‘Diversity in Diabetes’, an Organization Addressing Disparities Head-on
Quisha Umemba has dedicated her life to caring for people with diabetes. A Registered Nurse and Certified Diabetes Care and Education Specialist (CDCES) with a Master’s in Public Health (MPH), Quisha recently co-founded the People of Color Living with Diabetes Summit and its parent organization, Diversity in Diabetes. She is also the founder of Umemba Health, LLC, which provides workforce development training for public health professionals, community health workers, and more.
Ironically, when Quisha began her career in medicine, she did not anticipate diabetes; in fact, she hated endocrinology in nursing school. But after falling in love with chronic disease management and going to work as a clinical coordinator for an endocrinology clinic, she discovered her purpose: “I quickly realized that 80-90% of the patients in the endocrinology clinic had diabetes… diabetes kind of found me, I didn’t really find it.”
Call to Action
After moving out of the clinical setting, Quisha continued her work in administrative roles and as a diabetes nurse consultant. In March of 2020, Quisha met Kacey Creel at a diabetes conference that was lacking in diversity, and the two discussed how to address the glaring disparity. Three months later, the duo was planning the first annual People of Color Living with Diabetes Summit.
Editor’s Note: To read more about the first annual People of Color Living with Diabetes Summit, Click Here.
Quisha and Kacey realized that a one-time summit was just a start — that their work needed to continue, and Diversity in Diabetes was born. “As we work in the organization on a daily basis,” Quisha elaborates, “You start to see there are major areas that we need to do this work and populations that really need to be helped. We’re able to use our passion for helping people, our backgrounds, and then add in Kacey’s patient perspective and my clinical perspective and really come up with interventions and solutions.”
One area that needs urgent addressing is disparities in technology. Highlighted on the homepage of the organization’s website is the fact that “People of Color (POC) don’t utilize diabetes technology at the rates of non-Hispanic whites.”
Disparities in Tech
A recent analysis of Medicare recipients by Medtronic showed that Non-Hispanic white people are three times as likely to use technology as POC1, and study results presented at ADA last year showed that among young adults, more than 70% of Non-Hispanic Whites used diabetes technology compared to just 20-30% usage among their Black counterparts.2
Quisha — having previously been diagnosed with gestational diabetes and now living with pre-diabetes herself — believes the issue needs to be addressed on both the patient and provider side. From the patient side, she acknowledges that, “A lot of times communities of color don’t speak about diagnoses like diabetes… People have to talk more. They need to share the challenges related to their diagnosis.”
“We need people to be active participants in their healthcare,” Quisha adds. “A lot of times the patient doesn’t go that extra step, but the impetus is on us as patients to really be proactive individuals in our own self-care.”
As important as it is for patients to be proactive, it’s paramount that providers work to address treatment disparities as well. Quisha has seen stigmas associated and assumptions made against communities of color during treatment: “I’ve seen providers say, ‘I’m just going to tell her about insulin with the vial and syringe, because she won’t do XYZ,’ or maybe, ‘I don’t think she has the health literacy level to be able to understand how to manage her diabetes in that way.’”
Quisha believes that in order to properly address the disparities faced by people of color with diabetes, healthcare providers must offer the same options regardless of who their patient is: “Whatever information you’re going to give to Jane, you need to give that same information to Jamisha, and you need to let them decide what’s the best treatment for them.”
Although healthcare providers should be providing the same information to all patients, Quisha recognizes that healthcare still need to be individualized. A common trope she tries to stay clear of is the idea of “not seeing color.” Quisha describes, “If you saw me as a Black woman, then you would see everything that goes into me living and being a Black woman, especially in the US in today’s world.” She recognizes that understanding and diving into a patient’s background and ethnicity will help their care team better understand the how, what, and why during treatment beyond just their disease.
Quisha has also observed a lack of representation in the images that surround diabetes. “There’s little microaggressions and little undercurrents of racism like that in every pocket of society, that you don’t really realize unless you’re a person of color navigating the world,” states Quisha.
“A lot of times patients of color will look at wellness as whiteness, and that’s because for a long time, when you looked at commercials or when you purchased products out of the store or you’re watching TV or at a movie, you see white people participating in and working out, or hiking, or skiing, or eating the green smoothies. You didn’t see people of color doing that, and so people will assume that wellness equates to whiteness. We’ve got to do a lot better with portraying images of people of color using these devices, talking about their experience with these devices”
Quisha knows there is a lot of work to be done moving forward, but she is excited about what’s on the horizon for Diversity in Diabetes. Along with new advocacy campaigns and the onboarding and training of new volunteers, the organization is planning their second annual People of Color Living with Diabetes Summit. This year they hope to include communities across the globe and highlight initiatives that are taking place in communities of color.
1. Data on File Medicare – People with Diabetes Intensively Mananaged. Chalew, et. al. J Diabetes Complications. 2018;32(12):1085-1090.
2. Shivani Agarwal et al., Racial-Ethnic Inequity in Young Adults With Type 1 Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 8, August 2020, Pages e2960–e2969, https://doi.org/10.1210/clinem/dgaa236
This content was made possible with support from Medtronic Diabetes, who recognize that a major racial disparity exists in technology use and access in the diabetes community. Did you know that ethnic minorities are 3x less likely to use technology like a CGM or pump? The Medtronic ASK (“Acquire Some Knowledge”) campaign is all about education and raising awareness around this issue.
Learn more on Medtronic’s ASK campaign here.