Every minute, at least one person is diagnosed with diabetes. Native Americans have a higher risk factor of developing diabetes, and 30 percent of those living on the White Earth Reservation have been diagnosed with the disease. That's not to say it can't be controlled though.
Over 10 years ago, the White Earth Reservation started a program for those suffering from diabetes, and also for those at risk of developing it.
Community Health Education and Diabetes Project Manager LaRaye Anderson said through fitness centers, a mobile podiatry clinic and education programs, the reservation is trying to protect its residents and provide a better quality of life for them.
The first major step on the right track is a change in eating habits and exercise habits. Type 2 diabetes can be managed through diet and exercise.
"It's always been an issue, but there's a significant increase," Anderson said of diabetes on the reservation. "It's always highest in Native people, but abundantly higher in the Midwest Plains."
Diet and exercise are two of the key ingredients when it comes to controlling and preventing diabetes. The reservation offers multiple fitness centers, several with licensed trainers available to assist with exercise programs.
Fitness centers are in Mahnomen, White Earth, Rice Lake, Naytahwaush, Pine Point and Elbow Lake village.
Membership fees are low to non-existent, too.
"We're just trying to make exercise accessible for people," Anderson said. "The goal is to get people up and moving."
Keeping up with the latest in weight loss, the reservation offers multiple fitness programs like zumba, yoga, theraband, step aerobics, kettle bells, weight loss challenges and 5k runs.
"We try to promote physical activity at every event," Anderson said, adding that they will have booths, giveaways, etc. at events throughout the year.
Training and information isn't just for those with diabetes either. The personal trainers at the fitness centers have specialized training in diabetes, however.
"They are trained like anyone else," Anderson said, "but also (in) extras like glucose training."
Andrea Littlewolf, who is a personal trainer at the White Earth Fitness Center, said she helps check blood sugar levels before those with diabetes work out and can provide a glucose tablet for those needing one so they "can work out safely."
Training may vary depending on the age and strength of the client, and Littlewolf refers clients to a nutritionist for healthy eating concerns.
At her location, many of those working out are employees of the tribe -- since the fitness center is attached to the Tribal Health Building -- but other fitness centers, like Star Fitness in Mahnomen, get a lot more variety of people simply because of their location.
The other aspect is nutrition education. Anderson said the tribe publishes a cookbook specifically for diabetics, encourages gardening and fresh foods, a farmer's market and working with SHIP (Statewide Health Improvement Program) to get rid of childhood obesity.
"People don't put a lot of planning into meals or use fresh foods," Anderson said.
At the fitness centers, trainers are trying to track progress, and one way is by measuring body mass. Using the body mass index, at one center, 69 people are considered obese, 23 overweight and only 7 are rated as normal.
Anderson said the diabetes program also encourages traditional tobacco use and not recreational use. She is working with the Tobacco Coalition to help end smoking.
And with all the education and working out, the diabetes program staff is also working to make it fun. Gail Gardner, a registered dietician at the Indian Health Services Clinic and Paulie Neisen, a nutrition education assistant and employee of the Tribal Diabetes Project, worked together to design two Bingo games that make learning about diabetes entertaining.
First there is Diabetes Bingo, which is geared toward preventing and managing diabetes. Secondly, there is Healthy Living Bingo, which incorporates nutrition education and physical activity.
"We have a diabetes game that actually teaches people how to control their blood sugars, use their monitors, use the equipment they get and take the medication they get correctly, and how to tweak their diet," Neisen said.
She was hired to work for Gardner on the nutrition side of diabetes, and her talents as an artist came in handy.
"She (Gardner) was trying to do this bingo game and all she was coming up with was cute little stick figures," Neisen said with a laugh. "So when she found out I could draw a little, she said, 'I've got a job for you.'"
There are six sites on the reservation, and the diabetes group puts on the games at three sites per month. So this month, bingo will be in White Earth on March 11, Pine Point on March 21 and Naytahwaush on March 25. Then next month is Rice Lake on April 8, Mahnomen on April 11 and Elbow Lake on April 14.
Neisen said about 15-20 people come out each month at each site for the bingo games, and sometimes as many as 45 people will come -- especially during the summer when the kids are out of school.
"We have patented (the bingo games) and sell them to other tribes and organizations to help educate about diabetes," Anderson said. "These games are fun and effective ways to integrate education and prevention into our programming in non-traditional settings."
One more leg of the Diabetes Project is foot care. Dr. Kham Ung started a mobile podiatry clinic that visits the reservation monthly, and can assess patients and make referrals from there. In the past he has sent them to Sioux City, Iowa, for surgeries, but "we got him privileges to do surgeries in Detroit Lakes, so patients don't have to drive down there," Anderson said.
Type 2 diabetes isn't picky. It'll strike adults, teens and children. The reservation's Diabetes Project is just trying to spread the word and provide support for those willing to help the prevention of diabetes with healthy food choices and exercise.