CBHEC Spanish-language diabetes class saves lives through education

When 51-year-old Luis Espericueta went to the doctor for the first time in his life in August 2009, he received what many in the Hispanic culture view as a death sentence. The native of Monterrey, Mexico, had experienced many of the common symptoms of diabetes including rapid weight loss, constant hunger, dry mouth and frequent urination.
Espericueta says he refused to accept a future filled with diabetic complications and vowed to take his health into his own hands for the sake of his family. He followed his doctor’s advice and immediately enrolled in the Texas A&M Health Science Center Coastal Bend Health Education Center “Controlling Your Diabetes” class. Currently, the center’s diabetes program is the only diabetes self-management class in the Coastal Bend taught in Spanish.

Going beyond culture

“The main misconception within the Hispanic population is that if you have diabetes, you’re doomed,” says Delia Martinez, interim health education coordinator for the program. “But no, this does not have to happen. It’s just getting that message across that they can control this disease that is most important.”

To communicate with Spanish-speaking patients, Martinez and CBHEC’s registered nurse Eugenio Lopez have used their personal knowledge of the Hispanic culture in the seven-hour diabetes education class. They have incorporated their culture into every aspect of the curriculum. Martinez points to some Hispanic customs that could contribute to diabetes.

“During the holidays, tradition is to kill a pig and utilize a big part of it,” she says. “Frying the pork skins and using the grease that is left over is a big tradition in the Hispanic culture. Tamales are also a big tradition during the holidays, and using some of the leftover lard to make these tamales is common. How do you tell someone who has been doing this his or her entire life, ‘No, you really shouldn’t do that anymore’ or ‘No, you can’t have that because you have diabetes?’ That is why I think it is so important to teach the importance of moderation and nutrition.”

Learning to take control

At the center, even lunchtime is a learning tool, as participants are asked to serve themselves by actually measuring out serving sizes of their fajitas, rice, beans and tortillas with measuring cups according to their individualized meal plans created for them by CBHEC’s registered dietitian.

Espericueta and other class members have learned to adapt their traditions using this nutrition program.

“I learned I could continue to eat what I enjoyed by only adjusting the portion size and quantity,” he says proudly. “We’ve abided by that since the class, and I attribute my progress to doing this.”

Espericueta and his wife, Blanca—who showed her support by attending the class with him—have gone beyond portion control, completely cutting out sugared drinks from their diet and drinking more water. After just three months of incorporating recommended dietary changes, Espericueta is already seeing a difference in his quarterly lab follow-ups, which are provided to patients for one year following the class. The three-month average of his blood glucose levels is now in the healthy target range.

Sharing their success

The couple says what they learned in the class changed their lives. Now, they are sharing Espericueta’s success.

“My wife is trying to show family, friends and our grown children how she is preparing food for me, and they are starting to slowly adjust to the changes, too,” Espericueta says. “My wife is even screening our children for diabetes by testing their blood glucose levels so she can try to keep them from becoming diabetic like me.”

Thanks to the support of his wife and the CBHEC diabetes program staff, along with his determination, Espericueta is on the right path to keeping his diabetes in check. But for many other Hispanics in the Coastal Bend, diabetes is not the only barrier keeping them from living healthy lives.

Struggling but determined

Lopez sees his patients struggling to meet basic needs such as finding transportation to the class or figuring out where their next meal will be coming from.

“This one couple with a three or four year-old ended up showing up to class two hours late because they took several buses to get all the way across town, and then they had to walk the remaining two miles to get here,” Lopez recalls. “The woman took off her shoes to be weighed, and she had duct tape covering the diabetes sores on her feet because that was all she had.”

In another situation, a man living more than 20 miles away from the center was so determined to return to the diabetes clinic for his follow-up lab work that he caught a ride to the clinic knowing he did not have a ride back home.

Lopez says, “I asked him, ‘How are you getting home?’ and he said, ‘I don’t know, but I wanted to check to see how my blood sugar was doing.’”

In addition to transportation issues for some, there is also the financial obstacle of not being able to pay the $25 fee for the “Controlling Your Diabetes” class and quarterly lab work for the year. CBHEC Director Guadalupe Reyes Jr. is adamant that these financial challenges will not prevent diabetes patients from receiving the health care education they need.

“The Hispanic community has a right to receive a good education and has the right to have a good quality of life by having better health, and I think by working together as a community, we are able to do that,” Reyes says.

And, Reyes did just that. He called on community leaders to help raise awareness of the need for financial support for diabetic patients struggling to manage their disease. He was able to gain the support of Nueces County commissioners Betty Jean Longoria and Oscar Ortiz to tackle the challenge. The two commissioners set aside $6,000 to provide financial assistance for those who could not afford the diabetes education but, were determined to change their lifestyles and control their diabetes.

And now, Reyes plans to extend CBHEC’s diabetes education program to others in South Texas, especially the many indigent Hispanics living in substandard conditions in area colonias—rural unincorporated communities.

“Tailoring our programs in a different way to help target this population will be important to us as we begin to reach out to residents of the colonias,” Reyes says. “Because of this history and commitment, we will be able to build the respect and comfort level we need for the colonia residents to be receptive in accepting our services.”

For their part, Espericueta and his wife Blanca agree that CBHEC provides services that will help improve the health of the Coastal Bend community.

“We are very grateful for this program and the superb treatment we have received in this office,” Espericueta says. “We didn’t know a program like this existed, but we are very grateful for the excellent attention from the staff.”