What if a person told you there is a program out there that - if implemented - can add years or even decades to your life along with lots more energy, and it's free of charge?

Although it's not for everyone, a diabetes prevention program can do exactly that. Cloquet area resident Linda Dunaiski went through the program six years ago. She lost 45 pounds after starting it (and she's kept it off) and her blood sugar moved back into the normal range. Her heart rate got better; her blood pressure got better. She radiates good health and happiness sitting at the table.

"I'm 62 and I feel better than I did in my forties," said Dunaiski. "I literally credit this program with giving me back my life, because I was getting overweight and slowing down every year, getting a little bit less active. ... I think this program added 10-20 years to my life."

What is prediabetes?

Basically a person's blood sugar is higher than normal, but not high enough to be diagnosed with diabetes. There are often no symptoms of prediabetes, so people usually find out when they have a blood sugar test at the doctor's office.

Happily, finding out you have prediabetes means there's still time.

"It's a time where you can still make some lifestyle changes that can help you prevent or delay a transition to diabetes," said Chris Foss-Tietz, a health educator and lifestyle coach at the Min No Aya Win Clinic on the Fond du Lac reservation.

Foss-Tietz is one of several lifestyle coaches gathered to promote diabetes prevention classes and education about prediabetes, including Kim Matteen.

"It's like your last warning, time to figure out and make changes or succumb," added Matteen, who is helping promote prediabetes prevention programs in the region as part of Healthy Northland. "And we really don't want people to succumb."

Foss-Tietz frames prediabetes as "an opportunity" to prevent or delay the onset of diabetes, which is recognized as one of the leading causes of death and disability in the United States. Complications from diabetes include heart disease and stroke, high blood pressure, kidney disease, blindness, amputations, dental disease, depression and more. While it can be treated, diabetes cannot (yet) be cured.

Why not prevent that, argued Matteen.

According to the Centers for Disease Control and Prevention (CDC), 15-30 percent of people with prediabetes will develop type 2 diabetes within five years. The CDC also refers to an "epidemic" of diabetes occurring over the past 20 years or so. As of 2014, the number of people in the U.S. with diabetes reached 29.1 million, or about 9.3 percent of the population. About 28 percent of those people don't even know they have it. In Carlton County, according to a 2015 Bridge to Health survey, 8.2 percent of adult respondents said they'd been told they had diabetes.

"As we'd expect, those numbers are much higher for older residents than younger, with ages 55-64 being the tipping point," Matteen said.

Hence, the previously mentioned diabetes prevention program, which is free (but valued at $429) and offered in different locations around the Northland at different times of the year. In Carlton County, both Community Memorial Hospital and Fond du Lac Human Services are planning to begin programs in the next month or so. (See "Free diabetes prevention classes" on Page A8 for more information.)

The goal of the program is to help people make actual lifestyle changes and it's based on actual research that showed subjects who received intensive counseling on diet, exercise and behavior modification reduced their risk for diabetes by 58 percent (71 percent for ages 60 and older) compared with those in a placebo group.Subjects who took a drug (metformin) reduced their risk by 31 percent. For every 2.2 pounds of weight loss, risk for type 2 diabetes was reduced by 13 percent.

To get participants off to a strong start, the program begins with 16 class sessions over a four- to six-month time frame and meeting once a month after that. Classes cover everything from healthy eating and cooking to stress reduction to tips for eating out. Dunaiski said the time flew by for her.

"I wished the 16 weeks didn't end when it did," she said. "I had a connection with the other people. We learned a lot from each other."

Participants share their own challenges and stories together, journal what they eat and "wow" moments in their days. Dunaiski said she still journals, and is still embracing the lifestyle changes she learned in the program. In fact, she notes, it even affected her husband, who is also eating healthier foods because she is.

Mary Kay Marciniak, director of diabetes education at CMH, said it's about making big and small changes, "reaching for cashews and almonds instead of M&Ms."

"This is not a diet, it's a lifestyle," said Foss-Tietz.

In addition to eating better, the program also encourages people to move more. Thirty minutes five days a week is good.

"It doesn't have to mean going to a gym," said Foss-Tietz. "It can be a brisk walk, or cleaning your house, as long as you're moving."

Marciniak chimes in.

"It doesn't have to be all at one time either - you can break it up," she said.

Helping people lose 5-7 percent of their body weight through healthier eating and 150 minutes of physical activity is the key to success.

But what about parents who go from a sedentary job to cooking supper to helping kids with homework and bed?

"It comes down to being mindful and making (movement) a priority," said Darilyn Lane, who is just finishing teaching a diabetes prevention program at the Human Development Center in Cloquet. "Park farther away. Bring in one grocery bag at a time. It all adds up."

Having a buddy to walk with, or dance with, or garden with can make a big difference, said Marciniak. And remember that it doesn't have to be a formal activity. Training the dog counts and so does gardening, as does pulling the kids in a sled up a snow-covered hill.

Get up and walk around at work: "Don't sit for more than 20 minutes without getting up," she adds.

We are often our own worst enemies, she said. And we keep creating all kinds of things to keep us sedentary, from computers to video games to hundreds of TV channels with all kinds of content. Add riding lawn mowers and mopeds to the list, as well as ATVs which people ride instead of hiking through the woods or walking down the driveway to the mailbox.

People are working more to pay the bills, and running kids from one place to another and grabbing fast food at a drive through instead of eating something cooked at home.

"There's a lot that plays a role in this," she said. "We need to just simplify our lives and get back to some of the basics. Healthy eating, get up and move more. I think it'd be a better road for everyone."

As for healthy eating?

"Eat closest to the farm is what I tell people," she added. "If you can grow it and pick it, that's probably the best. If it comes out of box or a can, there's so much preservatives and sodium added in there."

Shop the perimeter at the grocery store, suggested Dunaiski.

While the suggestions roll in, that's all they are, points out Foss-Tietz. And that's what the diabetes prevention program does for participants.

"It's not a matter of telling," she said. "It's a matter of offering ideas, offering knowledge and resources and tools that can help people in this journey."

Marciniak described the program as "gentle, kind, supportive and non-judgmental environment."

"The changes that we make in this, it's not a light switch. It's a little bit at a time," she said.

"It's not boot camp," she said. "It's not a New Year's resolution. This program is for sustained lifestyle changes."

Free diabetes prevention classes

Community Memorial Hospital will hold information sessions about an upcoming diabetes prevention program at noon Tuesday, March 21, and 4:30 p.m. Wednesday, March 29, at the hospital for a possible May program start. Contact Mary Kay Marciniak at 218-878-7661 or email mmarciniak@cloquethospital.com for more information.

Fond du Lac Human Services will begin its next session of diabetes prevention classes the first week of April. Participants must be Native American and eligible for services at MNAW or CAIR clinics. Contact Chris Foss-Tietz at 218-878-3721 for more information.

Carlton Wellness Center (contact Emma Skelton at 218-384-1115) and Human Development Center (contact Darilyn Lane at 218-879-4559, ext. 6124) may also hold classes later in the year.

The Centers for Disease Control and Prevention show that people with prediabetes who take part in a structured lifestyle change program can cut their risk of developing type 2 diabetes by 58 percent (71 percent for people over 60) by losing 5-7 percent of their body weight, getting more active and healthier eating.

Editor's note: Check out the quiz posted online at pinejournal.com with this story to find out what your risk level is for prediabetes.