"Our clinicians wanted something to offer patients with pre-diabetes, to support them in slowing progression to diabetes and heart disease, and there weren't any programmes out there," she said.
"Since there is no magic pill for this, for most people reversing pre-diabetes means a healthy diet and weight loss.
We have a passion for prevention at our organisation, and invest a lot of time and energy working with patients to improve their health. The most prevalent chronic conditions, heart disease and diabetes, already have excellent programmes for support, so when Ellie Berghan (Northland DHB) asked for an innovative way to prevent these I held up my hand."
Melissa Peterson, prevention nurse at Te Hauora, who led cardio vascular disease (CVD)/diabetes (DM) DM prevention project, had for the last year run group sessions with patients who were interested in learning more about the condition and receiving support.
Each group met weekly for six weeks, followed by home visits by Whanau Ora nurses, with home testing of sugar levels for whanau or friends who were interested in monitoring their. They became VIPs (very involved in prevention), and would have direct access to Ms Peterson at the clinic for the full three years.
Ms Peterson presented awards to 10 Prevention Champions at Friday's luncheon, recognising the best of the past year's 10 success stories with 'portion plate' and fruit tree. The plates were designed by local artist Philippa Murray using a koru design in a teal (less appetising) colour, to which inspirational words in te reo were added.
"As far as we know this is the first Maori design portion control plate in the country, or the world for that matter," Dr Nehren said.
Before the programme was launched, patients, maori and non-Maori, averaged weight gain, compared with an average weight loss of the last year. Before the programme, 40 per cent of pre-diabetes patients improved (2010-2012); in the last year that rose to 55 per cent, she added.
The next step for Te Hauora o Te Hiku o Te Ika would be maintaining those successes and reaching more patients.
"Internationally research is increasingly focused on how long it takes to go from being diagnosed with pre-diabetes before people progress to diabetes. We are monitoring those numbers in our population, but with intervention hope to slow or reverse that progression."
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The programme allows each patient to choose their own diet, those that work well and are safe involving the limiting of caloric intake and decreasing carbohydrates, measuring portions and balancing the types of foods eaten. For some a formal programme like Weight Watchers is the answer.
Exercise is encouraged because it increases fitness and helps metabolism, but of itself it does not result in weight loss, so body fat percentage is monitored. Tangata Tautoko is available for patients who need support in becoming active.
Smoking is an independent risk factor for developing diabetes and heart disease. The Aukati Kai Paipa support team is available to support patients interested in tackling that problem as well.
"We think of the prevention project as a transitional programme bringing kaupapa practices into the clinic setting. It is not an isolated clinic vs home interaction, but a good hybrid approach to help people feel more comfortable using the medical resources available to them," Dr Nehren said.
"Groups have face to face interactions and weave together their stories and experiences, family are involved, and we explore traditional foods as well as ways to modify unhealthy food choices, decreasing sugars and fried foods."
