Sunday, April 14, 2013

Talking to Young Chicanas and Chicanos, Latinas and Latinos about Diabetes

Last Wednesday I spoke to a class of 21 students, mostly Latinas y Latinos under the age of 25.  This is a Spanish class for heritage speakers at The University of Nebraska-Lincoln.  The professor, Dr. María Isabel Velazquez, had invited me to talk about Diabetes.  The class had finished reading the chapter in their textbook on health, and Diabetes was one of the main topics because Diabetes has become an epidemic in the Latino community.  Last June, the Huffington Post (“Latino Voices”) ran an article entitled:  “Young Latinos Have Fastest Growing Rate of Diabetes, Study Says” (click here for article). 

The Centers for Disease Control (CDC) have estimated that by 2050, 1 in 3 adults will be diagnosed with Diabetes (click here). 

Before I showed up to the class, Dr. Velazquez had told me that she had asked the students in the class if they knew someone with Diabetes in their family, or in their circle of friends, or perhaps they have been diagnosed with Diabetes. All but three students in the class claimed one or more of Dr. Velazquez’s descriptions.  When she told me how the majority of her class knew someone or had it, we both took a pause.  I felt suspended in a cloud of worry, of sadness for them. But then quickly I moved toward action-- to give them what I know.

I felt (as I always do) a great burden in speaking about Diabetes because one small speech is not really going to explain all the various aspects of this chronic disease.  I ended up returning to the class on Friday so I could clarify a few points. 

Speaking to young adults about Diabetes is difficult.  The majority of young Latinas y Latinos are thinking about their futures.  They are seeing the gates of their adult lives opening, and they are stepping forward.  They don’t see how eating chips, beer, a hamburger, fries, tortillas, or horchata is a problem.  It’s what they live on to get going every day.  And this food is cheap!  They don’t have time to cook.  It’s fast food and processed food for them. 

Yet, when I walked into the classroom, I observed students who were attentive and concerned--some of them even looking scared. I reminded myself that, except for three students in this class, the rest were experiencing various connections to Diabetes and I wanted to give them all the information I could.  

I first invited them to ask me any question at any time during my talk.  Then I began with a brief and clear explanation of Diabetes, Type 1, and Diabetes, Type 2 (click here).  Then I focused specifically on Diabetes Type 2 because it is the most common, and Type 2 is what I have. Here is a link that will give you important information regarding a Type 2 diagnosis (click here).  

My main objective was to demystify the disease and to explain the definition of a carbohydrate and how our present fast food/processed diet is packed with an abundance of carbohydrates. This type of diet is causing a rise in Diabetes. I assured them that individuals with Diabetes can have a delicious and enjoyable diet while keeping the carbohydrate count low.  I also told them that I do not have the answer as to exactly what they should eat.  Each of them has to get to know her/his body, how sensitive her or his pancreas is to certain foods.  I also showed them a small book entitled, The Calorie King: Calorie, Fat, and Carbohydrate Counter that lists most foods we eat (even well-known restaurant/fast food items) and the carbohydrate count for those foods.  I told them how this book is my guide when I’m not sure about a food I’d like to try.  We discussed this section for a while.  The students wanted to know if a person with Diabetes could eat tortillas (yes, but always look at the carbohydrate count for each one). One corn tortilla can be about 10 grams of carbohydrates (depending on size). They were quite happy knowing that avocados, pinto and tepary beans, are an excellent food to eat.  I also had them consider cooking mashed cauliflower instead of mashed potatoes, because potatoes are high in carbs (think starch-- anything starchy is high in carbohydrates and low on fiber). 

Soft drinks are also major culprits in high sugar (carbohydrate) counts.  One twelve ounce can of Mountain Dew has 46 carbohydates.  And because it’s liquid, it hits the metabolic system fast and the pancreas can’t keep up with such a jolt.  46 carbohydrates is more than what I eat for a big meal.  The trick is to choose foods with moderate to high fiber (which will help slow down the jolt your body gets when food is introduced into the body) and a low carbohydrate count.  I also explained that eating three small to moderate meals a day, plus three snacks, and drinking lots of water (keeping hydrated) is important for a person with Diabetes.  This type of routine keeps the body balanced.  Skipping breakfast, lunch, or dinner, and then suddenly shocking the system with a high carbohydrate meal causes imbalance in the body. 

A student then asked me what I had eaten that morning.  I answered the following (which is often what I eat in the morning): 
boiled egg whites (0 grams of carbs),
1/2 cup of unsweetened soymilk (4.5 grams of carbs),
1/2 cup of Greek yogurt sweetened with two drops of Stevia (4.5 grams of carbs),
1/2 cup of fresh raspberries (3.5 grams of carbs)
12 almonds (2.5 grams of carbs). 

Total breakfast carb count:  15

The students were also surprised to learn that I eat an entire chocolate bar almost every day.  But it isn’t just any chocolate bar.  I thank Mary Jo Kringas, the founder of Chocoperfection Chocolate, who created the low carbohydrate/high fiber Chocoperfection bars.  One good-sized bar (the kind I like is dark chocolate with almonds) is only 3 grams of carbohydrates. (click here for my interview with Mary Jo Kringas!). 

As well, I explained that two people with Type 2 Diabetes can have different reactions to a food.  For example, a friend of mine who has Diabetes can eat a banana and her blood sugar levels will not dramatically rise.  If I eat a banana, I will see a sudden jump in glucose levels.  This is why every person who is diagnosed with Diabetes must figure out a diet regimen specifically for her or him.  What I eat may not be the best for you.  And that's why blood testing becomes so very important.  

The most difficult part of class (students were jittery about blood) was explaining the importance of blood testing because that is the only way an individual will know the glucose levels in her/his bloodstream. I offered to show the class how I test my blood, and immediately, one of the students said he couldn’t watch. A couple of weeks ago, a friend wanted to be tested, and the hardest part of the test was inserting the tiny needle (it’s called a “lancet”) into the finger.  
When I finally did it, my friend was surprised it didn’t hurt.  Companies have really designed lancets that keep the pain at a minimum.  But I’m 
not going to tell you that it never hurts.  Sometimes the lancet does hurt and the constant pricking of the finger can cause little calluses.  I’ve gotten over it, though.  Big deal.  So I might hurt for one second.  The reward is finding out what your pancreas is doing, discovering how much glucose is actually in your bloodstream.  You can’t find that out by thinking about how you feel that day.  It doesn’t work like that.  People are walking around right now as you read this posting, completely unaware that they have dangerously high levels of glucose in their blood.  The symptoms come later—and when they do come, the symptoms can be quite serious, (and it often means you have had the disease for a while.  One never dies of Diabetes.  One dies from complications of Diabetes: (neuropathy, nephropathy, retinopathy, cardiovascular disease).

Finally, I talked about exercise.  Key to managing Diabetes is exercise.  Daily walking, running, swimming, bicycle riding, yoga, -- anything that gets you sweating for over 30 minutes daily will stimulate the pancreas to produce the insulin that will clear out the glucose from the blood.  This too can be difficult because it demands discipline and motivation.  There are many days I would rather not exercise.  I just want to stay in bed all day or simply not be bothered because I have my work to do.  But without the exercise, without the body being in balance, then my attention span, my ability to do the work I need to do, is affected.

What has helped me keep the diet and exercise in check (and you may consider doing this) is my Diabetes Support Book Group.  I began this group a year and a half ago.  We meet every other week at a bookstore.  We agree on a book to read (currently, we are at the end of Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health by William Davis, and next on our list will be Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease by Robert H. Lustig, M.D.).  During our meetings, we check in with how we are doing, challenges or successes we had experienced the past two weeks, and goals for the next two weeks.  We discuss the readings.  Often we bring samples of new recipes we are trying.  There is much laughter and camaraderie.  It helps to know you are not alone. 

Later, some of the students said that they felt better knowing this information.  A number of them had been scared and worried, mainly because they had no idea what to do about the disease.  There is so much misinformation out there.

And yes—it’s true.  There is much misinformation because of the many complex aspects to the disease.  Doctors can be more of a problem than a help sometimes.  Often, doctors are too closely connected to pharmaceutical companies.  They are pressured to get patients on a drug regimen right away rather than taking the time to have their patients get educated about the disease. With education, the patient can decide whether or not she/he wants to manage it herself or himself before trying pharmaceutical drugs.  David Mendosa, a medical writer, advocate, and consultant specializing in Diabetes has the largest Diabetes website (click here).  He often writes about the dangers of Diabetes pharmaceutical drugs (click here). He advocates self-management and believes that managing the disease without pharmaceutical drugs is a much safer and more effective way to maintain good glucose levels.  

My own doctor is trying to get her patients off Diabetes drugs and on an exercise/diet regimen.  The reason?  A number of pharmaceutical drugs for Diabetes have too many side effects and cause other health problems.  The body can be trained (via exercise and diet) to maintain a low carbohydrate level.  It takes time and discipline, but it can be done in many instances—so says my medical doctor.  I believe her because I’m doing it.  I also know that in some cases (definitely with Type 1 and with some Type 2 patients) drugs (ex: insulin injections) are necessary.  My endocrinologist has told me that in most cases of Type 2, however, diet and exercise is a better way to go. If you are reading this and have been diagnosed with Diabetes, check out your options.  You have the right and the power to decide what is best for your body, and education will give you what you need to make that decision.  

It was a really good experience meeting and talking with these young Latina and Latino adults. Diabetes is now close to epidemic levels.  The more information we have, the better.  Those of us with Diabetes can live long lives.  It means slowing down the pace, taking the time to live meaningfully.  Planning meals ahead, penciling in the time to exercise, sharing good days and bad with friends and family are all very important to living a long life without complications from this chronic disease. 

¡Si se puede!  Together we can work toward stopping further Diabetes cases.  Sending all of you healing and vibrant energies!  


Olga said...

Thanks for blogging about this disease that affects so many people in our community. Students at your University are lucky to be getting this critical information in the classroom. Often we separate the body from the intellect; this is especially true in academic spaces, unless you're majoring in a health field. It's great to see health as an integral part of these young students' educacion.

Amelia ML Montes said...

Gracias Olga. You are so correct. Body and mind are linked. Each must nourish the other.

Cecilia said...

Hello, Olga. I appreciate the information about Type 1 and Type 2 diabetes. I'm assuming a person who has been diagnosed as PRE-diabetic would follow the same regiment and have a better chance of not becoming Type 1 or Type 2. Is this correct? Thank you! Cecilia

Amelia ML Montes said...

Saludos Cecilia-- gracias for your comment. I'm glad you found the information regarding Type ! and Type 2 helpful. Your assumption is correct. If you are diagnosed as having "PRE-Diabetes" it means you are very likely to have Diabetes 2-3 years later. The chances of getting it, however, are lessened by following a low carbohydrate diet with daily exercise. Sending you many good wishes. If you have any other questions, let me know. Sinceramente, Amelia