For Underserved Patients, A Fresh Approach to Diabetes

Diabetes experts from across the United States convened at Direct Relief's headquarters on July 18, 2019, as a part of the Community Health Summit, which focused on improving diabetes care for the most vulnerable. The meeting was held in collaboration with the Robert Wood Johnson Foundation, in order to share the learnings of past award winners from the BD Helping Build Healthy Communities program. (Lara Cooper/Direct Relief)

By Talya Meyers

July 19, 2019

What does mindfulness have to do with diabetes? A lot, it turns out.

On July 18 and 19, Direct Relief hosted a community health summit, where representatives from health centers across the United States met to discuss the best ways to manage diabetes and improve outcomes for underserved patients.

Health center workers hailed from places as far apart as Hawaii and Puerto Rico. Some of Direct Relief’s local partners, including the Sansum Diabetes Research Institute, also attended.

Telehealth, engaging community leadership and, yes, mindfulness were all on the table.

The community health centers represented are at the forefront of patient-centered, innovative care methods. They’re all former recipients of Direct Relief’s Helping Build Healthy Communities initiative grants, funded by the medical technology company BD. The summit itself was funded by the Robert Wood Johnson Foundation.

Diabetes, a long-term condition that requires patient education, careful monitoring, and behavioral changes, is notoriously difficult to manage. To make things more complicated, poorer patients, with little access to health care or nutritious food, are much more likely to develop the condition. It can also be worsened by stress – hence the mindfulness meditation.

At the community health summit, one strong thread emerged: The old-school model of diabetes care, in which patients are lectured about their eating habits and sent home with insulin, doesn’t work. Providers from the community health centers talked about patients who didn’t really understand what insulin did. Patients who couldn’t afford healthier foods. Patients who, feeling overwhelmed or offended, never came back again.

Over the past few years, these community health centers had worked to bridge the gap, building programs that incorporated digital self-monitoring, access to fresh vegetables, and stress-reduction techniques – to name just a few elements.

Jagriti Upadhyay, an endocrinologist at the Dimock Center in Massachusetts, talked about helping patients with finding housing, food, and utilities.

Gloria Palmisano, the chronic disease program manager at Community Health and Social Services Center in Detroit, explained that her health center incorporates mental health services into its diabetes care model, because there is a close link between physical illness and mental health issues.

Shajuana Day, director of care coordination at Jericho Road’s health center in Buffalo, had arranged for interpreters to be trained as Certified Diabetes Educators, to ensure that all patients had extensive access to reliable information.

Shajauna Day, director of care coordination for Jericho Road Health Center in Buffalo, New York, speaks at Direct Relief headquarters July 18, 2019, as a part of the Community Health Summit, which focused on improving diabetes care for the most vulnerable. Jericho Road serves a large refugee population, and employs 30 interpreters, which speak more than 20 languages. The center, with funding from BD, has been able to train those interpreters to also function as diabetes educators to patients. (Lara Cooper/Direct Relief)

Audience members wanted to know how community health workers earned their patients’ trust and how they inspired people dealing with diabetes to embrace the lifestyle changes they’d need to make.

By and large, the changes being discussed weren’t particularly high-tech or even expensive. Instead, they relied on the human element: cultivating great patient relationships, increasing access, and leveraging the power of community support.