HEALTH, WEALTH & HAPPINESS: IN CONVERSATION WITH DIABETES NURSE EDUCATOR LAKESHA ENNIS

“37.3 million Americans—about 1 in 10—have diabetes. About 1 in 5 people with diabetes don't know they have it.”

I first met Diabetes Nurse Educator Lakesha Ennis as a patient. My primary care Doctor set up an appointment with her to attempt to educate me in hopes of getting my Diabetes under control. Upon entering her office there was nothing different than the other offices and specialists I visited. Then after the pleasantries she began to talk and educate me on my condition. As she went on, I realized I have never understood my condition until now.  There was something in her voice that resonated that she cared about me and what was needed to reverse my condition.

The entire time she was talking I was thinking I must speak to her about writing a book. This sage nurse can help so many people like me. Diabetes is so difficult to reverse because we’ve been conditioned to eat highly processed food and a culture that promotes a sedimentary lifestyle. I believe I have been a diabetic for nearly 10 years since 2014 but I wasn’t diagnosed until 2020. In 2013 I was pre-diabetic and didn’t know what it meant and wasn’t concerned. When I was diagnosed and google Type 2 diabetes I freaked out. It states that Type 2 diabetes takes 10 years off your life span. I was a 52-year-old, single parent with a 5-year-old daughter. For the first time in my life, I was scared and really measured my mortality. As result I made some major changes in my life, but my blood sugar level is still out of normal range. I needed help and I believe for the first time in 10 years I had found it. What I couldn’t figure out was why now, why did I finally get it. Nevertheless, I asked her could we discuss her philosophies regarding diabetes care and prevention. I’m healthier, and wiser thanks to my one-hour session with Nurse Ennis. As a journalist I want to pay it forward to assist 11.3% of the population about 36 million humans that we can reverse this disease and make sure our children learn are educated and break the cycle, so they never have to suffer from diabetes and other related diseases.

THREE ROADS TO DIABETES REMISSION: Three levels to achieving the goal of diabetes  remission.

Diabetes Self-Management: Managing diabetes through education, support system, utilization of resources, medication, and lifestyle changes.

Diabetes Reversal: When self-management has led you to becoming your own patient advocate, lowering blood sugar numbers, lower A1c, reframed mindset, consistency with lifestyle changes, decreased or no medication.

Diabetes Remission: When you’ve maintained an A1c of<6.5 over a period of 3 months or longer.

STEPS OF SELF-MANAGEMENT: How to self-manage diabetes? The first and most important place to start with self-management is to Increase self-efficacy. Increasing your confidence in your ability to manage and overcome this condition is essential. To increase self-efficacy, includes reframing your mindset about diabetes and education related to managing diabetes. In addition, changing your perspective about necessary lifestyle changes and addressing the guilt and misconceptions about why you have this chronic condition.

Reframing your mindset starts with tearing down the walls of guilt and self-destruction. Removing the all or nothing approach and restrictive diets debunking myths about diabetes. Adding positive self-talk, giving yourself grace, making realistic goals, and embracing support systems.

If you or anyone you know has been diagnosed as being diabetic, I’m asking you to trust me, trust this process and more importantly trust yourself. Diabetes can be managed, symptoms can be reversed, and you can put this disease into remission by following the steps.

Let’s start by removing guilt and debunking myths. Diabetes is not for one reason. It’s not because you struggle with weight, it’s not because you eat sweets. Diabetes stems from different factors adding into your individual basket overtime. What do you mean by basket? We all have an individual internal basket. We can’t judge our basket solely from the outside. We must stop making assumptions about why someone has diabetes and ask the root cause questions. We must consider what’s inside everyone’s basket because we are not in a one size fits all box.

Some risk factors can accumulate in your basket and not be in your control. Things such as age. As we gradually approach 40 years of age, this increases our risk of diabetes. Other factors not within your control include ethnicity, family history of diabetes, history of gestational diabetes, and certain medication regimens.

Then we have things in our baskets that can be managed and removed. Chronic conditions such as hypertension, hyperlipidemia, thyroid conditions, hormonal issues, bad gut health, inflammation, increased waist circumference, poor stress management, physical stressors, decreased activity, increased alcohol consumption, smoking, and the way we plate meals.

Type 2 diabetics still produce insulin, but due to the risk factors in the basket, the pancreas can become exhausted, and the production of insulin will decrease. The risk factors are preventing you from using the insulin produced effectively.

Now, I want you to sit with the information I have provided you and think about what has accumulated in your individual basket and take notes of what's inside. The good news is your journey has begun, and you must remember this is not a sprint, it’s a marathon. Let’s not solely focus on the destination but rather focus on the journey of gradually removing things out of your basket. What we can’t remove from the basket lets evolve with a health care provider and resources to make sure those things are managed.

Let’s deconstruct a few thing that are common in most baskets.

ACTIVITY: What’s required of us minimally when it comes to activity? Making sure you move for 150 minutes per week and not sitting longer than 90 minutes at a time could make a vast difference in managing chronic conditions such as hypertension, hyperlipidemia, and diabetes. Activity helps to increase insulin sensitivity and move glucose from our bloodstream into our cells to utilize for energy. Physical activity plays an important role in managing stress and managing weight.

Let’s refrain from your perspective about activity. Activity is not a punishment. Instead of “I have to be active,” let’s can speak, “I’m grateful I can be active regardless of capacity.” Let’s get to the root cause. It may or may not be time to discuss pain management and/or physical therapy. So now we can gain strength and balance to become active and strong again. I need you to move. Activity doesn’t have to be a huge event.

 Sometimes we miss small opportunities to move while waiting on the big event like going to the gym or walking 2 miles. This may or may not happen and now you’ve missed the small opportunities to move throughout the day waiting on the big event. You can start with things like housework, yard work, dancing, stretching, taking the stairs, parking out further from the store. No matter how small or how big, just move!

WEIGHT MANAGEMENT: The goal is to become your own advocate, between you and your providers, to address the root causes of your weight and not the weight itself, but the symptom. Of course, you want to address nutrition and activity levels but sometimes you must go further. Do I have bad gut health, and do I need to follow up with a gastroenterologist?  Do I have thyroid issues, ovarian issues, hormonal issues and need to follow up with an endocrinologist or gynecologist?

Let’s reframe your perspective about losing weight. It’s so easy to feel misunderstood by family, friends, and healthcare professionals in this area. You are not a failure. It’s time to take control of your health, speak up for yourself, dig deep, and get to the root causes. This approach will not only assist with weight loss and decrease abdominal circumference but maintain weight loss efforts.

STRESS MANAGEMENT: Stress plays a huge role in affecting how you utilize insulin. Stress is like the cherry on top in the basket. This is not an overnight thing to address. Stress management is a journey. Physical stressors such as illness, infection, injury, pain, dehydration, and poor sleep qualify exhaust the body. Then we have mental stress. Remember it’s not the stressor but your response to stress. When we use negative coping mechanisms or if we do not address physical stressors, we release hormones that decrease stress levels, but producing these hormones for a period can impact how we utilize insulin efficiently. Therefore, causing glucose to remain in our bloodstream.

NUTRITION: When it comes to nutrition the goal is to try our best to eat “real” food. I have a rule, if I can’t pronounce the ingredients and if it’s an overload of ingredients that are artificial, I’m going to put it back on the shelf, because at this point it’s not ‘real’ food. We must start taking our time in the grocery store and start looking at labels and reading the ingredients. Let’s preferably eat fresh and frozen real foods. This is a great opportunity to connect with a professional registered dietitian for guidance in this area. You don’t have to figure this out alone.

They’re three sources of foods that regulate blood sugar. Fiber, good fats, and protein. These three sources of food help to prevent drops and peeks in blood sugar. Drops in blood sugar usually come from skipping meals, not eating around the same times daily, taking too much insulin, or overexertion of activity. These three food sources also help slow peeks in blood sugar related to eating carbohydrates. The goal is not to eliminate carbs, especially good carbs, but to pair them with fiber, fats, and protein to stabilize the carb and deliver it to your pancreas regulated and slowly. Your pancreas will be thankful for you for not overworking it with sugar, but instead you brought the sugar slowly, not exhausting or overworking it.

Let’s reframe your perspective about nutrition. I’m not asking you to live in restrictions when it comes to food. All or nothing can take some into self-sabotaging behaviors. It’s okay to moderate and eat your favorite foods that might not be high in nutritional value. Whether you’re at home or eating out make sure you pair your favorite foods with fiber, fats, and protein. Please don’t let the carbohydrates win on your plate. I encourage you to meet with a professional licensed or registered dietitian. You can furnish them with a list of your favorite foods, and they will suggest healthier alternatives for the things you like.

Finally let’s reframe your perspective on managing diabetes. The lifestyle changes that need to be implemented are not punishments. We should take a good look in our “own” individual basket and address stress management, and how we plate food. We need to address our activities and deal with the barriers. We need to decrease alcohol consumption, quit smoking, and work on decreasing our waist circumference. We need to manage our hormones, and address triggers of our inflammation and vitamin deficiency. Making lifestyle changes is not just because you have diabetes. You’re taking this journey not just to live life, but to live abundantly. To have a greater quality of life. To have a life with diabetes managed, reversed, and in remission.

Diabetic Nurse Educator Lakesha Ennis Baton Rouge General Health & Wellness Center 225 819 1175