’s inability to produce or use insulin, a hormone necessary to process the energy-giving glucose.

Type 1 diabetes, formerly called juvenile diabetes, is commonly diagnosed in children and young adults. Type 2 diabetes, the most common form of the disease, is often-called adult-onset diabetes because it tends to affect adult and elderly populations.

Diabetes is an epidemic in southeast Ohio. Researchers from OU-COM and OHIO’s Appalachian Rural Health Institute (ARHI) estimate that 11.3 percent of the population of southeast Ohio suffers from this chronic disorder, compared to 7.5 percent nationwide.

According to the ADA, 23.6 million children and adults are afflicted with diabetes nationwide. While 17.9 million people have been formally diagnosed, ADA estimates that 5.7 million diabetics do not even know they’re living with the disease.

The ADA estimates 57 million people are pre-diabetic, a condition that often precedes the onset of type 2 diabetes.

Physicians from OU-COM and the ARHI Diabetes/Endocrine Center have provided medical care to more than 4,000 people in the Appalachian Ohio region through more than 55,000 patient encounters. Outreach programs currently operate in the underserved Ohio towns of Nelsonville, Coolville, McArthur, Waverly and Belpre.

The referral-based Diabetes Free Clinic offers its patients specialized, discreet care in a region that sorely needs it.

“When I first heard ‘free clinic,’ I figured that they’d herd you in like cattle, but it’s not like that,” Robert said. “These guys go out of their way.”

The OU-COM Diabetes Free Clinic is funded by grants from organizations such as the Sisters of Saint Joseph and the Ohio Association of Free Clinics. It began in November 2006 and currently has more than 85 active charts.

“(The diabetes clinic) offers the total package,” said Trace. “Patients get a doctor’s visit, health education, follow-ups and free care.”

The clinic is staffed by volunteers from OU-COM and University Medical Associates, including endocrinologists like Frank Schwartz, professor of endocrinology and J.O. Watson Endowed Diabetes Research Chair. Schwartz is an expert on the disease, and with the clinic’s team of doctors, offers a level of specialized care rarely seen in the region.

It is also a level of specialized care that many could rarely afford without health insurance.

According to Schwartz, who also directs the University Medical Associates Diabetes Center, financial burden, such as loss of employment, can increase the risk for both obesity and diabetes.

“When people ask me what can be done to halt the progress of diabetes in Appalachia, I always tell them jobs,” said Schwartz. “When people are stressed, their bodies hold onto fat. And studies show that when people aren’t confident in where they will get their next meal, they tend to eat more.”

But Trace emphasized that there is no stereotypical patient at the Diabetes Clinic.

“The only thing that these people have in common is diabetes,” she said. “When people lose jobs, health insurance is often the first thing to go. And no matter your financial status, once you have been diagnosed with diabetes, it can become nearly impossible to get health insurance.”

For this reason, the Diabetes Free Clinic also provides referrals to doctors who offer volunteer medical services.

When Amy had stomach pain, the Diabetes Free Clinic sent her for a free colonoscopy at Doctor’s Hospital, part of the hospital’s monthly outreach efforts. The procedure may well have saved her life.

“(When) I woke up, they told me they removed a pre-cancerous polyp from my colon,” she says. “I just thank God for (the Diabetes Free Clinic). I don’t know what we would do without it.”


Diabetes research

The College of Osteopathic Medicine (OU-COM) is not only fighting diabetes in clinics, it is also fighting it in labs. The college is currently researching several new ways to improve the lives of patients with diabetes:

  • Developing an artificial intelligence insulin pump: Researchers from across OHIO have developed an artificial intelligence software program using case-based reasoning for insulin pumps for type 1 diabetes patients

  • INSPIRE Diabetes clinical trial: The clinical trial will look at the benefits of short-term intensive insulin therapy on long-term glucose control and pancreatic function

  • Use of C10 to suppress the autoimmune destruction of pancreatic beta-cells: Investigators are studying the potential benefit of C10 (an OU-COM compound developed by Dr. Kohn) to prevent insulin dependency in type 1 diabetes mellitus

  • The Clinical Diabetes/Endocrine Database & Biorepository: Created in 2005, this repository helps with the study on endocrine diseases

That is only some of the diabetes research happening at OHIO right now.

Related Links

Appalachian Rural Health Institute Diabetes/Endocrinology Institute College of Osteopathic Medicine

Additional Info

*Following this link takes you away from the Ohio University website.