AKWESASNE, N.Y. – Cecilia Cook walks through the door at the St. Regis Mohawk Health Services clinic and slips into her zone.
This white-haired woman knows the drill. She diligently comes twice a week. She gets her blood pressure checked, rides the stationary bike and does leg squats followed by other resistance exercises. She is fighting off a disease that has claimed the lives of loved ones and thousands of other Native Americans: type 2 diabetes.
"Both my mother and sister passed away from diabetes," she says. "When the doctor told me seven years ago I was starting to develop the disease, he advised me to start working out. I listened to him. I am glad. I wanted to do it."
Cook, who turns 81 Tuesday, has become "one of our success stories for healthy aging," says nurse Janine Rourke. Older people are more likely to develop the disease, so they should avoid a sedentary lifestyle, she says. Many studies have shown exercise can help control type 2 diabetes, along with changes in diet.
Cook and Rourke grew up on this reservation, a tribe of nearly 14,000 people extending into Canada along the St. Lawrence Seaway. Their family stories are sadly familiar among Native Americans, a group affected by diabetes at twice the rate of whites.
Nearly 26 million Americans have diabetes. Of the 3.3 million Native Americans and Alaska Natives in the USA, about 16% have diabetes, most of them type 2, according to Indian Health Services, part of the Department of Health and Human Services.
Rourke says her dream is to "have zero diabetes in our population." She has led fundraising efforts to build the new
multimillion-dollar clinic for diabetes and health care. Groundbreaking is June 18. More money is needed for an indoor track, but that will be installed during the second phase, when the money is there.
"There's a road that cuts through our town, and we're lucky if we can get trucks to slow down to 45 mph," Rourke says. "There are no sidewalks and no track at the high school, so it is hard to find places to walk."
Rourke says about 500 people are enrolled in the Let's Get Healthy diabetes and healthy heart programs. She has data to show how much money is saved by keeping people off expensive medications. Early diagnosis is important, she says, before damage begins.
"We think that if you count those who are undiagnosed, it's more likely 20% of the population is affected in our community," she says.
Being overweight puts people at higher risk for diabetes, as do smoking and inactivity. Exercise manages glucose levels before excess blood sugar levels can damage blood vessels, eyes, kidneys and the heart and cause heart attacks and strokes.
Three in 10 seniors have diabetes, the Centers for Disease Control and Prevention says. The American Diabetes Association recommends testing for diabetes at age 45 in patients who are overweight and who have one additional risk factor, such as physical inactivity.
The majority of Rourke's patients are older: More than 80% are 45 or older, and a third are over 65. She tells them exercise will help keep them healthier in other ways as they age.
Studies show exercise also improves cardiovascular fitness, eases painful arthritic joints, improves bone health and slows down the onset of dementia.
And exercise can help keep off extra pounds, a natural occurrence of aging for many people. Rourke says the obesity epidemic in the USA will add to soaring health care costs as more overweight people develop diabetes when they grow older. Here at St. Regis, "we're into healthy aging and functional fitness," Rourke says.
Lucille Peters, 66, and Kerry Montour, 49, hear her message loud and clear. They're both regulars. "Diabetes runs in my family," Montour says. "My mother passed away last year because she was diabetic, and she was only 66. I don't want that to happen to me."