A few years ago, Diane Turner Jackson went to the pharmacy to fetch medicine for his uncle and injected insulin.

She was confused, and confronted him face to face about his illness, but he argued that he didn't know.

It wasn't until Turner Jackson opened Eddie Park's closet door that she suddenly realized that her uncle had type 2 diabetes for many years and was skilled in keeping secrets from family and friends.

There are dozens of unused syringes and bottles filled with insulin in the closet.

"They sent it to him, and he put it in his closet," Turner Jackson said, sitting on the sofa at the South Linden house she shared with her mother.

"He started using it, he knew how to check his blood, but somewhere (on the way) he was completely shut down."

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After this discovery, Turner Jackson said that she acted quickly and became Parker's primary caregiver.

She and her cousin started taking him to the doctor, injecting him with insulin, and taking care of him when his condition deteriorated and he was admitted to the hospital. 

During his stay, Parker developed peripheral edema or swelling of his feet, ankles and legs.

He was unconscious due to multiple urinary tract infections and would remove the PICC catheter, which is a catheter inserted into a vein in the upper arm to provide medicine or liquid nutrition.

Parker eventually died of complications from diabetes on February 11, 2020, the night before he was discharged from the hospital, and was taken care of by his wife at home. He is 81 years old.

Parker’s death was one of the main reasons why 66-year-old Turner Jackson and her 85-year-old mother Shirley Turner signed up for the free diabetes prevention program provided by the Carmel Mountain Health System.

Last fall, they discovered within a month that they both had pre-diabetes, or were at risk of chronic health conditions, that is, the body could not make enough insulin, or could not use the insulin it made well. 

According to the state health department, in 2018, nearly 1 million Ohioans (approximately 11% of the state's population) were diagnosed with diabetes. 750,000 adults in Ohio have been diagnosed with prediabetes, and an estimated 1.3 million prediabetes remain undiagnosed.

Insulin regulates the amount of glucose or sugar in the blood. According to the US Centers for Disease Control and Prevention, too much glucose can cause serious health problems, such as heart disease, vision loss, and kidney disease. 

"I thought,'I don't want my mother to experience this. I don't want anyone in our family to experience this,'" Turner Jackson said.

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49-year-old Kelvin Ruffin suffers from type 2 diabetes about a third of the time.

He is a community health worker in Mount Carmel, and over the phone instructs Turner Jackson and her mother on how to reverse prediabetes through diet changes and weight loss.

Ruffin said that if someone has a high blood sugar level, they are considered to have prediabetes, but not enough to be considered a diabetic.

"What they want to look at is your A1C. If your A1C is between 5.7% and 6.4%, you are considered pre-diabetes," he said, referring to a blood test that measures average blood sugar levels over three months.

Ruffin said that once someone is diagnosed with prediabetes, they need to lose 5% to 7% of their body weight—for a 200-pound person, it takes about 10 to 14 pounds. He added that they can do this by changing their diet and participating in moderate activities for at least 30 minutes a day.

As a diabetic, Ruffin suffers from neuropathy or nerve damage in the feet and an eye disease that can cause blindness. "I have to check my eyes frequently," he added. "Now, not everyone will experience this. But some people may."

Since its launch in January 2018, he has been involved in Mount Carmel's prevention plan.

"I really don't want people to suffer like me," Ruffin said. "If I can help a person delay or prevent type 2 diabetes, I think I have done a great job."

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The 26-hour free plan in Mount Carmel is one of the few programs dedicated to diabetes prevention in the Greater Columbus area. Once someone is diagnosed with prediabetes, Mount Carmel will contact them with community health workers, such as Ruffin, who will advise them on how to make lifestyle changes. 

Elana Burak, the health case manager of the Columbus non-profit organization, said that LifeCare Alliance can provide consultations with dietitians for people with prediabetes, provided their insurance covers their diagnosis. She added that Medicare of Medicaid does not include pre-diabetes counseling.

According to its website, Ohio State University's Wexner Medical Center also provides self-management education programs for patients with prediabetes, but patients must be referred by a doctor before they can schedule classes. 

As part of the Mt. Carmel prevention program, Ruffin instructed Turner Jackson and her mother to record the number of grams of carbohydrates, calories, sodium, and sugar they consume each day.

He provided a cheat sheet to warn them of what to pay attention to in terms of ingredients, and told them not to eat processed foods and fast food, and to cook more at home.

This proved to be a small challenge because the mother and daughter like to eat out. But moderation is the key. 

"Every once in a while, I will eat a piece of Popeye Chicken." Shirley said with a smile.

In terms of the types of meals that Turner Jackson and her mother cooked at home, there was little change, but the ingredients changed. 

"Kelvin tells us that we can eat whatever we want. We just need to read the label," Turner Jackson said. "This is the key."

"Biscuit, biscuit," Turner Jackson said, pointing to Shirley, who rolled her eyes in her daughter's direction. "I have to say,'Mom, we have to push those cookies away. Let's stop buying cookies or rationing them.' So this is where reading labels is really convenient for us."

The two stayed active by using the 200-meter elevated walkway in the New Linden Community Center.

Turner Jackson shuddered at the thought of not knowing that she and her mother had prediabetes before the diagnosis. They encourage all Ohioans to undergo regular inspections.

"Don't be afraid to find out," Turner Jackson said. "Overcome fear because it will be in your best interest in the long run. It's like a time bomb, you don't even realize it.

"We need to know. We need to be our champions."

Monroe Trombly reports breaking and hot news for Dispatch. You can reach him at atmtrombly@dispatch.comor614.228.6447. Follow him on Twitter @MonroeTrombly.