Diabetes Education in Latin America
What is the Current Situation regarding Diabetes Education in Latin America?
Diabetes has become the first cause of death in most countries in Latin America. We all know it’s not diabetes per se, but rather it’s the complications due to a lack of adequate treatments and the lack of insulin and management tools that are killing our peers.
For diabetes, there is no official statistic in most countries and therefore there are no specific guidelines to treat different types of diabetes. As a consequence, not everyone has access to very basic tools. We just do not know how many people live with type 1 or type 2 diabetes in a country like my own, Mexico. The same story is repeated in other countries.
On one hand, there are no adequate diagnostic tools so we believe that most children die without even knowing they could have a happy, complication-free, normal life. On the other hand, treatments are not fully provided and most of them pay hard consequences on health.
Unfortunately, diabetes is an absolute out-of-pocket responsibility for almost every person diagnosed in Mexico. Diabetes education is only provided in some areas and in some mostly private scenarios. I have no words to describe the amazing work that non-profit organizations do in most of our countries. They provide diabetes education, they work and organize diabetes camps and they offer Diabetes Education Diploma Courses for health care professionals that need to learn diabetes in different ways to help us all.
How about Diabetes Education for Spanish Speakers in the United States?
There are great organizations that have listened to our needs. The Diabetes Online Community has played an important role. We began looking and reading what they had to say in other languages and other countries. The Diabetes Online Community wrote about technology and we discovered devices, some groups wrote about advocacy so some of us were able to learn from their experience and became advocates. Little by little, we began building our own spaces in our language as frequently our nationality represented a challenge and also a barrier.
There are still not enough online resources in Spanish for diabetes care. Although the pandemic has helped us build and create differently. Thankfully, there are nonprofits in each country that work hard to help us learn about diabetes and that provide diabetes education and programs. We have now more bloggers than ever willing to share their experience. We are now able to find Spanish speakers in Youtube, Instagram and Facebook. However, we still need more health professionals who recognize the value of identifying these sources to help their patients find them. There is no official recommendation nor a list to prescribe these so some of us have explored and built our own.
The Association of Diabetes Care and Education Specialists (ADCES) created materials and lists for their members. Now Diabetes Care and Education Specialists can use those resources if their patients are in need for more information from peers.
This list includes some blogs in Spanish that were reviewed in content, some non-profit sites not only in the United States but other Spanish speaking countries and other resources translated into Spanish. We definitely need an update of that same information as now there are different actors and amazing peers sharing their stories and resources of their own.
The work that Mila Ferrer and I did in Estudiabetes was listening to people, identifying their needs so we could provide the information that was needed. We should remember that not all Spanish speakers will have access to health care, so it is the internet where they look for information as a first option.
In 2018, we ran a couple of surveys to understand our readers’ needs and create our working plans. In one of these surveys, we learned from 249 participants that:
- 50 percent believed people with diabetes should always be part of an online community as they felt they were not alone and could emotionally handle this disease in better ways.
- 63 percent said health care professionals should join too, to understand our needs
About my work as a Diabetes Educator in the U.S.
Part of my work nowadays involves the community. Listening to them, analyzing data and info, helping and creating materials. Our populations do not have access to very basic tools so we have to help them not only to learn diabetes but also to advocate in their countries, and in the United States if they live here as well. My work in the non-profit space includes the creation of resources and materials that I know our readers need.
We cannot forget that not everyone will have access to the internet, computer or mobile devices so we require an in-person strategy and programs and hopefully I’ll be able to provide those kinds of resources as well in the near future.
Samsun Diabetes for example has a program called Mil Familias where they provide information and services. This is definitely one good example and an organization who I look up to.
I have not been able to become a cerftified diabetes care and education specialist in the United States as I’d require a U.S.-based master’s degree and my bachelor’s degree in psychology is from a Mexican university. My work experience as a diabetes educator has been outside the United States but I’ve been helping the Spanish speaking communities since 2009 when I started volunteering for Diabetes Hands Foundation. Despite all barriers, I’ll keep working as long as the community needs me.
What are the biggest challenges for Spanish speakers in the United States in terms of diabetes education? We need to become advocates for our own health. Language and communication between providers and patients are undeniable barriers. Providers who do not speak Spanish fluently may spend less time on educational efforts that depend on communication with the patient. Translating is not the complicated part, but language has culture and culture has also language if that makes any sense.
How should health professionals address these gaps and barriers our communities have? The thing is, caring for Latinos is not only being fluent in Spanish and being able to translate. If you want to create programs for Spanish speakers, invite them to join your teams. Researchers, professors, educators, health professionals, community leaders from Latin American countries and us people who actually live with diabetes. Working in bigger teams we will be able to build stronger communities.
What is the role of the diabetes online community in helping us find info and support?
As I mentioned before, ADCES created materials for their members but we are always looking for resources for our own personal use so I’ll share some of my own go-to places.
Advocates: Marcelo from Mi diabetes in Chile, Jaime mi Dulce Guerrero, Don Sacarino in Spain, Republika Diabetes sharing technology and expertise. Educadies from Elena Sainz in México.
Non-profits: Mexican Diabetes Federation, Asociación Mexicana de Diabetes, Cuidar Argentina Association for Diabetes Care in Argentina, Barcelona’s Hospital for Diabetes, Beyond Type 1 and Beyond Type 2 in Spanish, DiabetesSisters, and DiabeFem.
