Lessons Learned About Diabetes and Self-Care

In my work as a prevention health technician in the Lakota community of South Dakota, I encourage people to ask questions and learn the facts about diabetes. Once they are aware of what diabetes is and how they can prevent or control it, they become empowered.

I came to understand diabetes when I was young. I would help my uncle by administering his insulin shots twice a day, and I would help my grandparents by checking their blood sugar with their home glucometers. Sometimes my grandma would check my blood sugar too. When I asked her why, she replied, “Because maybe you have diabetes too, if you are using the bathroom that much.”

Frequent urination can be a warning sign of diabetes. Other early warning signs of diabetes include rapid weight loss or weight gain, dizziness, persistent thirst, and/or extreme fatigue. Native American people have a higher risk of developing diabetes, and we see many of our relatives living with the disease. I grew up thinking that it was inevitably going to happen to me. With the help of my Uncle Jay, however, I realized that I didn’t have to develop diabetes. Instead, I could stop it from happening.

In my work with diabetic patients, I see the same thing here in my community. People do not realize that they can prevent, or even manage, diabetes. Once they understand this, I see something change in them. Empowering patients with this information is the best thing a practitioner can do.

I have found, too, that many people are in denial. Sometimes patients come to me and say, “No, I don’t have diabetes.” But when I look up their charts, I find that they’ve had diabetes and high blood sugar readings for years. They will respond, “Oh ya, they told me that, but I’m not diabetic. I’m not on medication or anything for it.” Some people seem to believe that if they deny having diabetes, it will go away. So I encourage patients to go for labs and to have their blood sugar and blood pressure screened frequently.

What I love about my work is seeing people break the unhealthy cycle and take control of their own health. As Lakota people, we want to be good relatives and to put others before ourselves. Somehow, even with our strong culture, we have to remember that by being healthy and active we are not being selfish. Instead, we are ensuring the future of our people and being role models for the younger generation.

Exercise and nutrition are very important to a healthy lifestyle. In my family, we didn’t realize that what we were eating was contributing to our risk of diabetes. My grandmother constantly baked cookies, cakes, and meals packed with starch. Our family was full of people with diabetes, but topics like diet, portion control, and nutrition were never brought up.

To change nutritional habits, people have to start small. I began by identifying my own eating habits, which included entire pizzas, multiple cheeseburgers, fries, chips, and soda pop on a daily basis. I never drank water and rarely ate vegetables. So I decided to make just one change: to stop eating beef for a month. In its place, I tried salad and yogurt and began to acquire tastes for different foods.

That long month was difficult, but it changed my life. I have never eaten beef again. With that single change, I forced myself into healthier food choices. Other simple changes included taking coffee and pop out of my diet altogether, which helped me increase my water intake.

In the diabetes prevention program, we teach participants about portion control, what types of foods are best to eat, and what food labels mean. We work with a certified dietitian, Kibbe Conti, who developed the “Lakota Food Ways” plate model. Our patients can relate to the Lakota Food Ways because it speaks of our traditional eating habits and how we can re-balance our diet today to be more like it was in the past.

The traditional Lakota diet included a lot of lean protein, and our bodies are still set up to need those foods. It’s only been about 120 years since our diet changed. Today our people eat compound carbohydrates, processed food, and sugar, but our bodies are not built to process these unnatural foods. I believe that this is one reason why Native American people are at such high risk of diabetes, but I also believe that processed foods play a role for all people with diabetes.

If I could offer any advice to practitioners working with diabetic patients, it would be the following:

· Listen to your patients and “hear” what they are telling you.
· Help them adjust their eating habits and physical activity gradually.
· Remind them that they can control diabetes.
· Become aware of their culture, customs, and values so that you can understand the disease from their perspective.

If I could change one thing about my work, it would be to make my job obsolete. That is my dream, to start the cycle of healthy living for us, our children, and their children. The prevention program here in Rapid City, South Dakota, is called “Cokata Gli Najin,” which means “returning to the center.” This suggests balance, healthy living, and returning back to the roots of the Lakota people. Everyone can learn from this wisdom.

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