Our promotoras (community health workers from the neighborhoods they serve) spend more time in family kitchens than any doctor ever will. So this year, we asked them a simple question: what’s really getting in the way of managing diabetes?
Here are the themes we heard most, across listening sessions in the cities where our promotoras work.
1. The advice doesn’t fit the plate
Families are handed meal plans that don’t include tortillas, rice, or beans, the foods on the table every day. When advice feels like it means giving up your culture, people give up on the advice instead. What works better is portions and swaps, not bans.
2. Supplies cost more than the visit
Test strips, meters, and medications add up month after month. Promotoras described people stretching supplies, testing less often, or splitting doses to make them last.
3. Appointments happen during work hours
For people paid by the hour, a checkup can mean losing a day’s pay. Evening and weekend hours, and promotora visits at home, make follow-up possible.
4. Fear and shame keep people quiet
Many people have watched a parent or grandparent lose a foot, their sight, or their life to diabetes. That fear can make people avoid testing entirely. Hearing it from someone who looks like them and speaks their language makes a big difference.
5. The numbers are confusing
A1C, fasting glucose, “prediabetes”: the terms are confusing, especially when explained quickly in a second language.
If you’re living with diabetes
- Ask your doctor to explain your numbers in plain language, or in Spanish. At most doctors’ offices and hospitals, you have a right to a free interpreter.
- Focus on portions and swaps, not giving up the foods you love.
- Ask about lower-cost supplies and medications, including generics and manufacturer programs.
- Ask about evening or weekend appointments if daytime visits mean losing pay.
