In an effort to answer this question, Ohio University Nursing Professor Sharon Denham will host a workshop Nov. 4 to train area health-care professionals how to educate their communities about managing the disease.

The prevalence of type 2 diabetes, the most common form of the disease, is rising in Appalachia, where higher rates of poverty and lower income levels add to the problem. According to a 2006 report by the Appalachian Rural Health Institute, which Denham heads, the prevalence of diabetes in Appalachian counties is about 11 percent, compared with the national average of 7 percent.

With the help of a federal grant, Denham has spent the past four years developing a diabetes toolkit titled "Diabetes: A Family Matter," available online at www.diabetesfamily.net, that is designed to encourage conversation about the disease in Appalachian communities.

"One of my major concerns is that people don't talk about diabetes," Denham said. "They talk about the risks of cancer, although many more people have diabetes. If someone has diabetes in a family, there is a high risk for other family members. I wanted to create new community stories and help people to live healthier in the Appalachian community."

The workshop, held last month at Ohio University's Human Resources Center, will be repeated Nov. 4 at the same location and again in August 2010 at a site yet to be decided. At October's workshop, attendees in various health-care professions from eight counties listened to speakers and took home copies of the diabetes toolkit to distribute in their communities.

These volunteers, also called SUGAR helpers (Support to Unite Generations in the Appalachian Region), will each build up educational programs in their individual counties. Representatives from Athens, Hocking, Lawrence, Meigs, Perry, Pike, Ross and Vinton counties sat together in small groups to brainstorm ideas for their communities.

The toolkit provides a host of ideas to start with, including brochures, a short film about living with diabetes in Appalachia and three plays about families touched by the disease.

"This program is great for the underserved population of the county that we live in," said Amy McNaughton, a volunteer from Pike County. "This is tremendous to bring this family-related education back to them for diabetes control."

For more information about the program, contact Denham at sugarhelper@gmail.com.