The Latinx Diabetes Initiative Provides Culturally Tailored Care To Latinx Patients With Diabetes

Editor’s Note: Latinx is a gender-neutral term for people of Latin American cultural or ethnic identity. If you or someone you know needs them, Beyond Type 1 offers all of our resources and materials in Spanish at es.beyondtype1.org.

Andreina Millan Ferro serves as the clinical healthcare solutions manager at Joslin Diabetes Center’s Latinx Diabetes Initiative, a program designed to provide high-quality and culturally appropriate care to Latinx patients with diabetes.

Since 2005, Millan Ferro has made diabetes care more accessible for Latinx patients by supporting bilingual programming and education efforts. The bilingual clinic and education program is supported by Millan Ferro and a team of diabetes specialists, kidney specialists, nurse practitioners, certified diabetes educators and registered nurses, where they weave culturally tailored care into the fold of their work.

Beyond Type 1: What programs does the Latinx Diabetes Initiative offer? What impact has it made on the community?

Andreina: A big part of coming to Joslin is that we provide [diabetes] education at all times. Patients may go to see the diabetes doctor at a place where they may not have access [to other providers]… We function in teams where they have access to everything in one place. A patient may see their diabetes doctor and then right after, they will connect with the educator as well.

Because of COVID, we cannot do the same type of things we have traditionally done. We have always given patients the opportunity to come in person to have appointments. You can be seen by an endocrinologist, ophthalmologist, kidney doctor, dietician, exercise physiologist, nurse educator, or nurse practitioner. Because of COVID, our entire team is working to see patients in-person or remotely (video or phone visits) depending on the needs of the patient.

What have been some highlights and challenges in serving the Latinx population?

So our community has many challenges. We [Latinx people] are at higher risk to develop diabetes, particularly type 2. Once we develop diabetes, we are more likely to have a higher A1cs and diabetes complications. We try to help the patient achieve the goal of living a healthy life with diabetes. When we do that, it means trying to navigate the system with the patient to break those barriers that we know commonly exists. That could be food insecurity, helping them find affordable medications they can include in their budget, and helping them understand how to shop for medicines.

If a patient is a recent immigrant, they may not understand the role that the different healthcare team members have for their care because maybe their countries of origin don’t have nurse practitioners. They may have a different understanding of the role of the nurse and what they can do for me and my care. We try to help them understand that everyone on their team is going to help them in a different way.

As you mentioned, some members of your population are recent immigrants? How are they navigating the health insurance system in the U.S.? What do your efforts look like?

It depends. We see patients from all over Latin America, but we mostly see Caribbean Latinx [people] that come to our area of the country [Massachusetts]. Most patients [are provided a] team of diabetes specialists. In a limited number of cases, we receive referrals of patients without insurance and we help them understand the steps they should follow to apply for health insurance and try to connect them with resources in the community. When you come from another country and have limited English, the process of learning the healthcare system is a challenge.

You have worn many different hats and held a variety of roles. Which role has been your favorite at the Latinx Diabetes Initiative?

I enjoy working with Latino patients the most, working to help them achieve their diabetes goals and their goals in life in general. I am an immigrant myself. It’s kind of like you get to a new place, you need to understand a new environment, a new healthcare system, a new culture. And then it’s like, you are two things. One thing or the other. It’s the process of becoming acculturated to another culture. So when you think about someone from our community that has diabetes, they don’t like to see the dietician because they say, oh, I’m going to see the dietician, but that person is not going to know the things that I eat, for example. It’s not giving up the things that you love. It’s learning how to incorporate those things, and to still have a healthy diabetes life.

What are your goals within the coming years?

The idea is to provide Latino patients with the same opportunities, break those barriers, and provide the same high quality of care through a cultural lens so that we can help patients meet their diabetes care that is attuned with their culture.

If you or someone you know needs them, Beyond Type 1 offers all of our resources and materials in Spanish at es.beyondtype1.org.