As a nurse, Maggie was familiar with health education since she often had to relay it to her patients. She considered herself to be healthy, and though she wished to make some changes to her weight, the thought of being at risk for type 2 diabetes never crossed her mind. In 2012, a counselor at a weight loss clinic suggested she take a test for insulin resistance. She received a surprising diagnosis of type 2 diabetes with her results. Though Maggie was immediately placed on metformin to lower her blood sugar, it took her a year to come to terms with her diagnosis. For her, acceptance meant stepping into a more proactive role in managing her diabetes.
Maggie’s primary care provider (PCP) helped her achieve lower blood sugar through medications, but she wanted assistance with goal setting and problem solving that her PCPs weren’t able to offer. She says, “The doctors don’t always have the answers, or the time to listen to the whole problem.” Fortunately, in 2016 Maggie learned of an employee benefit in which she could access services through the phone and online. This was how she came to work with Diabetes Coach Toby Smithson, MS, RDN, LD, CDE.
Working with a diabetes educator allowed Maggie to tackle goals around nutrition, fitness and diabetes self-management that fit her lifestyle. Maggie’s relationship with Toby created a sense of accountability and a framework in which Maggie could develop her own SMART goals and solutions. Having a diabetes educator meant Maggie always had a second set of eyes on her progression, ensuring that support was always available. Toby used motivational interviewing with Maggie to empower her to have certain discussions with her PCP and provided detailed reports and interpretations of meter readings. She also offered sound advice and information on behaviors and lifestyle.
The way Maggie sees it “Toby provided about 50% of the guidance. She helped me understand what a balanced diet is — and at a time when I was hearing a lot of trendy buzz words related to dieting, she helped me cut through the noise to guide me on a sustainable whole foods path.”
Maggie still plays a very active role in her diabetes management. She is the kind of person that does her own research and stays on task, but a diabetes educator helps her come up with new solutions to keep the momentum moving forward.
When Maggie was trying out a new morning workout routine, she was often interrupted by a plummeting blood sugar that would send her running for snacks. Toby helped her tweak breakfasts, so her blood sugars were manageable enough to power through workouts. Maggie sees great value in the tailored goals, support, and solutions she receives from her diabetes educator.
By working with her diabetes educator, Maggie has been able to better manage her type 2 diabetes—in fact, she is no longer using medications to manage her blood sugar. Maggie saw so much value in the tailored goals, support and solutions she received from her diabetes educator, that when she retired from nursing and lost access to her employee benefit, she continued to pay for the services out of her own pocket.
To anyone considering working with a diabetes educator, Maggie says “Just do it, the input is so valuable. They can’t manage your diabetes for you, but they can definitely help you.”
Marisabel had experienced a lot of chest pain and fatigue for the past month. She finally decided to go to the doctor and was shocked when they told her to go to the emergency room. Her blood sugar was almost at 600 mg/dL. A blood glucose of this level could lead to diabetic ketoacidosis (DKA), requiring a hospital visit, and increasing the risk of other serious complications. She spent the next five days in the emergency room, where the staff gave her a multitude of diabetes self-care information. At first, she didn’t know what to do with it all, but finally, her doctor connected a stressed and confused Marisabel with diabetes educator Sandra.
The two met, and Sandra began working with Marisabel to understand the essentials of living with diabetes. These include checking blood sugar, injecting insulin and making other lifestyle changes based on the AADE7 Self-Care Behaviors. Together they made a plan to help Marisabel lower her A1C. “I learned about the food and just got motivated by Sandra." said Marisabel. "I wasn’t thinking, ‘Oh I have diabetes, I can’t do this.’ No, I was just living my normal life.”
However, lifestyle changes weren’t the only challenge Marisabel faced – she was also afraid of needles. But Marisabel’s daughter was her motivation to overcome this fear. “If she sees me, I would pretend like it’s nothing, like it doesn’t hurt, but you know, I’m really scared,” said Mariasabel. “I would just be brave because if I don’t, I’ll get worse. Take a deep breath and just overcome your fear.”
Diabetes can take a toll on one’s mental health, but when her clients with diabetes are feeling down, Sandra tells them, “You have sick days, but you’re not sick every day.” She uses motivational interviewing and takes the time to get to know each person with whom she works. She becomes their biggest supporter and works with them to determine a treatment plan.
To those who are newly diagnosed with diabetes, Marisabel says, “Think positive. Don’t think because you have diabetes you can’t live your life. Don’t let it bring you down. Motivate yourself, see a diabetes educator and put a goal in your mind.”
Within three months of her diagnosis, Marisabel was able to lower her A1C from 9% to 6.3%, changing the course of her life and greatly reducing the risk of future complications. Most recently, she has been able to get her A1C down to 5.7 and reduce or eliminate some of her diabetes medications.
“Marisabel is a very strong person,” says Sandra. “It takes a lot of willpower and it’s not easy…but once you do, that’s the tool to success.”