Start by telling us about yourself and what your interests are related to diabetes, or if you, yourself are affected by diabetes personally or through a family member?
I am a Registered Dietitian, Certified Specialist in Renal Nutrition, & Certified Diabetes Educator. My husband & I have been married for about 2 years & are expecting to add a member to our family early next year. I love to bless my friends & family with baked goods & cooked meals. I love the field of dietetics & the opportunities I get to have in order to empower my patients with nutrition-related knowledge to assist them in making healthier lifestyle choices. I currently work in dialysis which is a challenging field from dietary to emotional hurdles. However, my joy comes from being able to see my patients overcome those challenges through the ownership of their condition & making decisions to improve their quality of life.
I was first drawn to a career in diabetes education during my dietetic internship about 4 years ago. I found the diabetes disease process & how dietary changes could significantly impact blood sugar control fascinating. During my internship I realized that through diabetes management education, one with diabetes could live a long life with minimal complications by keeping blood sugars under control. This impacted me personally because I am half Mexican and a mix of African American. Thus, I knew that I was at a higher risk for diabetes based on my ethnicity. My grandpa had been diagnosed with diabetes towards the end of his life & was in denial regarding his condition. Thus, he did not manage his diabetes, which ultimately ended up with him having below the knee amputations on both legs, & eventually he lost the will to live. As I learned more about the diabetes disease process & ways one could make lifestyle changes to prolong or prevent diabetes-related complications, I became more passionate about helping those with diabetes learn how to better manage their blood sugars & set personal goals to improve their health outcomes.
What made you decide to choose the career path of a CDE?
After I became a Registered Dietitian in 2012, I began working at a diabetes education pharmacy where I worked with a dietitian with her CDE. She taught me so much about how dietitians can empower those with diabetes to make healthier lifestyle changes to prolong or prevent diabetes complications. As I began counseling patients with diabetes, teaching diabetes-related classes, & working with patients at a high risk for diabetes complications, I realized how rewarding a career in diabetes education is & made my decision to pursue my CDE.
If you could say one piece of advice to a newly diagnosed patient or family member what would that be?
You are not alone. Be honest with your feelings & emotions. Ask questions from your healthcare professionals & join a diabetes support group. Diabetes is not a death sentence, but an opportunity to make healthier lifestyle changes.
Do you have an example of a situation where you went above and beyond for a patient or their family?
Currently I work with dialysis patients that do their treatments at home. Many of our patients are on Peritoneal Dialysis (PD), in which they let a sugar based solution dwell in their peritoneal cavity for a specific amount of time.
Many of my PD patients are also diabetic, thus blood sugar control often becomes an issue. One of my PD patients with diabetes recently started on PD & was having a very difficult time controlling blood sugars. The patient’s blood sugars would range from 300’s to“Hi” on the glucometer. Over the course of 2 months, I worked closely with the patient: created blood sugar & food logs for the patient to log food & blood sugars, provided several dietary education counseling sessions for the patient & family, taught & reviewed carb counting to assist with better blood sugar control, accompanied my teammates on a home visit to the patient’s house to provide blood sugar management education, I would check in with the patient every 1-2 weeks to review bloods sugars, discussed insulin dose adjustments with the patient’s nephrologist regularly, & worked with the social worker to find an Endocrinologist for the patient to see for blood sugar management.
With the help of my team, we were able to assist the patient in bringing the A1c down from 10.7 to 8.6 in 2 months. The patient now reports blood sugars in the 100s & occasionally in the 200s & is grateful for the help & constant follow up. I am still working with the patient to get the A1c down to less than 7, however, since blood sugars have been better controlled, the patient has been feeling much better & is able to do daily activities that previously the patient was unable to do.
In reference to family support, what would you tell family members just learning about their loved one’s diagnosis?
Work with your loved one as a team. Make exercise & dietary goals together to show your support for your loved one. Lifestyle changes are challenging by themselves, but especially if your loved one feels that it is his/her burden to bear alone.
Give an example of a time where you constructively dealt with disappointment, and turned it into a learning experience.
I have been working with one of my patients with diabetes over the past few months for better blood sugar control. I have spent several hour long dietary counseling sessions with the patient & family. However, a few weeks after I had met with the patient, the patient continues to make poor dietary choices causing blood sugars to stay elevated. The patient was found to be missing insulin doses & injecting the incorrect insulin doses. Although the situation is frustrating, I continue to meet with the patient & family for dietary counseling & insulin education. I have been focusing on working with the patient & family to set at least 1 small goal each time we meet & provide simple handouts to reinforce topics we discuss during sessions. Through this experience, I have also learned that the patient is in control & I can provide all the education & resources in the world, but in the end it is up to the patient to make the change.
Do you have any special instructions that you give patients in reference to exercise and increased activity levels?
I encourage patients to start small. If the patient is sedentary, I encourage the patient to set a small goal, for example: walking 5 minutes 3xs per week. I encourage patients to increase activity level as they feel comfortable & as instructed by their physician.
What is/are the most important elements of consistency in Diabetes management and control?
Having the patient set small, realistic, measurable, & timely goals. Diabetes management & control is all about the patient. If the patient is not in the control seat, changes will generally only last for a short time.
What would you say are the best methods of treating a low blood sugar?
Keep a 4oz (kid size) juice box & protein bar in the car, purse, at work, &/or at home for emergencies. Make sure to test blood sugar levels 15 minutes post juice box ingestion, if blood sugar level is >70, follow up with the protein bar. If blood sugar level is <70, drink another 4oz juice box. If the patient tends to drop so low that the patient blacks out, consider asking your physician for a glucagon pen prescription & having family & friends learn how to use the glucagon pen in case of an emergency.