Danielle Bublitz, MS, RD is a registered dietitian and certified intuitive eating counselor. She created her own online company in November 2021 called Food Freedom Diabetes, LLC to assist people with diabetes, and she also works as a clinical dietitian on a per diem basis. In this interview, Danielle Bublitz sheds more light on Diabetes. She explains the health disparities surrounding diabetes as well as the stigmas, treatments, and doable preventative measures.
Why are people of color at higher risk for diabetes?
Danielle Bublitz: People of color have a higher risk for diabetes due to genetics as well as environmental factors. Having a lack of access to healthcare, socioeconomic status, and experiencing systemic racism can play a huge part in increasing the risk of developing diabetes. For people of color, experiencing racism causes a high level of stress, reduces their mental health and quality of life.
Here is an excellent study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820714/
How is discrimination related to diabetes?
Danielle Bublitz: People with diabetes often get judged by what they choose to eat and how much they weigh. This can make it feel very shameful to even share that they have diabetes. I have worked with clients that haven’t even told their families that they have diabetes for fear of appearing like they are lazy.
What causes diabetes stigma and do you see that it’s viewed differently in different communities?
Danielle Bublitz: The experience of diabetes stigma disproportionately affects people with a higher BMI or a higher A1C. I think diabetes stigma can be caused by how society understands diabetes as a disease, or rather, misunderstands. Oftentimes people do not understand that diabetes is complex and can be caused by many factors including: genetics, family history, comorbidities such as polycystic ovarian syndrome, hypothyroidism, medications (long-term steroid use). I also think the stigma can be internalized where a person with diabetes can feel guilt and shame as if they were the cause of getting diabetes.
What latest treatments have you seen be really impactful for your patients?
Danielle Bublitz: Having access to a continuous glucose monitor has been something very useful for my patients with all forms of diabetes (type 1, type 2, type 3C, LADA). For my patients on insulin pumps, the newest omnipod 5 pump has been a huge game changer for their management. It enables automatic insulin adjustments to help improve patients’ time in range. In addition, I have also seen that my patients with difficulty with metformin side effects do better with metformin extended release to reduce symptoms.
What are the biggest challenges your patients have seen when managing diabetes?
Danielle Bublitz: Access to supplies and feeling heard by their medical team. I try to help bridge the gap and create better communication for my clients with their medical team to help them see results with their A1C lowering.
What current research is happening for type 1 and type 2 diabetes that you’re excited about?
I continue to be excited about the ongoing research with pancreatic stem cells to help regenerate the pancreas.
Why is losing weight so absolutely vital?
Danielle Bublitz: What is the most effective technique to reduce weight for a type 2 diabetic? I actually do not believe weight loss is vital for diabetes and blood sugar management. In fact, sometimes the recommendation of weight loss comes before asking people if they have had a history of an eating disorder or helping clients focus on health-promoting behaviors. What is interesting to note is that oftentimes patients with diabetes that struggle with dieting and weight cycling can struggle with exacerbated blood sugars and increased insulin resistance. Since weight is not a behavior, it would be better to discuss with patients how they can choose movement and activities they enjoy, eat a diet that has a variety of food groups (including carbs), get adequate sleep, and seek out therapeutic support if they are struggling mentally or emotionally. It is vital, in my opinion, to help patients find ways to care for their diabetes that is sustainable and reduces the risk of the development of disordered eating patterns.
A great research paper: https://www.hindawi.com/journals/jobe/2014/983495/
When patients’ diabetes goes untreated what’s the strategy to treat it? As in a new diagnosis?
Danielle Bublitz: If new diagnosis, it definitely requires having either their primary MD or an endocrinologist step in to get them on a regimen like insulin or meds to help bring the blood sugars down. If it is someone that has had diabetes for a long time and they are struggling with management, I think it is important to understand where they are at mentally, emotionally, and financially. It may be best to first understand what resources they have to manage diabetes and go from there.
Can someone pass type 1 diabetes onto their children?
Danielle Bublitz: There is a chance that their children could have type 1 diabetes due to the genetic component and family history.
Are people with diabetes prone to infections?
Danielle Bublitz: Yes, and if someone with diabetes is struggling with high blood sugar levels, it can weaken their immune system defenses as well as create an environment where the bacteria can grow quickly.
What are the most common questions and the most difficult ones that your patients ask you when it comes to diabetes management?
Danielle Bublitz: The most common questions I get as a registered dietitian are, “What am I allowed to eat?” and “Can I reverse diabetes?”. I think the only difficult questions that I have had are related to a patient asking how to find resources for medications/supplies. The financial burden of diabetes management is huge.