OPENPUBLICA · PUBLIC MEETING RECORD
Record of Proceedings

City of Nashua Diabetes Awareness Meeting - November 19, 2025

Board of Aldermen Meetings — Wednesday, November 19, 2025
BodyNashua, New Hampshire
SessionBoard of Aldermen Meetings
DateWednesday, November 19, 2025
StatusFILED
Video Record
0:00 / 1:05:57

Transcript — Verbatim
0:02

Thumbs up.

0:03

I think we're all set.

0:05

All right.

0:06

So we're gonna get started.

0:08

Today we have Joan Hill with us to talk about diabetes.

0:11

Joan's a registered dietitian and certified diabetes educator with over 30 years of experience, which is amazing.

0:19

That's a long time in this field.

0:22

And she works with people who not only have diabetes but also pre-diabetic to help keep them away from that type 2 diabetes diagnosis.

0:33

So after Joan goes through her presentation today, I'll talk about the anthem diabetes resources, which I think is a very important piece to today's presentation.

0:42

So I'll go through those for you.

0:44

Some you might know about, it's always good to have just a reminder of things.

0:48

And then we do have our new nutrition program that we have here monthly that we're starting in December.

0:55

So I'll talk about that.

0:56

Just as a reminder, it's the session's being recorded for those that can't come live.

1:01

So if you ask a question, just if you can be loud about it, we don't have a mic to hand around today, but um Joan can repeat your question and then give the answer out.

1:10

Because I I think that's how we decided we were going to go.

1:13

Ask questions as as the presentation's happening, so it's fresh.

1:17

Um so without any further ado, I'm gonna turn it over to Jo.

1:20

Thank you.

1:30

Sure enough.

1:31

Thanks.

1:32

So hi everybody, thanks so much for coming.

1:35

Um I'm from the Boston area, and so it was a little bit of a ride.

1:40

Glad it was great weather.

1:41

I actually twisted my husband's arm to come with me today.

1:45

Um so that's Joe Hill, which is kind of interesting because we've been married for 42 years, and it's the first time I think he's ever seen me speak.

1:54

I don't know.

1:55

No.

1:57

Maybe one or two other times.

1:59

Anyway, um, my job is to help convey to you how serious diabetes is.

2:05

Um, but you know, when I think about the way that business works, sometimes the slides come and they are not necessarily answering the questions that you want to have answered.

2:18

So the way that I really like to open up the dialogue, and it really should be a dialogue, because as you said, I didn't get your name when you came in the room, but you said diabetes is a curse.

2:31

And um, what I'd like to share with you is that it doesn't need to be if you're actually engaged in the process of how to manage.

2:39

And I know it's become extremely complex over the last 30 years that I've been doing education.

2:47

I I tell this funny story that at one time it used to be we talked to patients about insulin and one pill.

2:56

And now I talk to patients about technology using insulin, devices that they never had to use before, as well as maybe 14 different classes of drugs that one potentially can use to try and help manage diabetes.

3:13

So, with that introduction, what I'd like to do is just take a minute and ask, why did you come and what question are you hoping that I may be able to answer for you before we leave today?

3:26

And because I'm over 60, I write it on the board because I suffer from CRS, can't remember stuff.

3:37

So I'm going to just take a few minutes to ask, is there any particular question that's pressing on your mind that you would like me to address?

3:46

And I don't know the answers to everything, but I will be able to direct you to some places that you can find out that answer.

3:57

Yes, in the back.

4:04

So the question is, is type 1 diabetes still two to 3% of the population?

4:10

It is.

4:11

So when I hear people talk about the differences of diabetes, which we're gonna address in just a minute, um, a lot of people think because type 1 diabetes may has to require insulin, they think it's the worst kind of diabetes, right?

4:28

And so when I think about addressing the issues of how to manage type 1 diabetes, it's definitely a smaller population.

4:36

And it is certainly an insulin requiring treatment.

4:42

Um, but when we think about the differences that we have now from when I first started, I'll I can address that a little bit later.

4:50

Any other questions that people want to make sure I answer?

5:04

So diabetes is diagnosed when you're greater than or equal to 126 fasting.

5:14

So if you're if you're concerned.

5:31

And what is reported is that it should be on two separate occasions.

5:36

So it's not just one.

5:38

And then some people ask sometimes, is it by finger stick?

5:44

Is it by continuous glucose monitor?

5:47

Or is it by venipuncture?

5:49

So when the doctor takes blood or the phlebotomist takes blood out of your arm, it is diagnostic from the arm, not a finger stick and not uh a continuous glucose monitor at this time.

6:02

Things may change.

6:12

So the question is how accurate is the A1C that you get on the glucose monitor?

6:18

The glucose monitor name nomenclature is called a GMI, which stands for glucose management indicator, and it is not an exact measurement.

6:32

So your A1C could be different than what your GMI is if you have a continuous glucose monitor.

Discussion Breakdown — Share of Meeting
Public Health█████████████████████████████████████████████70%
Strategic Planning█████████████20%
Public Health Services█████7%
Public Engagement██3%
Summary of Proceedings

City of Nashua Diabetes Awareness Meeting - November 19, 2025

This meeting brought together City of Nashua employees for an educational session on diabetes management, prevention, and available wellness resources. The event featured a presentation by Joan Hill, a registered dietitian and certified diabetes educator, followed by an overview of Anthem's condition care programs, the LARC digital prevention tool, and the city's new on-site nutrition counseling and walking challenges. The session emphasized the importance of setting realistic goals, understanding the difference between diabetes types, and utilizing employer-provided resources to maintain health.

Consent Calendar

  • N/A. The transcript reflects an educational seminar rather than a governing council vote on routine items.

Public Comments & Testimony

  • Joan Hill responded to audience inquiries regarding the prevalence of Type 1 diabetes (confirmed as 2-3% of the population), the accuracy of continuous glucose monitors versus venipuncture, and the impact of gestational diabetes on offspring (confirming a 5% increased risk for the child developing diabetes).
  • An audience member inquired about postprandial blood sugar ranges, prompting a discussion on individualized targets and the 180 mg/dL guideline two hours after eating.
  • A speaker noted that the session recording was valuable for those unable to attend live.

Discussion Items

  • Diabetes Pathology and Management: Joan Hill clarified the distinctions between Type 1 (autoimmune, insulin-deficient), Type 2 (insulin resistance), pre-diabetes, and gestational diabetes. She discussed diagnostic criteria, noting that diagnosis typically requires two separate occasions of fasting blood sugar levels of 126 mg/dL or higher, and explained that finger-stick tests are less accurate than venipuncture due to user interaction.
  • Setting Realistic Goals: The speaker emphasized the SMART goal framework (Specific, Measurable, Attainable, Relevant, Time-oriented). She shared a personal anecdote of nearly fainting due to fasting for morning blood work to illustrate the importance of making goals responsible and attainable, advising employees to start with small behavioral changes rather than extreme restrictions.
  • Anthem Condition Care Programs: The city representative detailed the "Condition Care" programs which provide 24/7 access to a care team, case managers, pharmacists, and coaches for managing diabetes, heart conditions, and other chronic issues. The program offers cost savings on supplies and helps coordinate specialist appointments.
  • LARC Digital Prevention Program: The speaker introduced LARC (Lifestyle and Risk Reduction Change), a digital tool focused on pre-diabetes management. Features include a wireless scale syncing to an app, personalized coaching, and a focus on weight loss (average 4.2% loss in 12 months). The program is free for employees and available via the Sydney Health App, though the desktop interface was noted as less user-friendly.
  • New Nutrition Counseling: The City announced a new monthly on-site nutrition program starting in December, led by Jaclyn Fedor of Nutrition Counseling of New England. Services include 30-minute one-on-one visits either in-person at the HR conference room or via Zoom.
  • Walking Spree Wellness Initiative: The city launched the "Walking Spree" portal, a step-tracking challenge free to all employees and their "plus-one" dependents. The program includes access to Les Mills workouts (yoga, Pilates, mindfulness) and offers prizes transitioning from gift cards to store credits (e.g., Whole Foods, Target). The current challenge focuses on "Maintain, Don't Gain" over the holidays.

Key Outcomes

  • Program Launch: The City has officially launched monthly on-site nutrition counseling with Jaclyn Fedor, with the first session scheduled for December 3rd.
  • Resource Dissemination: Employees were directed to enroll in the Anthem Condition Care programs and the LARC digital prevention tool via the Sydney Health App to access free, personalized coaching and resources.
  • Wellness Engagement: The "Walking Spree" challenge was introduced with a specific company code ("City of Nashua") for employee enrollment, successfully engaging 57 staff members in the prior "Fall Into Fitness" challenge.
  • Educational Consensus: The meeting concluded with a shared understanding that while lifestyle intervention (including modest weight loss of approximately 5%) is highly effective for preventing Type 2 diabetes (67% success rate in studies), individualized medical management remains critical for those with existing conditions.

Meeting Transcript

Thumbs up. I think we're all set. All right. So we're gonna get started. Today we have Joan Hill with us to talk about diabetes. Joan's a registered dietitian and certified diabetes educator with over 30 years of experience, which is amazing. That's a long time in this field. And she works with people who not only have diabetes but also pre-diabetic to help keep them away from that type 2 diabetes diagnosis. So after Joan goes through her presentation today, I'll talk about the anthem diabetes resources, which I think is a very important piece to today's presentation. So I'll go through those for you. Some you might know about, it's always good to have just a reminder of things. And then we do have our new nutrition program that we have here monthly that we're starting in December. So I'll talk about that. Just as a reminder, it's the session's being recorded for those that can't come live. So if you ask a question, just if you can be loud about it, we don't have a mic to hand around today, but um Joan can repeat your question and then give the answer out. Because I I think that's how we decided we were going to go. Ask questions as as the presentation's happening, so it's fresh. Um so without any further ado, I'm gonna turn it over to Jo. Thank you. Sure enough. Thanks. So hi everybody, thanks so much for coming. Um I'm from the Boston area, and so it was a little bit of a ride. Glad it was great weather. I actually twisted my husband's arm to come with me today. Um so that's Joe Hill, which is kind of interesting because we've been married for 42 years, and it's the first time I think he's ever seen me speak. I don't know. No. Maybe one or two other times. Anyway, um, my job is to help convey to you how serious diabetes is. Um, but you know, when I think about the way that business works, sometimes the slides come and they are not necessarily answering the questions that you want to have answered. So the way that I really like to open up the dialogue, and it really should be a dialogue, because as you said, I didn't get your name when you came in the room, but you said diabetes is a curse. And um, what I'd like to share with you is that it doesn't need to be if you're actually engaged in the process of how to manage. And I know it's become extremely complex over the last 30 years that I've been doing education. I I tell this funny story that at one time it used to be we talked to patients about insulin and one pill. And now I talk to patients about technology using insulin, devices that they never had to use before, as well as maybe 14 different classes of drugs that one potentially can use to try and help manage diabetes. So, with that introduction, what I'd like to do is just take a minute and ask, why did you come and what question are you hoping that I may be able to answer for you before we leave today? And because I'm over 60, I write it on the board because I suffer from CRS, can't remember stuff. So I'm going to just take a few minutes to ask, is there any particular question that's pressing on your mind that you would like me to address? And I don't know the answers to everything, but I will be able to direct you to some places that you can find out that answer. Yes, in the back. So the question is, is type 1 diabetes still two to 3% of the population? It is. So when I hear people talk about the differences of diabetes, which we're gonna address in just a minute, um, a lot of people think because type 1 diabetes may has to require insulin, they think it's the worst kind of diabetes, right? And so when I think about addressing the issues of how to manage type 1 diabetes, it's definitely a smaller population. And it is certainly an insulin requiring treatment. Um, but when we think about the differences that we have now from when I first started, I'll I can address that a little bit later. Any other questions that people want to make sure I answer? So diabetes is diagnosed when you're greater than or equal to 126 fasting. So if you're if you're concerned.

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