Health & Fitness

Reaching out to Hispanics to prevent or control diabetes

Alba López, who has diabetes, practices lunges outside of her home.
Alba López, who has diabetes, practices lunges outside of her home. FOR THE MIAMI HERALD

When Alba Raudez was pregnant with her third child, she was told she had gestational diabetes, a form of the disease that only occurs during pregnancy.

After delivering a healthy baby girl, Raudez, 53, lived a mostly sedentary lifestyle, eating Nicaraguan food high in fat and carbohydrates. She was a stay-at-home mom for her six children and later worked full-time at a Pizza Hut, where she would occasionally indulge in more than a few slices of pizza.

Raudez knew her lifestyle was not healthy, but being uninsured, she went more than 20 years without a medical checkup. With a five-foot, one-inch frame, Raudez reached 180 pounds before losing more than 40 pounds through diet and exercise.

One night, unable to sleep and feeling ill, Raudez knew something was wrong. At the emergency room, doctors told her she was having a fifth heart attack and would have died had she stayed home and not lost weight. Raudez was diagnosed with Type 2 diabetes and would need an emergency bypass.

“I got depressed,” she said after learning she needed six bypasses. “When you go through something like that, you think you no longer have that much time to live,” she said, speaking in Spanish at her modest Miami home.

Type 2 diabetes is a largely preventable disease, kept at bay by healthy eating and moderate but frequent exercise. Those at risk can tweak their diet and lose excess weight to decrease chances.

Raudez is part of a growing number of diabetics in the United States. According to the Centers for Disease Control and Prevention, 29 million adults in the country have diabetes, and 86 million have diagnosed or undiagnosed pre-diabetes. African Americans are 77 percent more likely to develop diabetes, and Hispanics are 66 percent more likely, according to the American Diabetes Association.

With a largely Hispanic community in Miami-Dade County, several healthcare institutions are teaching their patients how to prevent or manage diabetes.

At UHealth-University of Miami Health System, Dr. Olveen Carrasquillo led a study where community healthcare workers visited Type 2 Hispanic diabetics from Hialeah to Homestead for more than a year. The workers were not medical professionals, but were trained to identify patients’ needs and to help solve them.

The five-year study concluded that patients who had a community healthcare worker visiting them had better blood pressure and hemoglobin (A1C) levels than those who did not. Raudez was one of 300 patients in the study.

Carrasquillo, chief of internal medicine at the University of Miami School of Medicine, knew that although patients were aware of how to manage diabetes, there were often personal struggles that made it difficult to focus on their health.

“These people have many other challenges in life that have nothing to do with healthcare, be it housing, be it poverty issues, immigration. Sometimes they have problems navigating the healthcare system, so our community healthcare workers will help them deal with those challenges,” he said.

The healthcare workers visited the patients’ homes about six times over the course of a year and made about 20 checkup phone calls. There were group sessions every month with cooking classes, exercise routines or supermarket field trips.

Carrasquillo said he hopes the model of community healthcare workers.

Raudez, whose mother died from diabetes and whose siblings are all diabetics, said she misses the visits from her healthcare worker who helped “rewire” her, lower her blood sugar levels and improve her health. She now eats healthy meals and walks around her neighborhood twice a day, occasionally jogging and doing lunges.

“After my surgery, doctors told me I had to eat more greens, but they tell you that and you don’t know how to eat them,” she said. “All of this disease is caused by a lack of education. If you don’t have someone there to teach you, it’s easy to continue eating the same way.”

Leon Medical Centers, a Medicare service provider, is tackling diabetes with its diabetes center, composed of endocrinologists and nutritionists who focus on educating patients and their caretakers on prevention or controlling the disease.

Dr. Angel Alejandro, an endocrinologist and leader of the team, said every patient, prediabetic or diabetic, receives booklets in Spanish detailing the complications of diabetes and the symptoms of high blood sugar. They receive a personalized meal plan, measuring cups, even a plate divided in thirds with the appropriate amounts of food groups to consume.

With the complimentary transportation Leon provides, the mostly Hispanic patients attend regular checkups, monthly meetings and go to the healthy living center, a sort of gym for seniors with personal trainers.

“We do all this education because we want the patient to do their very best. We’re not here to just write scripts and see you in six months. That doesn’t work; there’s data that shows it doesn’t work,” he said. “You bring the patient back, you reinforce what you’re teaching, that works.”