An Unexpected Diagnosis

Taking care of other people is second nature for Deborah Quesenberry. As a community outreach worker for the Salvation Army, she helps others manage their health every day.  Like most caretakers, she also understands the importance of self-care. However, subtle changes in her system, like feeling tired or thirsty all the time and losing a little weight, went unnoticed. 

Deborah first heard about the annual Heart Fair last February. The event offers free screenings for blood sugar, blood pressure, body composition and cholesterol provided by qualified MoBap Community Education nurses. Deborah decided to enjoy the fun of the cooking demonstrations and access the free health screenings.

Know Your Numbers 

The first screening showed Deborah’s body mass index (BMI) was in the normal range, which was encouraging. During the next screening for her blood sugar levels, the nurses pricked different fingers to try to get an accurate blood glucose reading. “I was dehydrated but I felt fine,” Deborah said. The outcome was not something she was expecting.

It turned out that Deborah’s blood sugar was so high it was above the upper range of the machine, and they could not get a reading. The glucose reading was so high, staff was concerned Deborah was at risk for a serious complication such as diabetic ketoacidosis, which can lead to coma.

“It’s a scary thing. Everyone was so concerned and I thought ‘there’s no way this could happen.’ I don’t eat junk food. I’m not overweight and diabetes doesn’t run in my family,” Deborah said.  The nurses talking with Deborah were so concerned that they took her directly to the Emergency Room (ER) where she received fluids for dehydration and insulin to lower her blood sugar. She was subsequently diagnosed with Type 2 diabetes.

“Some members of the community come to our Heart Fair every year,” said Jane Kozlowski, RN, BSN, a lead nurse in the Community Education department at MoBap. “Many come for the screenings just to see how they are doing, to check if a diet, exercise, or medication change has made a difference, or as a preview before their upcoming doctor’s appointment. If we have a result that’s concerning, we will refer the person to the ER or to urgent care.”

In the community

In 2017, the MoBap Community Education team conducted eleven health screening events, including the annual Heart Fair, and reached about 900 people.

The team also provides a follow-up service for those identified at health screenings as being at high risk for heart disease. A Registered Nurse from the Community Education team reaches out to these individuals at four points over the course of the following year to help them navigate a road to lower risk.

Conversations focus on health management and lifestyle changes, as well as connecting individuals to resources like a physician. Nurses also invite them back to get rescreened at upcoming events like monthly Dierbergs screenings.

“We referred Deborah to a nutritionist and have followed-up to see if there were other resources she needed. Most importantly, we wanted to make sure she was feeling better and her health was improving,” Jane added.

Healthy Choices

Since being diagnosed with Type 2 diabetes, Deborah has learned how to administer her insulin, and the nutritionist she was connected with has helped her better understand the role of food choices in managing her symptoms. “I have three meals a day with 45 grams of carbs at each meal, and two snacks with 15 grams of carbs each.  I had no idea what that looked like,” Deborah said.  “[The nutritionist] showed me what serving sizes look like and where there are hidden carbs, like in fruit. I didn’t know that.”

They also talked about the importance of exercise in managing diabetes.  Deborah was active in sports, but before her diagnosis she didn’t have any energy and just walking had become a chore. “Now that I’m on insulin, I have more energy. I play pickle ball three times a week,” Deborah said.

With regular exercise, proper insulin management and a couple of tweaks in her diet, Deborah was able to lower her A1C level from 17 in February to just over 5 in just six months. A1C estimates a person’s average blood sugar levels over a 2 to 3-month span. Normal range is less than 5.7% with values over 6.5% indicating diabetes. Values over 7.5% indicate increased risk of complications.

“The nurses at MoBap check on me regularly,” Deborah said.  “MoBap has such a wonderful focus on diabetes. I’m so thankful for the Heart Fair.”