"It broke my heart to see so many people having problems managing their type 2 diabetes when it didn't have to be that way."

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When Lisa Sumlin, PhD, APRN, ACNS-BC, began her medical career nearly 20 years ago, she began to notice an alarming pattern among her patients in a medical surgery unit.

"The majority of patients were coming in for amputations or for kidney dialysis because their type 2 diabetes had gone unmanaged," Sumlin, a professor, researcher, and chief health officer at Community Coalition of Health, tells Health. "Of that group, about 80% were minorities."

That realization—that she was downstream of a major health issue among minorities—prompted her to return to school at the age of 34 to get her master's degree in nursing, focusing specifically on diabetes management. She later went on to get her doctoral degree in nursing, focusing on food and how it affects diabetes management. "It broke my heart to see so many people having problems managing their type 2 diabetes when it didn't have to be that way," she says.

According to Sumlin, one of the biggest issues minority communities face regarding type 2 diabetes is a lack of education. "Many people just think they need to do what the doctor tells them and that's it," she says. "What they often don't realize is that it's more than just taking the right medicine. You need the right medicine, the right food, and a proper amount of exercise."

For those in minority communities in particular, food is a large part of the culture—and diet changes are a tough suggestion. "When you tell people they can't eat their cultural foods, it's asking them to give up their identity," she says. "That's a tough sell."

In order to find a sustainable solution for those who heavily relied on food to connect to their culture, Sumlin knew she needed to find a different approach to diet changes. "I don't want people to not be able to eat grandma's recipes. I just want them to find some ways to make them a little healthier so they can continue to enjoy them, and that takes a mindset change," she says. "Too many people think, 'I have insulin so I can eat whatever I want.' And the reality is that's not true and you have to ask, do you have your diabetes under control or does your diabetes control you?"

Stress, too, is an important factor in controlling diabetes—and it's something those in minority communities are also disproportionately affected by due to health disparities. "It's not easy to rise above for a lot of people and not being able to handle that stress effectively can contribute to high blood pressure, high cholesterol, and type 2 diabetes," says Sumlin.

Another huge factor in managing diabetes—exercise—is also sometimes met with resistance, adds Sumlin. But, she says, getting in some physical activity can be easier than many people think. "A lot of people don't realize that if you have high blood sugar [levels], simply taking a walk around the block can help bring [them] down. And that's something you can do in the present moment to regain some control over your health," she says.

In addition to maintaining a healthy diet, watching stress levels, and getting some daily exercise, Sumlin also says that another good habit to get into if you struggle with type 2 diabetes is checking your blood sugar levels on a regular basis. "Not just to show your health care provider, who you may not be seeing for three months, but to know in the moment that you need to take some steps to manage it," she says.

While these may sound like minor steps, Sumlin explains how they can have big results. "Having these tools and education available opens up a whole world of possibilities for people in terms of what they can do, what they can take control of, to manage their diabetes better," she says.

But as a health care provider, Sumlin doesn't just teach and care for her patients—she learns from them, too; mainly how to be more patient. "There's a lot of denial in the beginning," she says. "People don't want to believe they have diabetes and I have to be OK with that. Sometimes it takes a long time for people to be ready for help. But when they are ready, I have to get people to realize that this is going to be a 24-hour disease that has to be managed to avoid these more serious complications."

Sumlin, who now has more than 18 years working with diabetes patients, has a message for people already dealing with the early signs of complications from Type 2 diabetes.

"It doesn't have to end up with blindness or amputations or kidney failure. You can live with it if you manage it, and the main thing I help people to think about is what motivates them to manage their diabetes," she says. "Maybe it's that you want to be here for your grandkids. But whatever it is, you have to find a reason to keep getting up every day and making the right decisions for yourself, because that's the only way it's going to work."

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