Nov. 15, 2017 — A panel of five female researchers and educators from the University of Florida examined the intersection of diabetes, women and health equity during a World Diabetes Day event held Tuesday evening in the George T. Harrell, M.D., Medical Education Building learning studio.

Gainesville Mayor Lauren Poe began the evening by giving the World Diabetes Declaration, naming Nov. 14, 2017 World Diabetes Day in Gainesville. City commissioner Adrian Hayes-Santos was also in attendance.

“I’m very happy to see the word ‘equity’ here,” Poe said. “Equity is something our city takes very seriously.”

Panel moderator Marian Limacher, M.D., senior associate dean for faculty affairs and professional development at the UF College of Medicine, introduced a group of 10 female UF undergraduate students, each living with Type 1 diabetes. Many tables in the learning studio featured centerpieces that outlined the young women’s journeys with the disease. Nursing student Hunter Cope offered a phrase, which fills her with strength: “Conquer it before it conquers you.”

The talks began with a presentation from Lisa Scarton, Ph.D., RN, a post-doctoral associate at the UF College of Nursing. Scarton explained the role culture plays in diabetes self-management within American Indian populations. She noted that American Indians are more than twice as likely to have Type 2 diabetes than non-Hispanic whites.

“American Indian women are oftentimes primary caregivers for their immediate and extended families, as well as for their communities. This can make it difficult for them to care for their own illnesses, like diabetes,” she said. “We need to continue to develop multi-level interventions that are culturally relevant to this population.”

Ashby Walker, Ph.D., of the UF Diabetes Institute, spoke about the studies she’s conducted to measure and analyze who is utilizing Type 1 diabetes care and how socioeconomic status affects access to this care.

“All women, regardless of income level, live with an omnipresent fear about their child’s health with Type 1 diabetes,” said Walker, who organized the event in recognition of World Diabetes Day.  “But while women from the highest income brackets were more likely to make a career shift to accommodate the demands of Type 1 diabetes care, women from lower income brackets experience fewer social support networks for diabetes.”

LaToya O’Neal, Ph.D., assistant professor and health and wellness extension specialist at the UF/IFAS College of Agricultural and Life Sciences, outlined the community-based prevention and management programs she’s helped to implement for health-vulnerable populations in Marion County living with the threat of Type 2 diabetes.  The UF/IFAS extension office offers multi-disciplinary programs in healthy lifestyles and chronic disease management in each county in Florida.

“We found that community-based approaches have positive individual and social impacts, as participant-reported outcomes included increases in positive health behaviors,” she said. “Focused, collaborative efforts can reduce the prevalence of diabetes and diabetes-related inequality.”

Sarah Westen, Ph.D., a post-doctoral fellow at the UF College of Public Health and Health Professions, introduced audiences to an unfamiliar term: diabulimia. The word refers to the practice of those living with Type 1 diabetes restricting their insulin intake to lose or maintain weight.

“Type 1 diabetes is a mind disease as much as it is a body disease,” she said. “Studies have found feelings of guilt, shame, blame, embarrassment and isolation can result from diabetes stigma.”

Laura Guyer, Ph.D., professor at the UF Center for Gender, Sexualities and Women’s Studies Research, ended the evening with a review of her research into diabetes patients who miss their medical appointments. She found that most frequently, women older than 50 with public health insurance do not attend their scheduled appointments. She explained that low literacy and health literacy rates, transportation and health insurance are all barriers to adherence to a treatment schedule.

“We need to understand why different groups of patients fit into the no-show group, because it comes at a cost to everyone involved,” she said. “No one wins with a no-show.”

Mark Atkinson, M.D., director of the UF Diabetes Institute, said Tuesday’s program represents an important start to the institute’s commitment to addressing women’s issues in diabetes.

“Diabetes presents challenges for researchers, family members, caregivers and patients alike,” he said. “We are confident that individuals at UF can generate positive change.”