Quinzel Cole lost a brother and a sister to complications of diabetes, so he knew what might be in store for him if he didn't deal with his own pre-diabetic condition.

Cole didn't want to take medicine, though, and he shared that information with his doctor who suggested that he get help from FirstHealth's Diabetes Self-Management Program.

"I wanted to give it a chance," says the 60-year-old Cole, who works in transportation for the Pinehurst Resort. "My wife thought it was a good idea, too."

Both Cole and his wife, Betty, enrolled in the FirstHealth program. Because of what they learned, they made several important lifestyle changes and are glad they did. Quinzel is especially happy about his success, because he achieved his goal of avoiding medication.

"I walk about 30 minutes every day, I quit smoking, and I changed my eating habits," he says.

Like many people dealing with diabetes or pre-diabetes, Quinzel Cole weighed more than he should have.

According to a report released in fall 2008 by the Centers for Disease Control and Prevention (CDC), the rate of new diabetes cases in the United States nearly doubled in the last 10 years. About 90 percent of the new cases were type 2, the form linked to obesity.

The data from the study, published in CDC's Morbidity and Mortality Weekly Report, showed that the highest diabetes rates were in the South.

West Virginia, South Carolina, Alabama, Georgia, Texas and Tennessee had the highest rates. Minnesota, Hawaii and Wyoming had the lowest.

Diabetes is also a problem in North Carolina, where 9.1 percent of the population has been diagnosed with the disease. It is a particular issue in the FirstHealth of the Carolinas service area, where the diabetes rate is 14.1 percent in Moore County, 16.2 percent in Montgomery County, 18.8 percent in Richmond County and 11 percent in Hoke County.

FirstReach Program

The disease is especially prevalent among minorities.

In Montgomery County, where the rate of minority female diabetes deaths is almost four times greater than the state rate and where 36.7 percent of local residents don't have health insurance, FirstHealth has introduced First-Reach, a one-year program designed to educate adults about diabetes and its signs, symptoms and risks.

Launched in July with a $40,000 disbursement from the FirstHealth Montgomery Foundation, the program provides screening, education and follow up to ensure successful diabetes management.

While the findings of the recent CDC study on diabetes dovetail with current trends in obesity and lack of exercise, experts say you don't have to become thin to avoid the disease, however. In fact, a study of people at high risk for type 2 diabetes shows they can cut their risk by 58 percent over three years by doing just two things:

n Losing 6 percent to 10 percent of their body weight.

n Getting 30 minutes of moderate physical activity five days a week.

Quinzel Cole weighed 214 pounds when he started Diabetes Self-Management. About eight weeks later, at the time of his first doctor's visit after completing the program, he was down to 197.

In addition, his wife says, his blood glucose (sugar) count was 126, or borderline diabetic, when he entered the program. "It's not been over 100 since we started that class," she says. "It's important to do blood checks every day. Even though we keep Quinzel in the safety zone, he checks his blood mornings and evenings, just to stay safe."

Jon Cucura, a registered dietitian in the Diabetes Self-Mana-gement Program, says Cole came into the program determined to avoid medication and was successful.

"He made a lot of lifestyle changes," Cucura says. "He saw the difference food was making on his blood sugars, and he ended up not having to be on medicine to control it."

'How Simple It Is'

Having his wife as a partner in the endeavor was also a factor in Cole's success, Cucura says.

"They were very receptive (to the program), and his wife was very supportive," he says. "They both have made lifestyle changes. They're doing their exercising together. They're really a good support system for each other."

Betty Cole says she and her husband learned a lot about diet and exercise from Cucura and the other Diabetes Self-Management educators. They also learned that some of the things they thought they knew about healthy eating weren't exactly true.

For example, she says, they thought they were improving their diet by substituting sweet potatoes for white potatoes. What they didn't know is that all potatoes are carbohydrates, which the body converts into sugar that is then absorbed into the bloodstream. People with diabetes have problems with the hormone insulin that can cause blood sugar levels to rise.

The Coles also learned that they didn't have to give up carbohydrates, which are an important part of a healthy diet, but that they needed to control their portions.

"You already think you know what to do, but we didn't," Betty Cole says. "Every time we went to a (Diabetes Self-Management) meeting, we learned something. We were amazed to learn how simple it is to do the right thing. It was one of the best things we've ever done."

Anyone who has questions about diabetes can call the free FirstHealth Diabetes Helpline at (800) 364-0499 Monday through Friday between 9 a.m. and 5 p.m. for any non-urgent medical or nutritional questions. For more information about the FirstHealth Diabetes Self-Management Program, call (800) 213-3284 toll-free.