Colorado diabetes fight about access
Living healthy easier for those with resources
DENVER – Doug Nutter credits the abundant trails near his suburban Denver home for keeping him fit after a diabetes scare.
In Towaoc, Bernadette Cuthair is desperate to bring healthier food to her Ute Mountain Ute tribe, where 1 in 4 has diabetes in a town without a grocery store.
In Greeley, Sable Madrid works to manage the condition that claimed her mom and could threaten her 7-year-old daughter.
Colorado has the nation’s lowest diabetes rate, 8.1% as of 2022. The state government promotes an outdoor lifestyle, invests in parks and trails and boasts about 300 days of sunshine every year. It spent tobacco settlement funds on preventing diabetes and other chronic diseases and in 2019 became the first state to cap the price of insulin.
But there are two Colorados. In one, trails are filled with fitness aficionados and white-collar employers offer financial incentives to stay healthy.
In the other, residents don’t have the time, means or resources to access open space, farmers markets or health clinics. This second Colorado, said Jane Reusch, a University of Colorado professor, “doesn’t really look dissimilar to what’s found in Mississippi, Louisiana and Arkansas.”
The great outdoors
As Nutter, 72, strode along Clear Creek Trailhead, he reached yet another milestone.
“Over 2,400 miles,” said Nutter, checking his smartphone. “Almost enough to get to New York City.”
The Arvada retiree counts every step since getting a warning from his doctor in 2021. Nutter weighed 234 pounds and had a 40-inch waist. His blood sugar levels had reached prediabetes range.
Nutter walked away – from poor dietary habits and decades behind a computer. He enrolled in a YMCA diabetes prevention program. For one year, he charted every meal and counted every gram of fat. Instructors urged him to get 2.5 hours of exercise a week. He decided he’d get that much every day.
He’s shed 45 pounds and 4 inches from his waist. He’s been able to discontinue medication for borderline high blood pressure. His blood sugar levels are within normal range.
His wife, a former aerobics instructor also with prediabetes, has joined him on his quest.
The cornerstone of Nutter’s regimen is his daily walks, and he credits the hiking trails, parks and open space for keeping him motivated.
He expects to reach his next walking goal by mid-November: the equivalent of Los Angeles to Boston.
A food desert
For decades, the tiny Ute Mountain Ute tribe in Towaoc has grappled with diabetes. Roughly one quarter of the nearly 1,100 members on the reservation in Towaoc and over the line in Utah have Type 1 or Type 2 diabetes, said Rita King, the tribe’s diabetes prevention coordinator. That’s more than twice the national average.
It got worse during COVID, “because everyone was home and we weren’t allowed to go to the grocery store,” King said.
Even now, some tribal members are reluctant to get outdoors and kids are content to stay home after school. Rising prices make fresh fruits and vegetables too much to afford, let alone access: The closest grocer is more than 20 minutes away.
The tribe wants to open a grocery store to diversify fresh food options.
“The vision is big,” said Bernadette Cuthair, the tribe’s planning and development director. “However, it’s dictated by dollars.”
The tribe has received a Department of Commerce grant. Plans call to begin with a farmers market.
Cuthair knows the importance of healthy eating. The 61-year-old learned she had Type 2 diabetes at 28. Her father managed his diabetes with insulin, but her mother and sister both were on dialysis.
She’s optimistic her own dietary changes and weight loss – she’s dropped 139 pounds over the past two years – can extend her life and set an example.
“We all want to live,” Cuthair said.
Bridging the divide
State officials are seeking to bridge the divide between the two Colorados. The YMCA program that guided Nutter is one of three diabetes prevention programs in the state. They are covered by Medicare for many seniors, and the YMCA offers scholarships.
But just over 690,000 Americans were enrolled in such programs as of July, according to the Centers for Disease Control and Prevention. An estimated 96.3 million Americans have prediabetes.
Stopping the cycle
Sable Madrid of Greeley learned she had Type 2 diabetes at 13, just a couple of weeks after her mother, Nadine, was diagnosed with it.
“When you’re 13 and you find out your whole life is going to change, that it’s something that will kill you, it’s daunting,” she said.
For school science fair projects, Madrid examined how diabetes ravages the body. Her readings advised a healthy diet, self-care and reducing stress. But her relatives would tell her a “good Latin never turns down work,” she said.
Madrid’s mother spent long hours on her feet as a hairdresser until COVID-19. Then her diabetic complications worsened. Nadine died in 2021 at the age of 61.
Madrid is determined to make different choices so she’ll be there for her daughter, Bella. She exercises, eats healthy foods, advocates for herself at the doctor’s office and goes to counseling.
“I need to focus on what can I do to make my child’s life better,” Madrid said, “and what can I do to make my life better.”