The Ascension Borgess Foundation
The foundation wanted to honor two major donors with a profile highlighting their contributions to Ascension Borgess Diabetes and Endocrine Center's Uninsured/Underinsured Clinic. The donors, however, are humble and want the focus on the clinic, not themselves.
To overcome the donors' objections to being the main focus of an article, I wrote an article about the Diabetes and Endocrine Center and the Uninsured/Underinsured Clinic with a sidebar about the donor's contributions. There was another sidebar with more detailed information about diabetes. The solution thrilled the donors and the foundation.
Education at the heart of Diabetes and Endocrine Center's mission
Donors' support of Uninsured/Underinsured Clinic ensures patients receive needed care
In 2010, Della Ingram-Stephens' top priority was working and taking care of her family. Seeing to her health was often an afterthought. That changed when she ended up in the Ascension Borgess Emergency Department (ED) at age 50.
"I was very dizzy and weak, and I couldn't see well," Ingram-Stephens says about her decision to ask her son to drive her to the ED. Hospital staff found that Ingram-Stephens had dangerously high blood sugar (glucose) levels and quickly went to work to get her out of danger, stabilize her and admit her to Ascension Borgess Hospital.
Ingram-Stephens' visit to the Ascension Borgess ED was just the beginning of her health journey. She was in the hospital for a week and a half, during which doctors and nurses were successful in lowering and stabilizing her blood sugar level. They also diagnosed her with type 2 diabetes, a chronic disease in which the body does not use insulin properly, leading to high blood sugar levels. Having high blood sugar levels for an extended period can lead to health problems such as cardiovascular disease, nerve damage, kidney damage or failure, and blindness.
Diabetes is a long-term disease, but patients can manage it through diet, exercise and medication. During her hospital stay, Ingram-Stephens learned about the Ascension Borgess Diabetes and Endocrine Center, where she could develop relationships with diabetes experts and learn how to control the disease. Ingram-Stephens began attending group education classes at the clinic and seeing the clinic's physicians, including Dr. Michael Valitutto, who leads the clinic.
Millions of Americans need diabetic care
While Ingram-Stephens' introduction to diabetes may seem dramatic, the diagnosis is not unusual. According to the Centers for Disease Control and Prevention, 10.5 percent of the US population lives with diabetes, while 34.5 percent of the adult population is prediabetic. Prediabetes is when a patient's blood sugar levels are higher than normal but not high enough to be diagnosed as having type 2 diabetes. Additionally, an estimated 7.3 million people are undiagnosed diabetics. These statistics should give everyone pause and incite a sense of urgency to create awareness about diabetes, says Dr. Valitutto.
"The facts are clear and heart-wrenching: Diabetes patients lose an average of seven years of life, and their chance of developing heart failure is two and a half times higher than average," Dr. Valitutto says. "And three-quarters of those with diabetes don't adequately control it."
Dr. Valitutto and others at the diabetes center are working to spread awareness of diabetes and increase understanding of why it is crucial to control the disease.
"If you look at the costly life-disrupting consequences of poor diabetes care, it's devastating," Dr. Valitutto says. When patients control their blood glucose, blood pressure, blood cholesterol and stop smoking, they significantly reduce their odds of developing severe complications from diabetes. "At least three out of every four diabetics don't adequately control" these four factors, Dr. Valitutto adds.
Educating patients about how to control their blood glucose, blood pressure and cholesterol through diet, exercise, medication and insulin, if needed, is at the heart of the center's work. "We have a world-class education program," Dr. Valitutto says. "We're a Michigan-certified and an American Diabetes Association-certified Diabetes Center of Excellence."
Dr. Valitutto explains that patients receive 10 hours of face-to-face education in their first year with the center. Each year after, if there's a change to their health, they can receive two additional hours of updated education if requested by a clinician. The education ranges "from understanding how to monitor your glucose, how to make better food choices, and how to administer these game-changing, life-saving medications," Dr. Valitutto says. In addition, patients work with a diabetes coach who "walks that journey with them because this is a marathon, not a sprint."
Providing care for uninsured/underinsured patients
An essential part of the Borgess Diabetes and Endocrine Center is the Diabetes Uninsured/Underinsured Clinic. The clinic provides eligible patients with free doctor visits, lab work, diabetes education, and glucose meters with ongoing testing supplies.
“Patients who receive care through the uninsured clinic receive identical care as those who have premium health insurance,” Dr. Valitutto says. In addition, a diabetes education coordinator helps patients complete assistance applications to pharmaceutical companies so they can benefit from free diabetes medications.
Funding for the uninsured clinic comes from generous donations from Cole Community Solutions, Schupan & Sons, and the Ascension Borgess Foundation. "We could not provide care to uninsured and underinsured patients without these generous donors," Dr. Valitutto says. "One hundred percent of the dollars from these donors has gone directly to patient care."
Patient Della Ingram-Stephens received care through the uninsured/underinsured clinic. She credits the education and care she received through the clinic with her now having her diabetes under control.
Ingram-Stephens learned about proper nutrition for diabetics at the clinic. She became a pescatarian which means she eats fish and eggs but not meat. The pescatarian diet also stresses other vegetarian foods such as vegetables, fruits, dairy, beans, tofu and grains. "I don't want to feel bad every day, so I will eat like this until the day I die," she says. "I didn't realize that what I was eating was all wrong."
Changing her diet and adding an exercise regimen that includes walking twice a day – two hours in the morning and two hours in the evening – has led to weight loss, stabilizing her blood sugar, and lowering the amount of insulin she needs. "I feel really good," she says.
Ingram-Stephens is grateful to the donors who make the uninsured clinic possible. She says financial donations to the clinic have played a large part in her success by making educational classes and medication available. "A lot of people can't afford the medication they need. That's why a lot of people die," she says. "Donations keep people alive."
The clinic is such an indispensable part of her life that Ingram-Stephens has included it in her will. "Whatever is left after I'm gone goes to the clinic."
Do you know your ABCDESS?
To minimize cardiac risk, Dr. Valitutto suggests diabetes patients keep track of their ABCDESS, which stands for:
A – A1C blood sugar regulated – aim for 7% or less.
B – Blood pressure control – the target is less than 130/80 mmHg.
C – Cholesterol – LDL cholesterol should be less than 2.0 mmol/L.
D – Diet – it is best to meet with a dietitian to learn which foods to eat.
E – Exercise – 150 minutes of moderate exercise each week.
S – Smoking cessation – smoking makes it more difficult to control blood sugar.
S – Salicylates or aspirin – can help control glucose levels in type 2 diabetics.
Warning signs of diabetes
If you experience any of the following symptoms, see your doctor and have your blood sugar tested:
Urinate (pee) a lot, often at night.
Are very thirsty.
Lose weight without trying.
Are very hungry.
Have blurry vision.
Have numb or tingling hands or feet.
Feel very tired.
Have very dry skin.
Have sores that heal slowly.
Have more infections than usual.
Type 1 diabetes
Type 1 diabetes, which generally begins in childhood through young adulthood, can develop quickly and be serious. With type 1 diabetes, the body does not produce insulin, which it needs to get the glucose it uses for energy from the bloodstream into the body's cells. In addition to the symptoms listed above, look out for nausea, vomiting or stomach pains.
Type 2 diabetes
Type 2 diabetes usually begins in adulthood (though younger people can develop it) and progresses over time. Unlike type 1 diabetics, type 2 diabetics' bodies produce insulin, but their bodies do not use it properly. Symptoms can be difficult to identify, so many people do not even know they have diabetes. In addition to the symptoms listed above, it's a good idea to become familiar with the risk factors of type 2 diabetes (listed below).
Gestational diabetes symptoms
Gestational diabetes is diabetes that occurs during pregnancy. Women who have gestational diabetes often do not experience the common diabetes symptoms, though increased thirst and more frequent urination are possible. Most often, testing that is a routine part of prenatal care discovers a woman's gestational diabetes. It is essential for women to know the risk factors for gestational diabetes (listed below) before becoming pregnant, so they can better monitor their health during pregnancy.
Type 2 diabetes risk factors
You are at higher risk of developing type 2 diabetes if you:
Are 45 years old or older.
Have a parent or sibling who has type 2 diabetes.
Lead a sedentary lifestyle and exercise less than three times a week.
Have had gestational diabetes or given birth to a baby that weighed more than 9 pounds.
Are African American, Hispanic/Latino, Native American or an Alaskan native.
Gestational diabetes risk factors
You are at higher risk of developing gestational diabetes if you:
Lead a sedentary lifestyle.
Have had gestational diabetes before or are prediabetic.
Have polycystic ovary syndrome.
Have an immediate family member who has diabetes.
Previously delivered a baby weighing more than 9 pounds.
Are African American, Hispanic/Latino, Native American or Asian American.
Source: Centers for Disease Control and Prevention
Personal experience motivates Cole family to raise funds for diabetes
For the Cole family, diabetes is a private, personal matter. However, the quest to aid others in their battle against the disease is public.
For more than 20 years, the Cole family and the Cole Automotive Group have raised funds to fight diabetes through Cole Community Solutions and their annual fundraiser, Touchdown for Diabetes. Each year, the family transforms the Cole Buick GMC Cadillac dealership campus into an enormous tailgate party. Tom Cole, Cole Automotive Group’s founder, started the event after his son, Tim, was diagnosed with Type 1 diabetes. Having lived with the challenge of managing the disease, the family wanted to help others take charge of their health and diabetes.
“He (Tom Cole) had a passion for diabetes because I am a diabetic,” Tim Cole says, “and it allows us to give back to the community, which has always been a driving force for Cole Automotive.”
After Tom Cole’s passing in 2015, Tim Cole and his wife, Tina, took over the event.
Initially, Touchdown for Diabetes raised money for juvenile diabetes, Tim Cole says, but transitioned to funding the Ascension Borgess Diabetes and Endocrine Center’s Uninsured/Underinsured Clinic. The family understands the many challenges diabetes patients face and saw first-hand the difficulty some patients have paying for treatment, Cole says.
“Being diabetic, I understand how difficult it can be to manage diabetes,” Cole says. “There are many negative effects, and if we can be a small part of a cause that helps people afford care, we want to do that.”
Cole emphasizes his admiration for the clinic’s educational component, noting that education is the key to managing diabetes.
Each year, Touchdown for Diabetes raises at least $70,000 for the Ascension Borgess Diabetes Uninsured/Underinsured Clinic and 2020’s virtual version raised $74,500. The 2021 event will again be virtual to protect participants who face a higher risk of severe outcomes from COVID-19. But, whether Touchdown for Diabetes is in-person or virtual, the event is overwhelmingly positive for the clinic, says Dr. Michael Valitutto.
Valitutto, who leads the clinic, says funds from donors make it possible to provide care, including doctor visits, educational sessions, and lab work, for about 250 uninsured and underinsured patients each year. “We could not provide this care to the patients without generous donors such as the Cole family,” he says.
Schupan & Sons’ Rich Holtz Golf Outing honors late employee
Rich Holtz’s favorite saying, “The man with the best army wins,” sums up Schupan & Sons' involvement in raising funds for multiple community organizations. Marc Schupan and the entire company have taken on the fight for diabetes with the Rich Holtz Golf Outing, named for the beloved late vice president of the company’s Beverage Recycling Division.
The 21-year-old outing is a labor of love for Schupan and his staff, who work numerous hours preparing for the event each year. It’s all to honor Holtz and lighten the load carried by many diabetes patients who are uninsured or underinsured and have difficulty paying for treatment. Every year, Schupan & Sons raises between $35,000 and $40,000 through the outing for the Ascension Borgess Diabetes Uninsured/Underinsured Clinic.
Schupan is humble about his involvement in the event and its success. “I am just happy it has evolved into such a successful outing,” he says. “I am hoping this one event helps impact peoples’ lives positively.”
Dr. Michael Valitutto, who leads the Ascension Borgess Diabetes and Endocrine Center and the center’s Diabetes Uninsured/Underinsured Clinic, says the funds raised by Schupan & Sons and other donors positively impact the lives of diabetes patients – about 250 each year.
“Patients who receive care through the uninsured clinic receive the identical care as those who have premium health insurance,” Dr. Valitutto says. “The services include seeing a doctor or another medical provider, sessions with an educator, and lab services. And we work through patient assistance to get the patients the meds that they need and deserve.”
Because Holtz received care at the clinic, it was natural to select it to receive the funds raised at the outing. While Schupan and those who worked with Holtz say they will never forget him, the event serves to ensure others remember him.
“I have never met anyone who, within 15 minutes of communication, could gain the respect and friendship as Rich was able to with new people,” Schupan said in his eulogy during Holtz’s funeral in 1996. “There is a quote that fits; I believe this truly describes the gift he had: ‘Remember that everyone you meet wears an invisible sign. It reads: Notice me. Make me feel important!’”
Through the Rich Holtz Golf Outing, “I feel positive knowing we are helping others in our community fight this dreadful disease,” Schupan says.