It takes teamwork to treat diabetesIt takes teamwork to treat diabetes
Interaction with other patients helps patients who suffer the disease, which affects more than 29 million people in the US.
By Noelia González @NoeliaGMo
Diabetes is a family matter, and Nilka Ríos-Burrows knows it. As an epidemiologist at the Centers for Disease Control and Prevention (CDC), she's used to repeating the same message: diabetes can be prevented.
Her aunts and uncles on her mother’s side in Puerto Rico have the disease, and Ríos-Burrows is aware that she is also at risk of suffering from it. That's why she puts her own advice to practice and takes preventive measures to keep the disease at bay.
When her relatives were diagnosed with the disease, “the knowledge that diabetes could be prevented” was not available, she says. “I am at risk.”
Ríos-Burrows has quit drinking sweet beverages, started limiting her carbohydrates and tried adding more vegetables to her meals. Doing exercises and seeing a physician regularly are other healthcare measures that people like her can take.
In addition to genetic predisposition, other risk factors for diabetes include lack of physical activity, weight, age, diet and even ethnic background. Although these factors are the same for all population groups, Hispanics and other minorities are more predisposed to diabetes. It is estimated that half of all Hispanics – men as well as women – develop the disease.
In 2013, diabetes was the seventh leading cause of death in the United States, where
every year more than 200,000 people die of this disease, according to a report that the CDC publishes every two years. Their estimates indicate that more than 29 million people in the US suffer from diabetes, whether it has been diagnosed and not. This number is greater than the entire population of the state of Texas.
Meanwhile, it is estimated that 86 million adults in the United States have pre-diabetes, which can lead to type 2 diabetes. It is also believed that nearly 8 million people suffer from diabetes and do not know it.
During the last three decades, the number of adults with diabetes has practically quadrupled and predictions based on the latest data indicate that by 2050 one out of every three adults in the country might have diabetes.
The report says that one of the reasons that explain why there are more people with diabetes is that
those who have the disease now live longer, due to improvements in personal care and advancements in healthcare.
The CDC also suggests that the latest figures are good news: the diabetes epidemic may be slowly decreasing. Nevertheless, this is not the case for minorities. The Hispanic and non-Hispanic black population and those people with less than a high school education are not following the same trend. According to the latest report from the CDC, based on the most recent national data for diabetes, 12.8% of people with diabetes are Hispanic, compared to 7.6% for non-Hispanic whites.
But the trend may also change for the population of Latino origin, Ríos-Burrows emphasized. The first step is staying informed about how to prevent the disease from developing.
On a general scale, the
Healthy People 2020 national plan establishes some of the objectives with respect to the practices in the preventive care against diabetes, aimed at reducing the number of people with this disease during that year. These include starting with a dilated eye exam, including a foot exam and finally checking levels of glucose in the blood.
But one of the preventive measures that is also recommended is attending classes on the personal management of diabetes, a venue where patients learn, for example, how to control their own levels on a daily basis; about the consequences of the disease and how to recognize the symptoms.
The most recent meeting of the group of Hispanic patients that gets together once a month at La Clínica de la Raza, in California, focused on how to recognize a stroke, one of the possible consequences of diabetes, and what action to take.
The group of around 15 people, consisting many of women, and where everyone speaks Spanish, sometimes the only language, meets monthly in Fruitvale, at one of La Clínica’s centers. The organization, a network of 40 service centers for primary and preventive care, serves more than 91.000 patients in three counties in California. The patients who go to La Clínica tend to be Hispanic, with and without medical insurance, and with and without documents, but all have something in common: low economic means.
“I believe the difficulties these people face have to do with money, housing and violence, if it turns out they’re living in an unsafe neighborhood,” Carlos Flores, a health educator at La Clínica, told Univision Noticias. Flores is the one who leads the group on personal management of diabetes together with a physician and a physician’s assistant.
Flores explained that for those who have little money it is more difficult to eat in a healthy manner, and prevent stress related to housing, money, the children and the general setting. For example, it is difficult to do any exercise in a barrio that is not safe, Flores said.
The monthly classes have a central theme, such as strokes, and in turn, the patients have the opportunity to meet individually with the physician, who usually follows up on the person’s condition and their medications, or refer them to other clinics or labs. Individuals can also control their blood sugar levels, their weight and their blood pressure.
Overcoming the Fear of Insulin
According to Flores, another one of the topics that is emphasized at these meetings is that of insulin, one of the treatments the Latino population
tends to look at with skepticism. “Most people in the group don’t want insulin,” said Flores, who explained there are different myths about it.
There are those who are afraid that insulin causes blindness, or they associate it with drug abuse, or they are afraid of negative side effects from insulin in general. “I believe much of this has to do with people’s experience with family members in their own countries,” who die shortly after beginning their treatment. However, this is due to the fact that when these patients are given insulin they are already in a bad way,” the health educator explained.
Flores said that in the group there is an attempt to talk about insulin as much as possible and about the benefits of this injectable medication. “Basically, we try to normalize it,” added Flores, who said that the message from the American Diabetes Association is that
most people diagnosed with the disease will need insulin at some point.
In fact, there have been some “successful cases” of some patients who have begun insulin treatment after hearing the experience of other patients.
The interaction with other patients, even with their own families, is another one of the positive aspects of these classes, said Flores, who recounted that the venue definitely works as a support group where the participants, who share the same concerns, often become friends.