The Faces of Diabetes
Jay H. Shubrook DO, FACOFP, FAAFP
Professor and Diabetologist
Director of Clinical Research and Diabetes Services
Touro University, California College of Osteopathic Medicine
We all know that diabetes is an important issue, but why do you feel personally drawn to tackling it?
I love that diabetes is largely handled with lifestyle. I believe we can be healthy if we take care of ourselves. I love to see people thrive when they realize that their positive behaviors make their health better.
I also love the math-- diabetes has lots of math and it is fun for me to figure this out,
I love the mystery- so many providers assume diabetes is one size fits all. There are many kinds of diabetes and we now can make the treatment very specific to the person. that is very satisfying for me.
Has there been a patient with diabetes who stands out to you?
There are a couple. I am amazed how sick children can get with diabetic ketoacidosis. What is even more remarkable is how quickly they can bounce back with the right treatments. Seeing the transformation is remarkable.
I took care of a health care provider’s wife who thought she could not get pregnant because she had type 1 diabetes. This was a real devastation as that was very important to her.Together we managed her diabetes through the birth of multiple healthy children. This was a celebration for both of us.
How does the body’s care for itself work with something like diabetes? How do you apply this principle?
For type 2 diabetes-- the most common type-- the body does not use insulin properly. However, with dietary modifications, improved sleep, the right amount activity at the right time, and weight loss the body can restore much of this function. To quote an osteopathic principle, if we remove the toxins of our diet and inactivity, we can largely reduce the burden of diabetes.
Rachel Mullin, College of Osteopathic Medicine '20
How old were you when you found out that you had type 1 diabetes? How did you and your family deal with the discovery?
I was diagnosed with type 1 diabetes at age eleven. The diagnosis came in the wake of a swimming competition when I barely finished my final race due to exhaustion. Initially I was in complete denial when I received the diagnosis. I went from an Olympic swimmer hopeful to a young girl who feared the unknown. My parents and my sister handled my diagnosis with grace and unwavering support. The first insulin injection I performed was on my Dad with saline solution. The first finger stick I did was on my mom’s pinky. Their efforts to normalize my condition inspired me to become an advocate for myself as well as the diabetes community.
How do you adjust your life, in big ways or small, to living with diabetes?
Living with type 1 diabetes has been compared to a roller coaster ride. With the daily highs and lows, it can sometimes feel that achieving blood glucose in range is an impossible feat. Many people, myself included, can experience burn out due to the inconsistency in treatment and desired results. The largest adjustment that I had to make was understanding that progress supersedes perfection, and that a blood glucose reading does not define my worth.
Have there been scary moments because of diabetes? Do you worry about your health?
I firmly believe that despite having type 1 diabetes I will live a long and healthy life. My healthcare team, my family, and myself have never accepted otherwise. With the tools and education available today, complications that many patients worry about can be largely prevented. Although it does take discipline and some additional work, I accredit my type 1 diabetes with teaching me resilience and strength in times of adversity.
Clipper F. Young, PharmD, MPH, CDE
Assistant Professor and Clinical Pharmacist
Touro University California College of Osteopathic Medicine & College of Pharmacy
What does treating diabetes mean to you?
My interest in diabetes traces back to memorable moments from my childhood with my grandparents. Growing up with my grandfather, I became his close companion or his personal “diabetes police” as he fought against type 2 diabetes. Although at the time I did not grasp the intricacies of pharmacotherapy with insulin injections and the oral medications, I knew his treatment allowed him to stay healthy. I hoped that the small part I played could help control the disease and possibly cure it. During the days walking by his side to the clinic to obtain insulin injections, I always looked forward to the day when I could do more for him; the day that I would be the man in a white coat, dispensing the correct medication dosage and educating him about his medications. Sadly, my grandfather passed away from complications of diabetes in November 2000. While I would never realize the dream of serving my own grandfather as a pharmacist, I want to be able to help grandfathers around the world with their illnesses. I will always remember the days with him; my experiences caring for my grandfather have developed into the desire to educate and motivate others to conquer their illnesses as a pharmacist and as a diabetes educator.
What are some of the issues that people with diabetes have when they come into the clinic?
Patients with diabetes are more complicated in a sense that clinicians treat more than just patients’ blood glucose levels; blood pressure, cholesterol, distress levels are oftentimes important components of the treatment plans. Due to the complications that arise from uncontrolled diabetes, healthcare providers pay attention to the preventive measures and treatment options, trying to either stop the progression of the complications or manage the existing ones.
What sets a diabetic patient apart in how you treat them?
Some patients have been dealing with type 2 diabetes for over 5 or even 10 years, but their knowledge on this chronic condition can be rather limited. As a result, patient education becomes a big part of my job. With an incomplete understanding about diabetes, many patients do not fully see the importance of being adherent to their medications to not only manage their blood glucose levels, but also prevent complications led by uncontrolled diabetes. In addition, many patients have a hard time testing their blood glucose levels multiple times daily. In order to help them, a big part of the job is to focus on education with the aim to introduce changes in their behavioral patterns.
Shima Novin, College of Pharmacy '19
Co-founder of TUC Interpersonal Collaboration for Diabetes Outreach
How has living with someone with diabetes changed your day to day life? In what ways
have you adjusted to live with the disease?
I have been married for 18 years and have 3 children. Right before our 4th anniversary, my husband was diagnosed with diabetes at a very young age. At that moment, I thought of it as a death sentence. Everyone I knew who had diabetes was much older, and several had passed away due to the disease's complications. But through this journey , there were lots of ups and downs, just like my husband's blood glucose level. The Hypoglycemic moments with cold sweats, shivering, and tightness of chest just made me stronger than I think I even needed to be to cover up my fear of losing him.
From those experiences, I found that I had to choose a path to learn more about his condition. During this time, our whole family has learned a lot about diabetes, and we have all been trying to eat better and have family exercise days. As a team, not only is my husband's diabetes better managed, but we as a whole family make better decisions for eating and activity. Living with someone who has diabetes has been very eye-opening for all of us as a family.
What would you say to those who find out that they too now have to live with diabetes?
Now, I believe that having diabetes is not a death sentence. But it is an opportunity to learn more about yourself. Through this journey, it is better if other people can help. This support can be provided by the help of family members, friends, or classes provided for the management of diabetes. Being strong and not giving up is the most important step. I hope that anyone with diabetes can find a good support system and a strong belief in themselves, something like the confidence that we have earned as a family.
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