Listening Beyond the Numbers

There is much misunderstanding associated with the word diabetes.  Many people automatically associate diabetes with someone who has eaten too many cheeseburgers or drank too much soda pop.  Others believe that they can easily get over diabetes, as if it were the common cold, while some people just know diabetes as the “sugar in the blood” that killed their mama. Over 30.3 million Americans have diabetes, but how many actually understand what this diagnosis means? (1)

As the Diabetes Quality Improvement Coordinator at Shadyside Family Health Center, I have a variety of responsibilities. My favorite part of my position is providing education and health counseling to patients with type 2 diabetes.  After a patient’s appointment, we sit down and talk, one-on-one, to answer any questions that they may have about the disease. I also host monthly group sessions, in which I provide education in a larger setting. The funny thing about my position is that, beyond what I had learned in my undergraduate Biochemistry and Biology courses, I knew nothing about diabetes before starting my year with Americorps. In a quest to learn, I connected with the three unofficial “Diabetes Educator Queens” of Pittsburgh. These women taught me the tricks of their trade and emphasized the importance of being a non-judgmental listener when working with patients.

Diabetes management isn’t as simple as just eating more vegetables or going to the gym. In addition to the complexity of the disease itself, many people have other issues, such as mental health, food insecurity, and low health literacy, which make diabetes management that much more difficult.  At the beginning of the year, when I saw patients with super high blood sugar levels, I thought to myself, “Wow, this person really doesn’t care about their health.” Now, these are the patients who intrigue me most because they usually have some underlying issues that are challenging to overcome.

For example, several weeks ago, I sat down with a woman who seemed to have seen every healthcare professional in the city, yet she still had not managed to get her blood sugars into a healthy range.  We spent the first 20 minutes talking about her family and children, before ever mentioning the word “diabetes.” Eventually, our conversation evolved into a discussion about her love for cooking. Although she was open to trying new things, she simply did not know any other ways to cook tasty chicken besides frying it. I spent the next morning sorting through diabetic cookbooks to find recipes for simple alternative ways to prepare chicken for her to try instead.

While some patients ask about ways to change their diet, another patient may simply want to talk about stress they are feeling at home. Either way, all of these conversations are related to diabetes management, no matter how significant the issues discussed may seem. Progress comes slowly and is very individualized.  Rather than being just another voice telling patients what the diabetes pamphlets say that they should and shouldn’t do, my goal is to establish a relationship with each patient and meet them where they are at. Being diagnosed with diabetes doesn’t mean that you can never eat cake or ice cream again.  Diabetes management is about finding balance so that those 30.3 million Americans with diabetes, some of whom are your neighbors, friends or family members, can live both comfortable and healthy lifestyles.

This post was written by NPHC member Laura DeMers.

Laura serves at UPMC Shadyside Family Health Center as a Care Coordinator.