ASHLAND — Karin Schwan sat at the head of a wooden table in a room that smelled faintly of hand sanitizer.
Printouts about “The ABCs of Diabetes” were on the table in front of her. A man and woman walked into the room, and Schwan greeted them by name.
Schwan works at the Ashland Christian Health Center as a nurse practitioner and certified diabetes educator. As a diabetes educator, she helps patients make healthy lifestyle choices and learn how best to navigate their diabetes, often working with them one-on-one.
On top of her one-on-one work, Schwan also has a diabetes support group she’s run for years. Currently, the group meets at Ashland Christian Health Center once a month. It covers different topics related to managing diabetes.
This particular night, Jan. 9, Schwan’s greetings are followed by a delve into the ABC’s of diabetes: A1C, blood pressure and cholesterol.
Diabetes impacts Ashland
Schwan was born at Samaritan Hospital in Ashland — a hospital she’d later end up working at before finding her way to the Ashland Christian Health Center.
She earned an associate’s degree at North Central Technical College, now North Central State. She also earned a bachelor’s degree at the University of New York and a master’s at Otterbein.
Schwan said she originally graduated from nursing training in 1982, but didn’t become a nurse practitioner until 2014. She began her career working in the ICU, but moved positions several times over the years.
She said several of her patients in the ICU had diabetes. It was also something she’d seen in her personal life. Her grandmother, father and brother all had diabetes.
“So, type two diabetes runs in the family and so that’s part of my passion,” Schwan said. “But the other piece is I love to teach. There’s nothing cooler than to see a light bulb go off in somebody’s eyes when they finally get it.”
Throughout her career, helping people with diabetes has remained a common theme.
In Ohio, one in eight adults have diabetes, or 12.2% of adults in the state.
That share is higher in Ashland, according to a 2019 report from the county health department. According to that report, 13% of Ashland County adults had been diagnosed with diabetes in their lifetime. Both figures are above the national average.
The disease means the pancreas doesn’t produce enough insulin, or the body can’t use the insulin it does produce. Insulin regulates blood glucose.
If diabetes is not well-managed, patients can suffer with hyperglycaemia, according to the World Health Organization. It can also lead to serious damage of nerves and blood vessels, and put people with the disease at higher risk of health problems like heart attack, stroke and kidney failure.
Managing diabetes often is a team effort that includes multiple providers. Not every person with diabetes is referred to a diabetes educator. But, diabetes educators can play an important role in empowering people with diabetes to become more effective self-managers.
That’s where Schwan comes in. In 2000, she pursued her certification as a diabetes educator. She also said she took over hosting the diabetes support group at Samaritan Hospital in 1999.
As Schwan moved to different positions and hospitals in her career, the support group followed along with her. Participation in the group ebbed and flowed, but no matter how many people showed up, Schwan was there to lead it.
She finally landed at Ashland Christian Health Center in what she described as her “dream job” thanks to a grant from the Samaritan Hospital Foundation in 2022.
When I was first diagnosed, I had no education.
Doug Pickersgill, a retired chef and regular support group attendee
According to 211, an organization that compiles social service groups in the area, Schwan’s diabetes support group is the only one that meets in Ashland County. Two groups — one for adults and one for juveniles — meet at OhioHealth in Mansfield.
Studies have shown diabetes education and support groups can have a positive effect for people who’ve been diagnosed with the disease.
A study published in 2015 titled “Effects of Providing Peer Support on Diabetes Management in People with Type 2 Diabetes” found patients who attended a peer support program saw improvements in “their own self-care behaviors and metabolic control.” The same study also found the program empowered participants with coping skills that reduced depressive symptoms.
Building connections
Denise Grimm and Doug Pickersgill are regular attendees at Schwan’s 6 p.m. support group meetings.
Ashland Christian Health Center diabetes support group meeting times
The group is free to all participants and meets on the second Thursday of each month in September to May. Schwan leads meetings at both 2 p.m. and 6 p.m.
Below are upcoming meeting dates:
- Feb. 13
- March 13
- April 10
- May 8
Grimm and Pickersgill met and dated when they were both students at AU, but their life paths took different directions. Pickersgill was previously married, but after his wife passed away, he and Grimm ended up reconnecting in 2017.
Pickersgill is a retired chef, and Grimm acts as his caretaker. Grimm first began attending diabetes support group with her mother years ago — she worried her mom was developing diabetes.
By the time her mother couldn’t attend the group anymore, Grimm and Pickersgill had reconnected. Pickersgill has diabetes.
So, post-COVID, the pair started coming again. During the group’s 6 p.m. meeting on Jan. 9, they were active participants. Pickersgill asked Schwan several questions about diet and medications, which Schwan answered with ease.
It’s a small group. Schwan had three attendees at the 6 p.m. meeting on Jan. 9. Still, the group is chatty, and Schwan knew each member well enough to ask them about specific medications, struggles they were having and more.
‘A deep honor’
Schwan said prior to the pandemic, more people attended the group. She has found it challenging to connect with people after the pandemic. Part of it, in her estimation, is that people don’t know the group exists.
With decreased participation, Schwan admits sometimes she struggles to stay motivated to keep offering the service. Why take the time if people aren’t interested?
But she figures if she can make an impact on one person, that’s enough.
“It’s always, to me… a deep honor when someone allows you into their personal space related to their health,” Schwan said. “That’s a gift that people give to me. I think part of it, too, is… these are my people. I mean, I get more from the people who attend. Over the years, they know my story.”
She added you never know the ripple effect touching one person might have either.
“When I was first diagnosed, I had no education,” Pickersgill said.
He shared his mom had also been diabetic, which helped him with a basic understanding of the disease. But since coming to support group, both he and Grimm said they’d learned a lot.
They’ve also connected with other attendees. One regular group member wasn’t in attendance at the meeting, so Grimm brought home handouts to take to them.
“It might not be high-volume, but just the other day, somebody here was getting handouts for another person who couldn’t make it,” Schwan said. “So, it really wasn’t just about the people sitting in the seat. It was about the impact it was gonna have.”