Jaime Lewis (Host): November is Diabetes Awareness Month, and here to share insights about diabetes care and the comprehensive programs available at Holy Cross Health in Fort Lauderdale is Dylan Chang, Registered Dietician and Certified Diabetes Care and Education Specialist. This is Thrive with Holy Cross Health, a production of Holy Cross Health in Fort Lauderdale.

I'm Jaime Lewis and Dylan, thank you so much for being here with us.

Dylan Chang, RD, CDCES: No, thank you, Jaime, for having me on the podcast. I'm excited.

Host: Well, since we're in Diabetes month, Diabetes Awareness Month, I should say, what key messages should healthcare providers emphasize to increase awareness and prevention in our community?

Dylan Chang, RD, CDCES: So I think what's important is that providers just encourage their patients to get regular checkups. And it's not only on the providers, but as well as the patients just to stay in tune with their health.

Host: Right. Well. Maybe for those who are unfamiliar, can you describe the primary differences between Type 1 and Type 2 diabetes, and how do the differences between them influence treatment strategies for patients?

Dylan Chang, RD, CDCES: Yes, absolutely. So Type 1 and Type 2 diabetes. I just want to say they're both very serious conditions. They should be monitored by a healthcare professional. Type 1 diabetes is insulin dependent diabetes. So persons who have Type 1 are going to have to take outside sources of insulin injections into their body because their body's just not producing the insulin that we need to get the sugar where it needs to get to in other words. And then Type 2 diabetes. Oftentimes people refer to that as the lifestyle diabetes. So what that means is you're insulin resistant, so your body produces insulin, but you're just not utilizing it correctly. So you may require insulin or you could require oral diabetes medications.

Host: Okay. What are the misconceptions about diabetes that you encounter and how do you set patients and families straight on those?

Dylan Chang, RD, CDCES: The greatest misconceptions I hear about diabetes is that there's a cure for it. So unfortunately, I have to debunk that right now. There is no cure as of yet. They are working strongly on a cure for that. But as of this time right now, no, there's no cure.

That doesn't mean you shouldn't take it serious. Lifestyle changes can make a difference in terms of your management. Another misconception I hear is people say, oh, it can't happen to me. I'm very slender. I'm not overweight. That's not the only factor. There's a bunch of other factors that go into having diabetes, and it's not just the sugar disease as oftentimes people like to refer to. Many, many different lifestyle factors influence whether you get diabetes or you don't get diabetes.

Host: It's not obvious at first pass probably, or first glance. It's not as cut and dry as that. I know. Can you give us an overview of what Holy Cross Health is doing in terms of education programs, and maybe tell us about the new services available at the Family Health Center in Oakland Park?

Dylan Chang, RD, CDCES: Yes, at the Family Health Center we have two programs for diabetes specifically. One is the Diabetes Prevention Program. So those are for persons who have either pre-diabetes or at risk of developing diabetes. So that's a year long program. They focus primarily on education, lifestyle changes, physical activity, healthy eating.

Those are components of the program. The program I specifically run is diabetes self-management. So I primarily see people who do or already have a diagnosis of diabetes, and I also focus on lifestyle changes. We go into a few more components such as medications, monitoring your blood sugars but overall, again, lifestyle changes. What's going to be best in terms of management for diabetes?

Host: Well, along those lines, how do stress and mental health impact diabetes management? I don't know that everybody associates those two things with caring for diabetes, but what kind of support can families provide to help address those challenges?

Dylan Chang, RD, CDCES: It's interesting that you say that because stress can influence your blood sugars greatly. The way I explain it to patients is when you're stressed out, your body goes into a flight or fight syndrome. I'm sure we've probably all heard of that. So your body doesn't know that it's going to prime it, right.

It's going to release extra sugar into your body to prime you for that fight or flight action. It doesn't know that you're in a meeting and you're stressed out with deadlines. You've gotten into a fight with your spouse. It's still going to release those sugars regardless. So it's important that we do manage our stress.

I also tell people there's good stress and there's bad stress. Because a lot of times people associate stress with negative feelings. But I also tell them if you win the lottery the next day, that's going to be a very good stress, I assume, right? What to do with everything. But it's very important to manage that stress.

So here at Holy Cross, we do have a diabetes support group. So, persons or patients can take part online at this moment in time. At the Family Health Center, we've recently opened, so we are looking to do in-person classes right now, but right now we do online sessions on Zoom in terms of diabetes support groups.

Host: Well, I've been noticing, I'm sure a lot of people who are listening have noticed people wearing continuous glucose monitors, the little white, you know, a patch that's sort of lifted. And I'm wondering how do they work, first of all? And then what kind of benefits do they offer compared to traditional blood glucose testing methods?

Dylan Chang, RD, CDCES: Yeah, so continuous glucose monitors, they're very interesting because they monitor your blood sugars all the time instead of having to do the traditional finger stick. So traditionally, yes, persons with diabetes should check their blood sugars. They would prick their finger, they would take a little test strip with a meter, they would get a number back.

But some people don't like that because constant finger pricks, fear of pain, fear of blood, maybe. So this is where continuous glucose monitors come in. So a few different brands. There's, you may have heard of some, some are called Dexcom, some are called Freestyle Libre. Those are the most popular brands right now.

And the way they work is every 10 to 14 days, depending on the brand, you would put a patch, as you said, Jaime, on your, either back of your arm or your lower abdomen. It's going to monitor your blood sugars continuously, and it's going to send those readings to either your phone or the device that they'll give you to monitor it.

And it's so simple as picking up your phone and just looking at it and say, oh, my sugars are this. So it just does it continuously.

Host: It's gotta be so valuable to do it in real time. Also with like associating the way you feel with the numbers. And if you love details and analysis like I do, I would just be in that app all the time looking at my numbers, but I'm curious, how do patients engage with advocacy groups and support networks?

How can they do that to better support their health and stay informed about new developments in diabetes care?

Dylan Chang, RD, CDCES: Yeah, so there's a few good support groups or advocacy agencies that they can look towards, especially online. I mean, online there's a plethora of information. It's just, are we getting the correct information? So I would recommend the American Diabetes Association as a good source to look towards.

There's also the Association for Diabetes Care and Education Specialists. So for persons like me, the regular common person can also go there as well and access information in terms of diabetes. The ADA, which is the abbreviation for the American Diabetes Association, also has support groups as well.

 I would say those two are good places to start, and as well as if they're still seeking more information, they can come to Holy Cross Health and we can also provide them with greater diabetes education.

Host: Absolutely. Well, last thing, is there anything else you want to leave with our audience about diabetes education management?

Dylan Chang, RD, CDCES: I will tell people it's something that can be very manageable. It's not the end of the world. Some things that people get the misconception about as well is that I don't need to go get checked out because I don't feel bad. With Diabetes Awareness Month, it's important to go get your regular checkups because symptoms, especially with diabetes, are not always apparent.

So I've heard plenty of times from patients, I don't go to the doctor unless I feel bad. You want to make sure you go regularly, even if you're not feeling bad. So for diabetes awareness, just make sure you go get your checkup, get your regular routine blood work, and prevention is much better than treatment of an issue. That's what I like to say.

Host: Yes. Absolutely. Well, thank you so much for being here, for sharing your insight and expertise.

Dylan Chang, RD, CDCES: Yes. Thank you, Jaime, for having me.

Host: That was Dylan Chang, Registered Dietician and Certified Diabetes Care and Education Specialist at Holy Cross Health in Fort Lauderdale. To learn more about diabetes prevention and education programs, visit holy-cross.com/dpp and thank you for listening to Thrive with Holy Cross Health.