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South Eastern African American Center of Excellence in the Elimination of Disparities in Diabetes

Foot Care Training“My grandma lost both legs to diabetes; my mama already lost her foot and now I got diabetes.  I figured I would just lose my legs, too.  I never know there was anything I could do to stop it.” 

When the REACH Charleston and Georgetown Diabetes Coalition began its community assessment and planning during 1998-2000, similar comments were heard during focus groups with community members.  Participants were concerned about diabetes and the possible loss of lower extremities resulting from diabetes-related nerve and vascular complications.

Diabetes is the leading cause of amputation of the lower limbs. However, half of these amputations might be prevented through simple but effective food care practices.  Good foot care is an essential part of diabetes management.

The purpose of REACH US SEA-CEED is to eliminate health disparities related to diabetes prevention and control, especially related to hypertension, stroke, and amputations in 121 counties in South Carolina, Georgia, and North Carolina with populations greater than 30% African Americans at risk and with diagnosed diabetes.  The REACH Charleston and Georgetown Diabetes Coalition was officially created in 1999 in response to a call from CDC for Racial and Ethnic Approaches to Community Health (REACH).  At the request of several initial Coalition partners, the Medical University of South Carolina’s College of Nursing and the Diabetes Initiative of South Carolina were identified as the lead agencies to coordinate Coalition activities.  In 2008, REACH US SEA-CEED was funded to work with communities outside the Charleston and Georgetown counties. Small grants support the efforts of 3-4 African-American communities that share a passion for decreasing disparities for diabetes.

REACH has contributed to the formation of the Center for Community Health Partnerships based in the College of Nursing. Each year faculty and students within the College volunteer their time to work with REACH community activities.  The College of Nursing faculty have created foot care course for both health professionals and lay leaders, and have provided outreach in communities.  Most of the outreach activities have included service learning components for students so that students and community members learn together, while the students are learning to work effectively with community groups to decrease disparities.

The Coalition and its partners have reached more than 45,000 African Americans with educational messages about diabetes that helped enable them to better understand the day to day management of the disease, including the importance of effective foot care.  As a result of this community intervention, one very important lesson was learned: diabetes education and outreach must be offered through multiple channels that meet the needs of community members, including making classes accessible and available where people meet during the day, evening, and on the week-end. REACH relies on community partnerships to succeed in addressing the diabetes complications in each area. 

Since the program's inception, diabetes related amputations in Charleston and Georgetown counties have been reduced by 43% for African Americans and by more than 50% in African American men. Community partners working with REACH have improved health care for people with diabetes and access to medications and supplies have been increased, especially for the uninsured and under-insured.

Diabetes care and disparities in testing for complications have improved significantly and are continuing to improve, but more work is needed.  We need to improve blood pressure, blood glucose and blood lipids to prevent the complications of diabetes. Our current focus in on community, systems, and policy changes to improve diabetes.

If interested in volunteering with REACH or in contributing to REACH, please contact: Dr. Carolyn Jenkins (e-mail: or call 843-792-4625 for further information). You can also visit the REACH website for more information:

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