Nutrition Month 2022: A message from our dietitians

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Nutrition month is upon us! Take this month to assess the food going in your body. Registered Dietitian Shelby Hunke shines a light on diabetes management during this month of nutritional awareness.

Understanding diabetes

There are multiple forms of diabetes. Type 1 diabetes is purely genetic and occurs when the body cannot produce insulin, a hormone crucial in converting blood glucose into energy. Type 2 diabetes is also genetic but heavily influenced by lifestyle choices. With type 2 diabetes, the body doesn’t utilize insulin properly, so medical intervention is necessary. Diet, exercise and proper management with the help of a care team are essential components of living with diabetes.

The third form of diabetes is gestational diabetes. This kind of diabetes occurs in some individuals during pregnancy. It can be dangerous for the mother and baby, so it’s important to monitor sugar levels while regularly meeting with a doctor.


Prediabetes refers to the time before a person develops type 2 diabetes. Many people are prediabetic and don’t realize it. Some of the signs and symptoms may exist, like elevated sugar levels. Being diagnosed with prediabetes can often lead to a significant turning point in nutritional behaviors. By following a plan, it is possible to prevent diabetes.

A message from Shelby

If you’ve been diagnosed with diabetes, don’t panic. I’m here to help! For starters, it’s important to work with your provider and a dietitian to craft a plan that works for you. For many people, I will recommend the “Diabetes Plate Method,” promoted by the American Diabetes Association. Its sometimes referred to as the Mediterranean Diet. This diet involves making half your plate non-starchy vegetables, ¼ protein and ¼ carbohydrate foods. Also, try really hard to avoid sweet drinks. Choose water and low calories drinks as much as possible.

I’ve been digging through my recipes and found a really fun one for you to try during Nutrition Month. Having diabetes doesn’t mean you can’t enjoy good food; it means you have to get a little creative. Happy nutrition month, and stay healthy!

Soppy JanesDiet is a crucial part of managing diabetes.

Source: Sloppy Janes (

Required items:

  • nonstick cooking pan
  • a diced medium onion
  • 1 seeded and diced medium red bell pepper
  • 1 clove of minced garlic
  • a pound of lean ground turkey
  • 1 tablespoon of tomato paste
  • 2 tablespoon Dijon mustard
  • 1 tablespoon of hot sauce
  • 2 cups of canned crushed tomatoes
  • 1 tablespoon of honey
  • ½ teaspoon of black pepper
  • 8 whole-wheat hamburger buns


  • Apply cooking spray to the nonstick pan over medium-high heat
  • Put the onion, red bell pepper and garlic into the pan. Sauté for 5 minutes while stirring regularly.
  • Add the turkey and continue to sauté for 5-7 minutes. Stir regularly until the turkey is cooked.
  • Add the tomato paste, Dijon mustard, hot sauce, tomatoes, and black pepper. Let it simmer for 5 minutes and stir frequently.
  • Fill each bun with the mix and enjoy. This recipe should make around 8 Sloppy Janes.

About the author

Shelby Hunke RD, LD, CDCES, lives in Wadena with her husband and kids. She is passionate about nutrition and spreading her knowledge and experience with others to make healthier lifestyle choices. She works in the dietary department at Tri-County Health Care and sees patients at the Wadena clinic location.

Diabetes management during the pandemic

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The COVID-19 pandemic has strained the healthcare system. Medical staff is facing a stream of patients that are COVID positive. Many people observing the health crisis are choosing to avoid medical care. The pandemic has created an underlying issue. People who desperately need care are going without that vital resource. One very concerning condition is diabetes. Diabetes management during the pandemic can seem like one more boring chore, but it’s more important than ever. That’s because people diagnosed with diabetes are at a higher risk.

Tri-County Health Care diabetes pandemic COVID-19 management insulin

Marci Olson

In 1996, Marci Olson was diagnosed with type 2 diabetes. She’s been managing her diabetes and hasn’t let the pandemic halt her progress. “I’m 100 percent self-quarantined,” said Marci. Since March, she has been fully isolated and only sees her husband. Due to diabetes, Marci believes COVID-19 will kill her if she catches it. Her added caution does not keep her from receiving help. For over a decade, Marci has partnered with Tri-County Health Care to manage her diabetes. She meets with Shelby Hunke, a registered dietitian at Tri-County.

Before the pandemic, Marci had an appointment every three months. This is no longer possible. However, technology and a little help from her husband make receiving care safe. Marci talks with her care staff over the phone. She also uses Video Visits to meet with her general care provider.

Marci is on an insulin pump, which must be regularly checked by Shelby. Marci’s husband brings the insulin pump to Tri-County. From there, Shelby can download crucial data and tweak the machine’s settings. Telehealth has filled the gaps in her care, and right now, the health care system needs more people to follow suit.

Tri-County Health Care diabetes pandemic COVID-19 management insulin

Stay on track

Marci wants to remind everyone to be mindful of their health during these uncertain times. “Be careful with your diet, count carbs, dose your insulin appropriately, and stay on track!”

November is American Diabetes Month. Additional information and resources are located here.

For help with diabetes management during the pandemic, please call 218-632-7113.

I CAN Prevent Diabetes Participants Lost an Average of 16% of Their Body Weight!

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Last spring, I had the wonderful opportunity to facilitate a I CAN prevent diabetes class for Tri-County Health Care. This is a lifestyle change program focusing on losing about 7% of current body weight and increasing physical activity to 150 minutes. The program meets weekly for 16 weeks, then monthly thereafter until a full year is completed.

I am happy to announce these three wonderful ladies have successfully completed one year of the I CAN prevent diabetes program. They lost an average of 16% of their body weight! And increased their physical activity to 150 minutes or more each week!

So I asked these ladies during our last meeting together…What’s Your Story?

Left-Right: Berni, Linda and Jancie are recent graduates of the I CAN Prevent Diabetes Program.

What words of wisdom can you share with other who learn they are at risk for type 2 diabetes?

  • “Be honest and accountable”
  • “It takes both food and activity to be successful”
  • “Eat smaller portions”
  • “Eat more fruits and vegetables”

What did you find most helpful during those moments in the program when you felt discouraged?

  • “Keep going, stay motivated”
  • “Seeing your progress on paper”
  • “Coming to class and talking with other”

Write a message to your future self. What do you want to tell yourself about this experience and the importance of continuing the lifestyle changes you have made?

  • “It was worthwhile”
  • “Remember how much better you feel now”
  • “Don’t go backwards”

For questions about future classes or pre-diabetes contact Shelby Hunke at 218-632-7115 or

About the Author: Shelby Hunke is a Registered Dietitian working at Tri-County Health Care in the hospital and clinic. She has a degree in Exercise Science and Dietetics with a passion for helping patients live a healthy lifestyle. She lives in Wadena with her husband Paul and two kids, Madison and Jackson. In her spare time she enjoys family time, running with her dog Bela and cooking!

Shelby and her family.

Why Step Out for Diabetes in Wadena

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By: Pam Doebbeling, RN

pamdiabetesblog2As part of the Tri-County Health Care Diabetes Education team since 2007, I have seen many changes in diabetes from treatment to the sheer number of people diabetes. Today, 29 million Americans have diabetes, and those numbers are only increasing.

I feel diabetes is a disease that has or will touch almost everyone at some time in their life, thru family members or friends.

It is a disease that involves participation and lifestyle changes to help control.  These seem to be the biggest benefits and the biggest drawbacks. Change is hard.

Thru the American Diabetes Association (ADA), we are able to “Step Out” and make more people aware of diabetes.  This past May we hosted our first ever diabetes walk. We had a group of people participate on a cold Saturday morning in May at Sunnybrook Park. Many local Wadena businesses participated along with Novo Nordisk, Lilly, and Bayer. Not only did we have fun and support each other while out getting some exercise, but we raised $1,000 for the American Diabetes Association!

At Tri County we are proud to have “stepped out” for diabetes as an awareness event.

Look for an announcement coming soon about our date for 2017! We will be having vendor displays, a beautiful walk around the park, and the opportunity to raise money, plus awareness for diabetes.

Get on your walking shoes and join us in supporting this important cause!

2016 Diabetes Walk

2016 Diabetes Walk

About the Author: Pam Doebbeling, RN, has been at TCHC for 23 years. She’s been a part of the diabetes education team for nine years. She lives in Verndale and has two grown children and five grandchildren, and one cranky cat! She’s also part of the Wellness Committee and is in charge of the monthly Diabetes Support Group. To learn more about that group and the various monthly topics, click here:


Living With Diabetes

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Living with diabetes can be scary. Depending on insulin to save your life can be scary. And, switching from daily insulin injections to managing your disease with an insulin pump can be scary. The fear can be a big hurdle for many – both physically and emotionally. And, for Ron Grewe, of Bertha, he was no exception. In fact, one could argue that Ron’s hurdle was larger than most because not only was he living with Diabetes, he had also lost the use of his left arm five years earlier to a stroke.

Ron’s journey with Diabetes began more than 15 years ago. It started with a blood sugar level of 640, just 10 units shy of the point at which organs start shutting down. Prior to his diagnosis, Ron was unaware that Diabetes ran in the family. The oldest of 10 kids, Ron quickly learned that he wasn’t alone in this journey. Although no one had previously talked to him about their chronic disease, after he learned of his Diabetes, he also learned that both his parents and all of his siblings were diagnosed with the same fate.

When Dr. Pate first detected that Ron had Diabetes, he started Ron on a prescription of pills and sent him to Diabetes Educators Pam Doebelling and Sue Sigurdson. Because medications are only effective for a given amount of time, Ron got to a point in his life where he needed to make a choice about what to do next. And, approximately six years ago Ron choose insulin shots, a common decision and one that many people living with diabetes choose.

Recently, Ron was faced with another decision – continue insulin shots or try something else. With the help of Miranda Weaklend, Tri-County Health Care’s newest Diabetes Educator, Ron was introduced to the Insulin Pump. Rather than spikes and jolt of all the insulin units at one time like you get with the shots, an insulin pump gives a steady flow to your body, working much more like a working pancreas. The pump would allow Ron to correct his insulin with precision.iStock_000002701372_Large

Initially, because Ron doesn’t like change, he said “No.” Through education and conversations with Miranda, Ron learned that pumps can be pretty amazing things and can help lead to lower A1Cs and fewer low blood sugar events. Saying yes, was a courageous new step for Ron in his diabetes management.

And, while learning the infusion pump is scary and frustrating for most newly diagnosed patients, Ron was justifiably frustrated learning a task that generally needs two hands. “I could see the wheels spinning in his head as he was trying to figure out how to adapt what needed to be done and how he could do it with the use of just his right arm,” said Miranda.

Change is scary when you don’t know what is involved, admitted Ron. Yet, if you have a good educator that can show you how it works and you can call when needed, the easier it is, he said.

Paper bag with the word diabetes filled with healthy foods

A healthy lifestyle is an important part of diabetes management.

Ron was quick to add that the infusion pump is only as good as the user. If you aren’t honest or accurate with your carb counting, you don’t consistently check your blood sugar and you don’t do all the regular stuff involved with diabetes management, you won’t get accurate results. An insulin pump is no magic solution, they do exactly what you tell them to do with the information you input. Since having the pump, Ron has not had an incident of high blood sugar. And, he can feel a difference, physically. He is not so groggy, he has more energy and according to his wife he is even bossier.

With the infusion pump, Ron doesn’t have the safety net of that long last lasting insulin in his system, but like many things in life it’s a compromise. With the insulin pump, Ron receives smaller doses of rapid acting insulin every few minutes. It responds more like a non-diabetic pancreas, giving Ron more control and flexibility.

Learning to live with Diabetes – to check blood sugar, to count carbs, to choose healthy food options – these are permanent life changes, and they are tough. And, having a machine as your constant companion can honestly get annoying. Yet, according to Ron, all of those moments pale in comparison to how hard work, the support of his wife and the dedication of Miranda, his diabetes educator, and the rest of his medical team keep him alive and well.

Want more information?
For more information about Diabetes Education at Tri-County Health Care, contact Miranda Weaklend, Registered Dietitian and Diabetes Educator at 218-631-7471 or via e-mail at

Support Group Information:
Tri-County Health Care offers a support group for people living with Diabetes. Anyone with an interest in understanding more about Diabetes is invited to attend. The Diabetes Support Group meets the second Monday of each month at 3:30 p.m. at Tri-County Health Care’s Wadena campus. Please visit the front desk for meeting location. Click here for more information:

About the author:
Ron Grewe has lived in Bertha, Minnesota most of his life. He graduated from Bertha High School and worked at the Creamery in Eagle Bend until it closed. He then moved to the Twin Cities area where he lived for four years before returning home and buying a farm. He and his wife, Karen, have been married for 52 years.


I-CAN Prevent Diabetes

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Pat Lorentz (in red) celebrates Christmas with her children and grandchildren.

Pat Lorentz (in red) celebrates Christmas with her children and grandchildren.

With a family history of diabetes, Pat Lorentz was worried about her health. When she received her pre-diabetes diagnosis and was advised to take prescription medications to help her avoid being diagnosed with type 2 diabetes, the Wadena native knew she had to make some lifestyle changes. After hearing about a new, free program called I-CAN Prevent Diabetes (offered by Tri-County Health Care in partnership with the University of Minnesota Extension) she decided to give it a try.

Utilizing a group approach, participants in the ‘I CAN Prevent Diabetes’ program find support and offer encouragement to one another. The trained program facilitator educates participants about pre-diabetes and shares practical approaches on how to feel better and become more active in every part of their life.

The class met for 16 weeks and continued with individualized monthly support and additional learning sessions to round out a year of support.

Within 16 weeks of weekly sessions, Pat lost 12% of her weight, nearly double from the original goal shared by Marilyn Hofland, U of M program coordinator. She is down two dress sizes and with daily walks at Sunnybrook, Blacks Grove and the Maslowski Wellness and Research Center she continues to lose weight.

“The sessions were very informative and motivational,” said Pat. “Most days I get a minimum of 60 minutes of exercise a day, instead of the 60 minutes of weekly exercise I was getting prior to this program.”

In addition to losing weight, Pat was very proud to learn at her last appointment that her A1C had gone down enough for Shaneen Schmidt, MD, to take her off her pre-diabetes medications. “It is nice when other people notice the weight loss,” said Pat. “But, the main thing is that I am off my medications and I can tell a difference. I want to be healthy and watch my grandchildren grow up.”

Each session consisted of a weigh-in, a healthy snack and general information and sometimes exercise activities. Pat’s favorite part was the accountability that came from meeting others with the same battle. The group supported each other, celebrated accomplishments and kept one another accountable.

Pat Lorentz loves spending time with her grandchildren. They are one of her reasons for participating in the “I-Can Prevent Diabetes” program and her motivation for staying healthy.

Pat Lorentz loves spending time with her grandchildren. They are one of her reasons for participating in the “I-Can Prevent Diabetes” program and her motivation for staying healthy.

“I have learned that label reading, portion control and journaling what we eat is very important for consistent weight loss,” said Pat. “The main thing was being aware of what we were eating and being less nonchalant about the food in our mouth. I learned when times were stressful to make better food choices.”

Pat believes that we should be accountable for what we put in our mouth, but that doesn’t mean we can’t enjoy our food. She is an advocate of the 90/10 philosophy – 90 percent of what you eat should be good for you. “And, if you don’t enjoy it, don’t eat it!”

If a doctor is telling you that your numbers are creeping up, or if you are pre-diabetic, Pat encourages you to learn more about “I Can Prevent” program. “There is so much to live for, and these sessions are held in a positive environment and really focus on teaching us to make balanced choices. It made a huge difference for me,” said Pat.

icanpreventRisk Assessment:

Do you think you may be at risk for diabetes? Take this short, 10-question CDC (Center for Disease Control) questionnaire to assess your risk. Always speak with your doctor about any medical decisions.

About this program:

Tri-County Health Care is pleased to partner with the University of Minnesota Extension to offer the ‘I CAN Prevent Diabetes’ Program. In this FREE program, participants learn how to create a healthier lifestyle and to help them prevent the onset of diabetes. Participants will meet with a trained life-style coach to learn how to lose weight, eat healthier and increase physical activity.

The I-CAN Prevent Diabetes program will be kicking off with a new group later this fall. You are invited to be part of this exciting opportunity! If you are interested in participating, please contact Sara Stone, TCHC Medical Social Services Manager at

Watch other participants speak about the program…