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GAINESVILLE, Fla. (WCJB) – Cost and accessibility are issues within the type 1 diabetic community that challenge people in managing the disease. Results from a study of type 1 diabetics at the University of Florida showed that both factors play a role, but the main problem is negative interactions with the specialist or an endocrinologist.
“It is our job to listen, we have to receive knowledge and not just impart knowledge,” said Dr. Ashby Walker, director of equity initiatives at the UF Diabetes Institute. “They felt judged, they felt wrong.”
The study was aimed at type 1 diabetics who missed two or more endocrinology appointments, had diabetes-related complications in the past year, and were receiving primary care in a state-qualified health center. This focus is intended to include minority communities that fall under these parameters. Participants say a visit to the endocrinologist does nothing to help manage diabetes or morale.
“We need to involve the endocrinologist in understanding the perceptions of people coming to their clinics, as well as the fears and concerns,” added Dr. Walker added. “The experience of being humiliated or belittled, whether intentional or not, was experienced by many of our participants.”
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Continuous glucose monitors, or a CGM, are the most effective way to manage type 1 diabetes, and getting one isn’t easy. The study found that minority or low-income groups who report negative and degrading interactions with their endocrinologist no longer go to appointments.
“We must also address, from an endocrinologist’s point of view, how it would feel if you were someone facing a very serious health complication and you want a tool to improve your health, and you is said no. Mentioned Dr. Walker.
“So I really think these are multi-layered interventions, but the ones we didn’t address as a field are implicit biases.”
In return, patients say they don’t see the benefit of an appointment – despite the fact that the best way to treat the disease is with a CGM obtained with the consent of an endocrinologist.
The ECHO Diabetes project at UF is one way of breaking down barriers for patients dealing with the disease. In addition to helping people navigate life with diabetes, the program provides primary care tools to better serve marginalized communities.
Read a full copy of the UF Study: Barriers to Technology Use and Endocrinological Care for Underserved Communities with Type 1 Diabetes here
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