Muskegon Community Health Project managing diabetes, one patient at a time

M0424DIABETES1"It's just like brushing your teeth," said Todd Paschal. "You know you have to do it." Paschal, 45, of Norton Shores, has been a diabetic since he was 13 years old. Four times a day he checks his blood sugar levels and takes insulin injections. "I want to be around for my kids and my grandkids," said Paschal, who is a father of five.
Diabetes is a bigger problem in Muskegon County than in much of Michigan, but local health advocates emphasize it's a problem patients can manage.

About 10.5 percent of Muskegon County adults have been diagnosed with diabetes at some point, compared to 9.4 percent of Michigan adults. However, the actual numbers of people with the disease are likely higher because of undiagnosed diabetics.

Muskegon Community Health Project diabetes coordinator MiMi Rankin said part of her work is promoting getting tested for diabetes, but mostly she helps low-income people to pay for their treatment and sets them up with a primary care doctor. The goal is to keep patients out of the hospital, she said, and to avoid complications.


“When they finally find out that they are diabetic it's usually through the emergency room,” she said. “Nine times out of 10 they don't have a doctor and they don't have a way to get their meds.”

Ron Cloud, of Spring Lake, said he only found out he had diabetes in March, after he had surgery on his leg for blood clots. He said he has had to make changes in his diet and get used to taking insulin.

“I've had to cut out a lot of sweets,” he said. “I don't like needles and here I am giving myself four shots a day.”

Rankin came to talk to him while he was in the hospital and helped to get his insulin, cholesterol medication and medicine for nerve damage in his foot paid for, he said. He is unemployed and is applying for Social Security disability payments because of his damaged foot.

“I can't stand on my foot for more than 20 minutes because it swells up and hurts really bad,” he said. “If it wasn't for the health project I wouldn't be on any medication. I couldn't afford it. I can't say enough good things about them.”

Most of the patients do well managing their diabetes once they are able to pay for their medications and testing equipment, Rankin said.

“Some of them are hard-headed but 90 percent of them will do what you ask them to if they can get their medication,” she said.

Another client, Todd Paskel, of Norton Shores, turned to MCHP after the gas station where he worked closed and he could no longer pay for his insulin.

Paskel said he was diagnosed at 13. He managed the disease throughout his teen years, but started having trouble after he left home and found a job. He went 16 years without seeing a doctor because he couldn't find the time while working a full-time job. He bought his own insulin, but didn't think he needed to test his blood sugar.

“My blood sugar had been so high for so many years it was normal to me,” he said.

He realized he needed help this past summer, when he no longer had the energy for his daily activities. He went to MCHP on his brother's advice and found out that not only was his diabetes out of control, he also had high blood pressure and high cholesterol.

“I couldn't get out of bed. I was really dizzy,” he said. “I don't know if I'd be here without them.”

M0424DIABETES6Paschal, 45, of Norton Shores, has been a diabetic since he was 13 years old. Four times a day he checks his blood sugar levels on a glucose monitor, pictured, and takes insulin injections.

Now he's eating healthier and regaining some of the weight he lost when his blood sugar was out of control. He also tests his blood four times per day with supplies paid for by MCHP and its partners.

Rankin manages 187 patients' cases. She calls to check on them and sometimes has to prod patients to take care of themselves, even visiting them at their homes or jobs. Hospitals and clinics also sometimes call her to track down patients who aren't keeping their appointments, she said.

In some cases, patients also need help with other issues, like housing and food assistance, she said.

“There are things in your life you have to have a passion for and this is my passion,” Rankin said. “My biggest role is to make sure that they have all the tools to control their diabetes.”

Rankin's diabetes work started in 2000 when MCHP received a grant in partnership with Grand Valley State University for a diabetes education program focusing on African-Americans. The program now works with people of all races.

African-Americans are almost twice as likely as non-Hispanic whites to have diabetes, and more likely to suffer complications from uncontrolled blood sugar, like blindness, limb amputation, kidney disease and heart attacks, according to the American Diabetes Association. Latinos, Native Americans, Asian-Americans and Pacific Islanders also have an increased risk of developing diabetes.

Family physician Dr. James Twesten-O'Toole, who works with Norton Family Practice, said genetics likely play a part in determining who gets diabetes, but people who have family members with the disease shouldn't resign themselves to fate.

“Nobody, to my knowledge, has been able to establish a gene” that causes diabetes, he said. “It's very clear that if you make the appropriate interventions early you can effectively treat the disease.”

Rankin said she also is involved with planning the annual African-American Diabetes Conference, held in the fall in Muskegon Heights. The conference's topics of hypertension, heart disease and other health topics are useful to people of any race, but the conference also tries to target cultural issues like high-fat cooking, she said.

She also is helping to coordinate the Diabetes Walk at Heritage Landing, to be held June 4. Last year the walk raised about $15,000 to help support Muskegon-area diabetes patients.

“Every dime of it goes to supplies, medication, eye exams,” she said. “With people losing their jobs we've just been bombarded with people needing help.”


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