NARRAGANSETT – In 2003, just before an activity-filled day, Charlestown native and Narragansett Tribal Elder Heather Mars-Martins thought her eyeglasses had stopped working properly. It turned out, however, that Mars-Martins’ vision troubles were not stemming from faulty eyewear, but rather Type 2 diabetes, which she was diagnosed with soon after a trip to the eye doctor. The development took a toll on Mars-Martins, a mother of two and grandmother of three, who was forced to drastically alter her active lifestyle to accommodate the harsh realities of her new disease.
“Some of the activities I love to do became scary and I lost some of those freedoms,” she said. “I would make sure I ate properly, go out to participate in an activity with friends or my family, and find myself in a dangerous diabetic situation.”
“It became very disruptive,” Mars-Martins continued. “I’m very outgoing, very fun and full of life. I want to go out and do these things with my family. But I started feeling like my health would interrupt these events. It still bothers me. Diabetes slowly eroded my ability to enjoy these freedoms that I participated in with my family and my community.”
Mars-Martins grew up on a farm in Charlestown and notes she was only allowed to watch television on Sundays. With a family history of diabetes (both her mother and father were diagnosed with diabetes), her parents sought to provide their children with a lifestyle that would hopefully bypass the medical condition, which can be passed on through genetics. As a result, Marts-Martins was an active child who loved swimming, biking, running and hiking. On their farm, the family grew and ate all of their own food, from meat to vegetables to fruit. She was even teased by other kids for how skinny she was.
“My father always believed that an honest, good day of hard work kept one active,” said Mars-Martins. “My parents believed, after seeing diabetes sort of ravage the community, that they were going to give us every opportunity to dodge that bullet. That’s how I know the myths about diabetes are just that- myths. You can do everything right and still be diagnosed with diabetes.” ”
Native Americans have a greater chance of having diabetes of any other racial group in the country. Kidney failure among Native Americans is the highest of any race in the US. The disease often leads to significant disability, including renal failure, blindness, limb amputation and premature death. According to the US Department of Health and Human Services and the Centers for Disease Control, more than 23 percent of Native Americans and Alaska Natives age 18 or older will be diagnosed with diabetes, compared to only 8 percent for non-Hispanic white populations. Some tribes live on reservations or remote areas, restricting access to healthy foods, and many tribes have been removed from their native lands. Further, structural disparities in healthcare and other areas make it more challenging for Native populations to seek out effective treatment once being diagnosed.
With Mars-Martins' diagnosis came weight gain, a significant loss of energy and many risk factors. Daily life changed, and once-menial tasks had to be planned out or foregone entirely. Multiple medications had to be consumed and insulin injections became a regular occurrence. At one point, Mars-Martins was taking insulin six times a day. Shortly after her diagnosis, she was hospitalized for two days following a mix-up of insulin doses after a long day at work. Mars-Martins believed she would be living with the disease and its ailments for her entire life.
In May of 2019, an email from her brother lead Mars-Martins to inquire about a program being offered through her employer of 27 years, Pequot Health Care, that worked with native populations to reverse diabetes with a nutrition-based approach, rather than medications. Thinking “what do I have to lose?” Mars-Martins enrolled in the program, receiving a nutritional coach, a doctor and a smartphone app that tracks biometrics and food intake.
“My life changed on that day,” said Mars-Martins. “It had always been more medicine, more medicine, more medicine, but that wasn’t making me any healthier.”
Participating in Virta Health, which champions an individualized approach to lifestyle changes with a strong support system, Mars-Martins, after just two months, was able to eliminate her fast-acting insulin doses and reduced slow-release insulin doses by nearly two-thirds, down from about 64 units per day to about 24 units per day. Her blood-sugar level has also decreased by over two points and Mars-Martins says she now has more energy than ever in recent memory.
“It put me back on a bike, it got me back swimming, it was wonderful,” she said.
Virta Health, a company working to reverse diabetes in populations and groups across the country, partnered with Pequot Health Care recently, hoping to provide relief and treatment to the Mashantucket Pequot Nation. The company also works with Comcast, Inc. and its employees, other tribal nations across the country, and even businesses and organizations that employ longhaul truckers or drivers.
“We are trying to help people find a way of doing this for life,” said Dr. Frank Dumont, Virta Health Commercial Medical Director. “The people who come to us have metabolic dysfunction. Their metabolism is not working well. That is something that has taken years and decades to get to. That’s something that doesn’t go away.”
“But what we can help them do is find a way of eating that works for them, where that nutrition is not only enjoyable, but works for their metabolism so that they can remain in a metabolically-stable and healthy state going forward without the use of medications.”
That treatment comes down to an emphasis on nutrition rather than medication, where a team of medical professionals and technology combine to give patients the support they need to uphold a lifestyle and eating change. Patients regularly communicate with nutritionists and doctors to form a plan around their lifestyle that will seek to combat diabetes through food intake, namely increasing the amount of healthy fats consumed and drastically reducing carbohydrates.
“My whole life, I had been burning carbohydrates for energy, based on the food pyramid that we all know,” said Mars-Martins. “Then I learned to burn fat for energy.”
Virta Health nutritionists also teach patients more practical practices such as how to read restaurant menus to better understand the nutritional facts and ingredients in prepared dishes and how to grocery shop without facing potentially unhealthy temptations.
“My coach, who is a friend now, was always enthusiastic with support and guidance,” said Mars-Martins. “I would call, text or email her several times a day or a week multiple times a month. I learned quickly the food that my body couldn’t adequately break down through that process, using these methods.”
“What we do is we utilize technology, we have a continuous remote care platform, where patients interact with us, usually on their smartphone, on a daily basis,” said Dr. Dumont. “They have a coach that’s working with them, who can adjust their nutrition plan in real time.”
Doctors within the program will monitor biometrics such as glucose levels, ketones, weight and blood pressure for each patient.
“If something isn’t going well, the coach and the patient know about it right away, and can adjust what’s happening nutritionally,” said Dr. Dumont.
The difference, according to the doctor, is that normal, primary care doctors are not set up to interact with the same patient daily, meaning a diabetic seeking nutrition-based treatment will not have as much access to medical guidance without something in place such as Virta Health or a similar program. Drastically altering one’s eating habits, especially for someone diagnosed with diabetes, can be extremely risky from a health standpoint when not medically supervised. Dr. Dumont notes that in addition to the professional guidance, individualized plans and check ups, positivity and having faith in patients also acts as a supplement in improving health.
“It’s really helpful to have a team around you that knows the science and is optimistic about the goals you can accomplish,” he said. “I was trained to be a medical pessimist. I was basically taught that people couldn’t make these kinds of changes and you had to push them toward medicines and important procedures. That’s a pretty unhappy place to be as a patient, where you’re coming in to see your team member, and they don’t have confidence in you.”
“Our environment is very different,” he added. “Having that very positive support, that’s not just a cheerleader in your corner, but has a different understanding of the science, I think is incredibly powerful. That optimism that we deal in as caregivers transfers to our patients.”
A big emphasis in treatment is placed on individual lifestyle, and coaches will work with patients to learn the details of their lives - where and how they work, daily activity level, what foods they enjoy - to build specific plans and forge new habits.
“If you can actually understand where someone is and what their challenges are and help them do it in a way that really works for them, in their environment, with their preferences and their restrictions, it works a lot better,” said Dr. Dumont. “What foods does this individual like? Are there foods that they can’t eat? Are they vegetarian, or vegan or pescatarian, do they have food restrictions? Are they living in a food desert? Are they always on the road and traveling for work? Those are all things that we work with patients to understand so that we can help them find a way of doing the nutrition that also works for their metabolism.”
After one year enrolled in Virta Health, 83 percent of patients are still participating in the program. For participating members of the Mashantucket Pequot Nation, A1C levels, a simple test used to measure blood sugar, dropped an average of 1.7 percent.
“On medications, at best, you can hope for a .5 or a .7 point decrease,” said Dr. Dumont.
Also, Mashantucket Pequot Nation participating members decreased diabetes medication use by 78 percent after one year, a figure which takes into account Mars-Martins’ personal improvements.
“The results gave me all the motivation that I needed,” she said. “And that weight that I slowly put on, started coming off. I would always lose five pounds and then find it again. This time, the weight I loss stayed away. I recognize that for me, this is a lifestyle change, using food as medicine. This is me reclaiming my life with the help of Virta through my employer.”
Now, Mars-Martins is working within her community to help others, recommending the treatment plan whenever possible and seeking to widen access to more individuals within both the Narragansett and Mashantucket Pequot Nations. She has also gotten back on the bicycle, resumed swimming, running and all of the activities she used to enjoy - now worry-free.
“The last two years have been life altering,” she said. “It’s like someone dialed the clock back for me. I’m older now, I have gray hair, but I feel younger today than I did a decade ago. There’s a part of me that’s come back, that was missing. I don’t have fear about being involved with life anymore.”
Between the patient and caregivers, the feeling is mutual.
“This has been the most fun part of my career,” said Dr. Dumont. “The last two years working here at Virta and getting to work with patients like Heather has been the most enjoyable. It is so much more fun to stop medicines than to start medicines and watch people succeed.”
To learn more, visit virtahealth.com.