An Interview with Susan Weiner from the Science Advisory Council

1/15/19
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Susan Weiner, (MS, RDN, CDE, FAADE) is the owner and clinical director of Susan Weiner Nutrition, PLLC. She has been elected to serve as a Director, on the American Association of Diabetes Educators (AADE) Board of Directors, 2018-2020. Susan was named the 2015 AADE Diabetes Educator of the Year and is an AADE fellow. Susan is the “Diabetes in Real Life” column editor for Endocrine Today. She co-authored “The Complete Diabetes Organizer” and “Diabetes: 365 Tips for Living Well” Susan is a well-respected national and international lecturer on a variety of topics related to nutrition, diabetes and health. She earned her Master’s Degree in Applied Physiology and Nutrition from Columbia University. Susan is also a new member of the Beyond Type 1 Science Advisory Council.

When did you first become involved with diabetes?

I’ve been a registered dietitian and a certified diabetes educator for close to 30 years. Ever since I can remember, I’ve had an interest in food, nutrition, health, wellness and sports. I enjoy collaborating with people of all ages and backgrounds, which is why I began my own private practice. It’s amazing to spend time with a person, really get to know them, and work together as a team.

Can you tell me about the work you’re doing with AADE (American Association of Diabetes Educators)?

I’m honored to serve as an elected director on the 2018-2020 board of directors for AADE. Additionally, I was selected to chair the 2019 AADE-SMRC (Stakeholder-Member Relations Committee). The SMRC is responsible for maintaining effective relationships with AADE’s members, key stakeholders, and constituencies. This year, the SMRC will continue to focus on collaborative partnerships with diabetes peer support communities. We continue to expand our diabetes advocacy efforts and support our renewed vision for our organization.

AADE membership includes a robust network of practitioners working with people who have diabetes and prediabetes, as well as those who support and care for them. I’m so proud to be part of the AADE leadership team as well as a member of the Beyond Type 1 and Beyond Type 2 science advisory council!

Are there any general guidelines that you have when working someone with diabetes?

My general practice guidelines are based on actively listening to the person with diabetes, and their concerns. I never use a pre-printed copy of anything. Everything that I do when I work with a person one-on-one or with their family, is individually developed for them, with them. And that may involve, in many circumstances, narrowing in on, let’s say two goals for that week. Maybe one of the goals is to cut back on carbs that they’re eating because that may help with blood glucose management. I try to introduce low carb vegetables and nutritious meal choices that they might a person might not have considered eating before. We discuss various ways a person could boost nutritional intake, in a tasty and delicious way! We focus on very individual, specific goals, and realistic goals.

I don’t like to generalize — I’m very into savoring the flavors of what you eat, that work for you on your schedule. I work with some people who could be police officers on overnight shifts or even people who are in the entertainment industry. That’s different than someone who is a young parent, or a single parent who’s taking care of their kid. They’re on different schedules with different needs. I think the key from a provider is to be very, very nonjudgmental in your approach and with your language when you’re talking about nutrition.

What is your opinion about the role diabetes education plays in addressing health disparities within the Type 2 diabetes community, particularly among socioeconomic and ethnic groups?

Along with exciting advances in diabetes treatments and technologies, diabetes education and emotional support are a crucial part of Type 2 diabetes care. Diabetes education must be individualized and consider personal, socioeconomic, emotional and environmental factors. Health literacy concerns also affect health outcomes for people with prediabetes and Type 2 diabetes. It’s so important for health care providers to use non-judgmental and person-centered language, and respect an individual’s culture and background. It’s critically important for diabetes educators to ask a person about their journey with diabetes, and actively listen to their concerns and goals. If a person can’t afford their diabetes care, it will obviously limit treatment options and must be addressed as soon as possible. Active listening is critically important for diabetes educators in order to provide non-judgmental, practical, relevant and timely information. Communication focused on active listening is key as everyone is different!

The diabetes community is more connected than ever thanks to social media — What is the importance of social media for those that don’t fit the stereotypical Type 2 identity?

Social media and peer support communities can be an effective tool to reach millennials as well as others who are living with Type 2 diabetes. It’s important to be able to connect with people in your age group who are having a similar lived experience. Learning along with your peers is a great way to broaden your knowledge about health in general. Millennials may have concerns about life with Type 2 diabetes that may be quite different than a person in the baby boomer generation. Thoughts about dating, body image and daily diabetes care (including blood glucose checking) may change over time and therefore require different communication touch points.

How can we better serve younger populations with Type 2 diabetes, who may feel stigmatized by having it? What advice do you have for them as they deal with the emotional, mental and social aspects of T2D management?

It’s fairly common to hear from millennials and Gen Xers that they feel judged by health care providers, as well as friends and families about their diagnosis with Type 2 diabetes. Perhaps they have seen Type 2 diabetes portrayed as an “older person’s or lifestyle disease”, which can lead to feelings of shame or guilt. It’s important to connect with a positive-thinking health care team, that will support you and listen to you about your concerns regarding your physical and emotional health. Health care providers can provide fantastic support, and address the emotional and social aspects of dealing with Type 2 diabetes.

Thinking about having a chronic disease at a young age can be overwhelming for a young person. Additionally, costs associated with diabetes management can be a lot to handle. The younger generation has a lot of stress, and pressures. Adding to those daily pressures, managing diabetes can be a challenge! My advice is to talk to your health care provider or a mental health professional who may be able to offer some advice or guidance. Consider becoming involved in a peer support community, either online or in-person.

What are some misconceptions about Type 2 diabetes and obesity that visitors to the Beyond Type 2 website should know?

Two misconceptions about Type 2 diabetes is that it is an “older persons disease” and “solely a lifestyle disease”. This excludes consideration of the genetic components and other contributing factors. These statements may cause feelings of embarrassment and judgement, especially for those who are overweight. In some cases, folks may avoid medical appointments for fear of being judged by health care providers.

On a positive note, many people may view a diagnosis of Type 2 diabetes as a reason to embrace some healthier habits. The Beyond Type 2 website will provide education, information and support to help improve your overall health!

What about Type 2 diabetes management has surprised you most throughout your career?

Everyone manages their Type 2 diabetes in their own unique way. Younger people with Type 2 diabetes may hide their condition out of worry about what others think, and have may have a harder time with the financial and emotional challenges. In addition, the issue of lack of sleep and diabetes distress are issues for people of all ages who are diagnosed with Type 2 diabetes.

I’m also often surprised at the continued generational divide associated with Type 2 diabetes. Women are more likely than men to say they put others’ needs before their own, and may face more challenges with self-care, due to other responsibilities. Again, everyone is different! The Beyond Type 2 website will help folks find resources surrounding these issues and provide much needed support.