Tips for helping Latinas manage gestational diabetes

A diagnosis of gestational diabetes mellitus can be stressful for any mother-to-be, but more so if there is a language or cultural barrier. For many Latinas, diabetes conjures images of relatives who have lost feet, gone blind or may have died from complications. Through effective communication you can alleviate your client’s fears and help her feel more in control of her diagnosis and take the right steps to having a healthy baby. While gestational diabetes is a manageable disease, it is also a serious one that if not controlled can have negative outcomes, particularly for Latinas.

Diabetes mellitus is the seventh leading cause of death for white women, but fourth for Latinas. Gestational diabetes mellitus occurs in about 1 in 20 pregnancies, with Latinas having higher rates than non-Hispanic white women. Obesity rates among Latinas in North Carolina are rising, setting them at even higher risk of developing gestational and type 2 diabetes; and though gestational diabetes normally goes away after pregnancy, at least half of the women who had it will develop type 2 diabetes within the next 5 to 10 years. Latinas of Mexican descent are even more likely to develop type 2 diabetes than Latinas from other backgrounds.

Causes and Treatment of Gestational Diabetes Mellitus

Women’s bodies go through many changes during pregnancy, a grand portion of which are due to hormones. Because hormones regulate the production and use of glucose and insulin, hormonal changes during pregnancy have the ability to alter this process unfavorably. Consequently, when a pregnant woman’s body does not regulate the glucose-insulin process as it should, gestational diabetes mellitus occurs.

Treatment for gestational diabetes normally includes meal planning, scheduled physical activity and sometimes insulin. A Latina’s diet will probably already consist of healthy portions of fruits and vegetables but she will need to begin choosing items higher in fiber when it comes to carbohydrates, like whole grain rice and tortillas instead of other kinds. Also it is important she eats three small meals and two or three snacks at regular times each day, being sure not to skip any meals. When advising on physical activity, be sure to recommend she take walks with friends or family or dances to her favorite music. For a successful meeting with your Latina client about her condition and how to manage it, be sure to consider your client’s primary language, health literacy, and cultural lifestyle.

¿Comprende?

Creating a meal and exercise plan may be second nature to you and seem the easiest thing to follow, so when your client does not adhere to a plan or regimen it can be a bit frustrating. Stop and consider whether your client really understands the information you give her. Health literacy is an issue that affects a large portion of people in the general U.S. population. Cultural and language differences make it difficult for some of the Latino population, leaving them at a disadvantage once they leave the clinic or doctor’s office.

Tips to assure your message is understood

• Use a professional interpreter to ensure that your client receives the right message. This will increase the chances she will correctly follow instructions. Although it seems convenient to utilize a client’s friend, family member or even one of the Spanish speaking non-clinical staff, misinterpretation may occur because the person interpreting may not comprehend all the medical terminology.
• Speak in simple terms and use as little scientific, clinical language as possible. Remember, you use clinical language and medical acronyms on a daily basis, but more than likely, your client does not hear these terms very often. If you need to use clinical terms, also explain them using familiar words. For example, if referring to hyperglycemia, you may just want to say "high blood sugar."
• Use materials that include illustrations and/or audiovisuals, like picture stories, videos and CDs. Visuals are great help in communicating a message and serve as a reminder to the client what she has been advised to do; not to mention people remember a greater portion of things they hear and see in contrast to only hearing it. The bilingual fotonovela (picture story) Embarazo y Diabetes: Pregnancy and Diabetes, does a great job describing what gestational diabetes is and confronts some of the myths around treatment for the condition.
• Encourage your client to bring a friend or family member to attend the visit with them for added comfort. Family is special and revered among Latinas. Having a family member present can help Latinas feel more at ease and also may help your clients follow through with meal and exercise plans.
• Involve the family in education and treatment decisions. Encourage family members to do physical activities with your client and help her remember to eat her scheduled meals and check her blood glucose levels (if needed).
• Create an environment that makes your clients feel comfortable enough to ask for clarification or more information. This will ease their anxiety about the situation and help them not be ashamed.
• Have your client repeat back or even demonstrate what you have instructed so you are sure she understood you.