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Before Kathy Dowling started the YMCA of York and York County’s diabetes prevention program, she was prediabetic and had an insatiable craving for all things bread.

A year after the program, Dowling has dropped 14 percent of her body weight, no longer has high cholesterol and can keep up with her dogs Bailey and Willow.

“It wasn’t ‘you have to do this, you have to do that,’” Dowling said. “It was the encouragement and setting your own goals.”

November is National Diabetes Month, and as obesity rates rise nationwide, so does the prevalence of sometimes- preventable type 2, or adult onset, diabetes. Drastic, lifestyle changes are something participants can look forward to said Cori Strathmeyer, director of healthy living for the YMCA of York and York County. The four area Y's are among just 30 nationwide branches that offer a variety of programs to treat and prevent chronic disease.

About 5,800 new Pennsylvanians  will get the news this month that they have a chronic illness that’s treatable but not curable. According to the American Diabetes Association, diabetes has both substantial health and financial implications. While serious complications of the disease include heart disease, stroke, amputation, kidney and vision problems or death, the $13.4 billion annual cost of treating diabetes also hits every Pennsylvanian's wallet.

“Eight to 10 years ago, we started to notice the need in the community, not just for wellness programs for people who wanted to exercise but opportunities for the unwell or people who weren’t even sure they needed to improve their lifestyle to prevent other types of diseases," Strathmeyer said.

So the Y, she said, shifted focus to programs that could directly affect health outcomes, things such as diabetes prevention, support for cancer patients and exercise for the over-65 population.

In the YMCA’s diabetes prevention program, participants receive support to change their lifestyles. Total lifestyle changes can be accomplished if  participants stay on track. Strathmeyer said research shows 58 percent of people who follow through are able to prevent the development of type 2 diabetes. While there is a cost for the program, the Y doesn’t turn away those who cannot afford the fee, and starting in 2018 that fee will be paid by Medicare.

Diabetes isn’t the only chronic illness that puts a strain on both finances and health. Other preventable illnesses cost the health care system billions.

“So many people think my mom has heart disease and my dad has heart disease, so I’m going to have heart disease," Strathmeyer said. "Certainly there’s genetics, but we want people to take control of their lifestyle so they can decrease the risk of developing disease.”

Strathmeyer also said more than half of York County residents are overweight or obese, aren’t eating nutritional food and don’t take the time to exercise. These health risks are outlined in Healthy York Coalition's regional community health needs assessment. The review of the area's health risk factor is done every three years in partnership with Healthy Adams County.

In a county ranked middle-of-the-pack of Pennsylvania’s 67 counties, York's ranking suffers because of a 32 percent obesity rate, too many low-birth-weight babies and teen births, too few mental-health providers and relatively high rates of sexually transmitted infections and violent crime, according to the needs assessment.

Jenny Englerth, Family First CEO, has a personal passion for addressing the challenges that contribute to chronic disease. The federally qualified health center she oversees receives federal support to offer primary medical and dental care and other supportive services to the uninsured. Building a relationship with a primary-care provider and getting preventative care is essential to addressing many of York’s issues

“Ideally preventative care is going to help identify those risk factors for chronic illness early on before that’s even able to materialize,” she said. “Focusing on children and adults through healthy eating, exercise, immunizations — all those things position people to prevent progression of that illness.”

The center came as a direct result of York’s race riots in the 1960s and the town hall meetings that followed, establishing health care in York City as one of the community’s top priorities. Within a few months, federal funding helped the facility open.

Even with the diagnoses of chronic illness, Englerth said people can live  longer, healthier lives when they have the tools and education to treat and further prevent  disease.

“We don’t see education as something that’s separate and apart from what we do," she said. "It’s how we as a family medicine practice function and do our job every day. Often that’s most effective, (and) being integrated into medical care, people listen.”

According to the American Diabetes Association, type 2 diabetes symptoms can be mild enough to go unnoticed. See a doctor to prevent complications from untreated diabetes if you experience the following:

  • Urinating often
  • Feeling very thirsty
  • Feeling very hungry - even though you are eating
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are slow to heal
  • Tingling, pain or numbness in the hands/feet
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