As an endocrinologist with 19 years of experience treating diabetes patients, one of the most important lessons I have learned is that communication is key.
Patients with diabetes live with the heavy burden of making daily decisions and actions to control their blood glucose levels. Fortunately, advances in technology have come incredibly far, giving way to tools like continuous glucose monitors, automated insulin delivery systems, and more. But for Spanish-speaking populations, there’s often one more barrier to overcome to get the care they need: finding doctors, resources, and technology in their language. How can we expect better outcomes for these patients if the treatment tools and methods were not designed with them in mind?
The Burden of Navigating Diabetes for Spanish Speakers
Diabetes disproportionately affects Latinos more than non-Latino white Americans. According to the American Diabetes Association, in 2022, an estimated 11.8% of the Latin American population will have been diagnosed with diabetes, compared to 7.4% of non-Latino white Americans.
Social determinants of health, including socioeconomic status, support networks, and access to quality health care, play a major factor in this disparity. Spanish-speakers with diabetes face many challenges, from navigating America’s complex health care system in a language that may be foreign to them, to finding health care providers who can offer culturally competent care. Additionally, the cultural diaspora of the Latin American community is not one size fits all, which can make it even more difficult for health care providers to provide personalized treatment that connects with these patients.
Inequity in receiving health care continues to prevent Latinos from receiving and accessing adequate diabetes care. The Centers for Disease Control and Prevention advises on the importance of communication, emphasizing that if you can’t fully communicate with your doctors or they don’t understand your values and preferences, you’re less likely to follow treatment instructions and make changes to your treatment. Lifestyle.
Failure to receive proper care or treatment can lead to serious complications of diabetes, such as vision problems, loss of limbs, and heart and kidney disease. Latinos have the highest rates of diabetes complications, making it even more critical to provide diabetes education in their language so they can manage their disease before it causes irreversible damage.
How I care for my Spanish-speaking patients with diabetes
As a native Spanish speaker based in Texas who has been working with Latinos throughout her career, I am extremely familiar with these patients and their needs. Communication, in their native language, between a clinician and their patients is essential in the management of chronic diseases such as diabetes. In my experience, Spanish speakers significantly underuse diabetes technology. Therefore, exploring the barriers to adherence, health education, the perception of the use of technology and family support as part of the medical visit are of the utmost importance. When we discuss diabetes management with our Spanish-speaking patients, we need to consider how behavior change can affect not only our patients, but family dynamics as well. Integrating technology into healthcare can be intimidating, but the reality is that most of our diabetes patients are willing to give it a try when it’s presented in an easy-to-use way. In my opinion, access to educational information and technology in their language results in greater participation in diabetes care. I have witnessed the positive impact on glucose control, hypoglycemia prevention, and quality of life that access and use of technology and diabetes medications have on my diabetes patients.
Engaging our patients in managing their diabetes and addressing their concerns not only about medications and devices but also about how the use of those medications and this lifestyle can affect their families is one of the things we I focus. I like to offer treatments and technology that can improve the health of the entire family. Approaches that have been successful with this patient population to treat diabetes include:
Educate families and loved ones. Family is particularly important to the Latino community and ensuring that a patient’s family is engaged and invested in their treatment plan helps reinforce the support network they need to navigate diabetes care.
Spending extra time walking a patient through their diabetes treatment plan and giving them time to ask questions and discuss concerns.
Help patients set up diabetes technology on their mobile devices. For example, when I work with patients to set up their Dexcom G6 CGM, I show them how to download the phone app, which is available in English and Spanish, to ensure a smooth start.
Review the use of technology during your follow-up visits.
Share the data I have analyzed during the medical visit and evaluate the areas of opportunity to improve diabetes control.
Refer patients to a certified diabetes educator specialist.
Access to CGM technology for Spanish speakers
CGM technology is a powerful tool that healthcare providers like myself prescribe to patients to help them manage their diabetes. A CGM uses a wearable sensor and transmitter to wirelessly measure and send glucose values to a smart device or receiver 24 hours a day. This eliminates the need for multiple daily finger pricks commonly used in blood glucose monitoring. CGM technology is widely considered the standard of care and is clinically proven to improve outcomes for people with diabetes.
Sometimes there are barriers to presenting the CGM in their treatment plans to Latino patients. They often confuse a CGM with an insulin pump and need more information about the approach of each device. Since I sit down and explain to them how simple it is to use CGM, they are much more willing to use it. Another problem my patients run into is that the information is, for the most part, in English instead of their language. Getting critical health information in your language helps manage diabetes care.
Leaders in diabetes technology, such as Dexcom, have realized how important it is for their users to receive glucose information in their language, which has led to more features for this population. This is a small but crucial step towards improving health equity for Spanish-speakers with diabetes. Although there are still challenges facing Latino patients with diabetes, receiving health information in Spanish whose only translation is how to turn the information into actionable steps is a victory for both patients and healthcare providers like me. . And it’s a win when it comes to patient-provider communication.