Community Table: Nutrition, Health + Wellness in the Black Diabetes Community

This content originally appeared on Beyond Type 1. Republished with permission.

By JDRF-Beyond Type 1 Alliance

During our second Community Table discussion, Beyond Type 1 sat down with a group of experts and community members to discuss nutrition, health, and wellness in the Black diabetes community, and share helpful resources and perspectives. Watch the discussion in full!



Speakers included:

  • T’ara Smith, who served as the moderator for this event, was originally diagnosed with type 2 diabetes in 2017 but was re-diagnosed with LADA diabetes in 2019 and is Senior Manager of Beyond Type 2.
  • Keith Crear, who has lived with type 2 diabetes since 2017, is a sports photographer and multimedia specialist.
  • Alexis Newman, who has had type 1 diabetes for 37 years and is a registered dietician.
  • Dex Geralds, who has had type 2 diabetes since 2016 and works as a personal trainer and CrossFit coach.
  • Joy Ashby Cornthwaite, a dietitian and a certifies diabetes care and education specialist.

Partial transcript of conversation below, edited for content + clarity.

What does wellness mean or look like for you, and has your diagnosis changed the way that you live?

Dex: It’s balance. I know a lot of times when I’m with people who don’t typically know about diabetes, there’s a lot of things surrounding food that they believe I cannot have at all. Once you find the balance, you’re able to still eat some of the things that you’re eating before your diagnosis, maybe not at the same amount that you were eating before. Just finding balance with the way you eat, balance in the way you exercise. Whether it’s like myself who exercise maybe two hours a day or just going out for a 15-minute brisk walk. Just finding balance in what comes with that. The last thing in balance is just your mental health and making sure you check in with yourself and your feelings and your emotions and figure out what brings you happiness and joy.

Keith: It is a balance. It’s knowing what to eat, what not to eat, what to consume, when to consume it. Exercise is very, very important.

Alexis: For me, what it looks like is making sure that I am well, not only with how I’m eating, but also exercise. Making sure I’m honest and checking in with my friends and family, my support system, too. Also, the spiritual aspect of it. I’m a Christian, so making sure I’m connected in the sources that I feel encouraged in. When one of those are kind of out of whack, I don’t feel well.

Joy: I think of health on a continuum, and I encourage that in every day. In my family life, in my personal life, but also for those who I help to balance their journey with diabetes because everyone has their own journey and their whole complete individual. When someone comes to a session with me, I find out where on the continuum you are and what can we work on today? It has to come from you. It has to be what you want and not necessarily what I want. But I’m going to use my skills to get you to where you need to be.

What misconceptions have you encountered pertaining specifically to Black people with diabetes when it comes to fitness? What is some of the ways that you’ve helped your Black clients move past those stigmas and misconceptions?

Dex: The biggest thing is support in our community and in the world in general. If you’re overweight you get looked down upon and that can add to depression and lead to worse things. I know a big term going on right now is “unlearning” and taking everything, looking at it through a different scope, and then figuring out what brought you to this point and then what can I do to change this. It’s not just a one-stop shop kind of thing. It’s going to take a while for you to start to see changes for the most part. You have to create these better habits and getting through that way.

Learning to love yourself is vital, and when you learn to love yourself you want to do the things that’s right for you and you’re going to quiet that outside noise and put your blinders on and work for yourself and not think about the negative things that you might be getting from someone else. My family has a history of diabetes and obesity. My oldest sister, she’s lost 150 pounds now, but still just over 400 pounds. I remember things people would say to her growing up. Now that I support her and my family’s supporting her, she’s been on this incredible journey and losing weight because now she feels confident enough to do the things that once scared her or felt ashamed about. Being able to conversate and talk to my sister, or just clients in general, I’ve been able to learn what’s going on and been able to apply that to them in their journey in fitness.

Alexis: The kind of things that I’ve seen is that they believe that people think they’re lazy so they don’t want to push through that because they’re afraid of what people are going to think. I’ve also seen the fear of not knowing what to do overtake them in my discussions with my patients. Another idea is that they have this perceived idea of what exercise looks like, so really breaking it down into bite-sized pieces of like, “Look, as long as you’re like being consistent with the movement, whatever you choose to do, you can add on time, you can add on intensity. But, as long as you’re out there trying to move.” Those are the things that I have conversations with my patients about in terms of fitness.

Another thing too, is that an ideal weight of someone who’s African American may not be similar to another culture or race. We need to keep that in mind as we are discussing food, nutrition, health, and weight that the ideal weight that a doctor may have for you may not be appropriate. I think that needs to be said and also needs to be addressed when we’re talking to these patients about weight and health and glucose numbers and things like that.

Joy: When it comes to fitness, one of the great disservices, especially for the Black community, is to tell people that they need to lose weight if they’re moving. For many people who are living with diabetes, movement doesn’t always equate to weight loss. It also doesn’t always equate to better blood glucose values.

There’s a lot of things that go into thinking about exercise. When you’re telling someone that it’s going to make them better to exercise and they’re saying that their blood glucose is either crashing or going up way too high with exercise there’s a disconnect. You haven’t heard what they’re saying to you. You need to find out what people are experiencing in their exercise journey and then address those things and say, “Look, you may not lose weight, but let’s check your blood glucose before and after.” Celebrate the win over either the hyperglycemia that you have been feeling or the hypoglycemia that you were feeling if you didn’t pre-exercise meal or whatever reason. Celebrate the win that is more than weight.

How can we celebrate our culture or different types of Black cultures throughout the year, not just during Black History Month?

Joy: Support each other. I know for years I felt like I was the sole person saying, “Black people aren’t making ourselves sick with diabetes.” We need help. We need medications. We need diabetes health care and management. We need to know how to take care of ourselves and we don’t have to do that alone. Whatever we need to do we need to support each other and do it together and then we’re louder.

Dex: Our culture is so vast and rich, and it needs to be shared every day and whatever way possible. Whether it’s through social media or just through conversation or the way you dress, the way you wear your hair. It just needs to be expressed and be out there for people to see and enjoy and learn. I love my culture so much.

Alexis: Buy Black. There are so many amazing Black companies, I’ve been focusing on and amplifying those businesses on social media and telling my friends. I’m in a friend group and we’re talking about face care. I’m like, “All right, I’m using this” and they’re using this Black company. We’re just sharing information of these amazing Black companies that are out there. If we can’t do that, then no one else is going to. It’s really important to invest in Black businesses because they’re everywhere.

T’ara: Yes, please support Black businesses that you see, especially in the diabetes community. There’s so many Black people in the diabetes community who have businesses and organizations who could use amplifying on your social platforms. That social sharing could do a whole lot because you never know who can see their products, so please amplify it.

Keith: Constant delivery of content from Black creators. Constantly delivering things from Black history that could be done every day. The way you wear your hair, the clothes. Just something that constantly keeps it in the public eye so it’s not condensed down to just one month. There are a lot of people out there that are doing it and it’s always great to see that. If more of us continue to do that it’ll shift the narrative and it will shift the visual aspect of how we’re seen in society as a whole.

Source: diabetesdaily.com

COVID-19 Vaccine for People with Diabetes: What’s Going On?

The COVID-19 vaccine is here, and like most things dealing with the pandemic, the rollout of both the Pfizer-BioNtech and the Moderna vaccines has been a nightmare. The Trump administration’s Centers for Disease Control and Prevention (CDC) Advisory Committee for Immunization Practices (ACIP) released loose guidelines for states to follow in determining how to disseminate the vaccine but has largely left most of the decisions up to the states. Most people don’t yet know when they’ll receive the vaccine, and on the whole, most states are still in phase 1a, disseminating shots to frontline healthcare workers and those living in long-term care facilities.

In their initial recommendations, people with type 1 diabetes would receive the vaccine further down on the priority list, along with healthy individuals under 65 years old. People with type 2 diabetes are classified as, “at increased risk for severe COVID-19–associated illness”, and are thus to be given priority access in phase 1c, along with people who suffer from other conditions, such as cancer, heart failure, sickle cell disease, chronic obstructive pulmonary disease (COPD), and smoking. Type 1 diabetes is classified as, “might be at increased risk for severe COVID-19-associated illness”, to be given access in phase 2, with other conditions such as being overweight (BMI >25), and suffering from neurologic conditions.

This would put people with type 1 diabetes in the general population rollout, months after not only people with type 2 diabetes have gotten their shots, but behind many other chronic conditions, too. This is a harsh slap in the face for a community that could face so many negative consequences should they contract the virus (not to mention people with diabetes make up 40% of all COVID-19 deaths).

But recent data has come out that people with type 1 diabetes suffer from mortality from COVID-19 at similar rates as people with type 2 diabetes, and a study conducted by Vanderbilt University said people with either type 1 or type 2 diabetes who have COVID-19 have three to four times higher risk of severe complications and hospitalization as compared to people without diabetes.

Several more studies show that having type 1 diabetes is potentially even more dangerous if you contract COVID-19  than having type 2: A Lancet Diabetes & Endocrinology study published last year looked at medical records from the National Health Service in England to conclude that the risk of dying from Covid-19 was almost three times higher for people with type 1 diabetes and almost twice as high for type 2 than for those without diabetes.

In Scotland, another Lancet study said being admitted to an ICU or dying was more than twice as likely for type 1 diabetes patients and nearly 1.5 times more likely for type 2 diabetes patients than for people without diabetes.

People with type 1 diabetes have been told that they live with a disability the entire time they’ve lived with this incurable illness. We’ve sat on the sidelines while going low, been discriminated against in the school and workplace, shut out from certain industries and employers, and know the unique and awful feeling of our skin tightening from a hyperglycemic event after our pump failed for the umpteenth time in our sleep. We require special accommodations, a militant watch on our medication, exercise, insulin, and food intake, and are never offered a break, a day off, or even a hint of affordable insulin.

We live in the unique situation of a dual-reality: having a chronic condition, yet feeling its invisibility every day. We’re never quite “sick enough”; we never “look” diabetic; sometimes, we feel like we don’t even “deserve” the meager accommodations that we get (always pre-board flights, because you’re allowed to!). We live every day with the knowledge that our life expectancy is likely shorter, our days are harder, and especially during this pandemic, many of us have lived in fear of a serious complication should we contract COVID-19 and the bleak consequences we could face. Many of us have stayed home, shut-in, and waited this out, while watching some of our able-bodied peers continue to ignore public health protocols and guidelines.

The end result of the CDC’s recommendations burns and is tangible: states, including Iowa, Illinois, and Virginia, are prioritizing dissemination of the vaccination to people living with type 2 diabetes before people living with type 1 diabetes. Simply put: we’ve been told to stay in, shut up, and wait it out for the vaccine, due to our fragile health condition, and now that the vaccine is here, our disability is yet again being ignored.

Yes, type 2 diabetes is being prioritized and that is right, good, and important, but type 1 diabetes needs to be prioritized, too. They’re not mutually exclusive. Currently, the United Kingdom is not differentiating between type 1 and type 2 diabetes; they are prioritizing people who have either type. Other countries are following suit.

On Tuesday, the Trump administration reversed course, adopting part of president-elect Joe Biden’s distribution plan, advising states to prioritize everyone over the age of 65 and any person with a chronic condition to get the vaccine as soon as possible; states have yet to officially adopt these plans on a wide scale.

Recently, several letters were sent from various diabetes advocacy organizations to the CDC urging them to reconsider their guidelines. Organizations such as T1International, Mutual Aid Diabetes, The American Diabetes Association, JDRF, Beyond Type 1, Children with Diabetes, The diaTribe Foundation, DiabetesSisters, and T1D Exchange have lent their voices to make the needs of the 1.6 million people living with type 1 diabetes in America known.

The bottom line is that we need to curb the tide of this pandemic. Almost 400,000 Americans are dead, with a holiday-related surge in cases, hospitalizations, and death on the way. We need to get shots into as many arms as quickly as possible and stop telling some of our most vulnerable populations that, yet again, they aren’t sick enough to qualify, and that they can wait. We can’t.

Source: diabetesdaily.com

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