Episode Transcript
[00:00:00] Speaker A: This is the All1Nerds podcast where we are bridging the gap between the stethoscope and the soul and getting back to the human side of healthcare.
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Did you know that the term diabetes comes from the Greek word siphon, which refers to the excessive urine seen in uncontrolled diabetes. Also that the word mellitus is Latin for honey or sweet, and it was added when ancient physicians discovered that the urine of people with diabetes was sweet due to the high glucose levels. Now, I don't know how they figured that out, but if you have not already guessed, today we're going to be talking about diabetes mellitus with an awesome guest speaker, Dr. Nakia Sellers.
Welcome.
[00:01:10] Speaker B: Thank you so much. And thank you so much for inviting me. I'm looking forward to this.
[00:01:15] Speaker A: Yes, ma'am. Thank you. And it's an honor to even have you here, especially at a time like this with it being November and with Thanksgiving right around the corner and Christmas, you know, all that good eating, good food.
[00:01:29] Speaker B: So just because November Savvy is awareness month.
[00:01:32] Speaker A: Yes, yes. So that is. I'm just excited. And you are very good at what you do. So let's get right into it for my listeners. Let me tell you about Dr. Nakia Sellers. She is a DMP who is board certified as a family nurse practitioner with over 20 years of experience. She is a certified diabetes care and education specialist and has a board certification in Advanced diabetes management. She is the owner and operator of Diabetes Care and Wellness Clinic. She has published an article on diabetes and periodontal disease and courses for providers for the American Diabetes association and other organizations. And currently, Dr. Sellers serves on the advisory group for the Women's Interprofessional Network of the American Diabetes association. And she has been invited to speak nationally to discuss diabetes management and awareness. So I'm just excited. I think I have the right person here to speak on this topic during a month that helps bring awareness to diabetes. So welcome again.
[00:02:41] Speaker B: Thank you.
[00:02:42] Speaker A: Yeah. For my listeners, as always, I ask you to open up your heart to receive this impactful information so that it may resonate with you even as a new nurse, as an aspiring nurse, as a nursing student, or as a patient who may be listening because you have experience having, being diagnosed with diabetes or hearing the term that you're pre diabetic. What does that mean? And so I just ask you to open up your heart to receive this information as we dive into Dr. Sellers professional journey, which we're going to start off with her background story because a Lot of times we need to know where someone came from in order to see where. How they got to where they're at, especially in a nursing profession. Then we'll get into her personal insights and what she. Her motivation, her challenges. And then we'll get into patient perspective and educational insight as well as, you know, all that. Probably just start going in together. Once we get started with that. Dr. Sellers, tell us, who are you? What's your origin story?
[00:03:49] Speaker B: Well, to be honest, let's start, I guess, like, high school. The reason why I say that is because initially I didn't want to become a nurse. Initially, I thought I was going to be a veterinarian. So that's what started. So I thought I was going to be a veterinarian. And then I was like, okay, well, wait a minute. You just don't get to play with the cute animals. You know, you have to do all these different things with horses and all that. So I kind of changed my mind in high school. Like, okay, well, I'm gonna go into nursing. So I looked into nursing. Can't really remember why I went into nursing.
I just said, well, this is something I want to do. And then years ago, I actually saw an article that was written up about different high school seniors. And in the article, it said that I was gonna go and graduate and then after graduating, become a nurse practitioner. So I guess in the 12th grade, I knew. I just don't remember how I wanted to or who I saw that, you know. Cause I don't have any family members or anybody who are nurses or anything. So I really don't remember what made me go into nursing. But I'm so glad. I'm so glad I did because it's such a rewarding field that I definitely love. Um, so I went to Arkansas State undergrad, Arkansas State University.
And from there I graduated in 2002. Seems like it's so long. Um, and then I went back to school and we got. And I received, excuse me, my master's degrees from Arkansas state again in 2007. And I practiced for a while, and then I received my Doctor of Nursing practice degree or doctoral degree from the University of south Alabama in 2023.
[00:05:30] Speaker A: Okay.
[00:05:31] Speaker B: And so that's kind of my overall, I guess, how matriculated through college and undergrad and graduate school.
But it's okay. Getting into my nursing career.
[00:05:43] Speaker A: I also graduated from ASU, it was in 2011, with my bachelorette degree in nursing. But coming out of nursing school initially, what did you start off doing? Did you start off with Med surg. Like, what has that looked like at the med surge?
[00:05:59] Speaker B: Got you. Got you. So actually when I was in college, I worked as a nurse extern and I was on a med surg floor there. I learned so much. I had some excellent nurses that, you know, showed me the ropes, showed me how to do things, made me think critically as a nurse extern. And then I stayed on that floor again. That was a med surg floor. I think I might have stayed there two years. And then there was an opportunity on the nurse managers on a neuro floor. She had neuroortho. She wanted me to become a pcpcc, a patient care coordinator, which is the same thing, like assistant nurse manager. And from there I, you know, learned different things. And again, she took me under her wing. And so that was from that moment, being under her wing, I. We develop a great friendship and she was a mentor in life, nursing and everything else. And she recently passed in September this year. And.
[00:07:01] Speaker A: Sorry to hear that.
[00:07:02] Speaker B: Yeah, she was turned into a great friend. That's why I always want to give back to nurses and everything too, because she poured into me and even poured into me later in life.
I was on neuro and ortho floor and that's where I finished my. I was in school and I ended up finishing my master's degree. I really did kind of got to get myself together. I didn't mean to talk about Dana that quickly, that song, I'm sorry, but. No, it's fine. That's fine. And so I was in school. I was started graduate school and then I ended up finishing. And so from there I took a job at a neuro office because one of the neuro physicians, he was like, you know, I think you'll be great. Because like neuro it was okay. You know, I did like med search the best out of all of that, but it was okay. Neuro, ortho. So I did that. And then we had to. He let me go because he had a non complete, a non compete clause in his.
[00:08:06] Speaker A: Wow.
[00:08:06] Speaker B: He left a big organization, started on his own. Then that's when I went with him. And then he ended up having to let me go because he was in violation of some things. And so then I went back to Methodist as a hospitalist.
[00:08:20] Speaker A: Okay.
[00:08:21] Speaker B: Then I went into internal medicine, internal medicine and family practice at another office. And I stayed there for a long time and probably was there a few years, probably about five years or so. And I noticed like everybody would send me their diabetes patients. So it was a group of two physicians and three nurse practitioners. And they would say, like, well, we're sending you these diabetes patients because you're our diabetes person. I like, I am. So it really took somebody else telling me that I was good at diabetes. Okay, now, this was maybe 20, 15 or so, 14 or something like that. So back to my first manager role or whatever, assistant manager. That same nurse, she was then the chief nursing officer for a hospital. And she was like, hey, they're about to open a diabetes center here. She was like, I think you would be great to be over it. I was like, me, why wouldn't you know? But it's the same person, the same nurse that poured into me years ago that was like, I think you should do this.
[00:09:27] Speaker A: Oh, wait.
[00:09:28] Speaker B: And now I'm a diabetes nurse practitioner.
I love it.
[00:09:33] Speaker A: It's like God was ordering your steps and you didn't even know it.
[00:09:37] Speaker B: You know it. And every. And this is what I tell nurses, too. Younger nurses, every job that I had or every position, every role that I have been in, I learned something from it. And it's taken me. It's helped me to apply different things in life. Even now, opening my own practice, I can. From different things I learned in medsearch, different things I learned as being in leadership and in management. So I've taken everything. Well, not everything, but, you know, I've taken different things from different roles. And I think that's so important, especially for any, you know, aspiring nurses or nursing students that may listen to this. It's important to always learn something. And in our field, as you know, we're always learning, but we should be, you know. Yes. So that's why I always try to tell, you know, the younger nurses. Learn something. Keep your mind open. Don't just. If somebody's trying to tell you something, don't. Like, oh, my God, like, why is this person, you know, just take it out, lead. Some. Some might apply to you. Some. Some of the things may not. But there's always opportunity to learn from everybody.
[00:10:40] Speaker A: Yes. I found some nursing students, and they're actually, like, interning around the hospital that I work for. And some may start complaining about their experiences, and I say, you know, or they'll try to tell another nursing student not to go work on a certain unit or not to go. And I'm like, well, first and foremost, everything. You have to see it as an experience. So I'm glad that you said that. That you took something with you from every experience.
[00:11:06] Speaker B: Yes.
[00:11:07] Speaker A: Because initially. Well, I can't say initially, but it appears that a lot of new nurses want to come out of school and want to go straight into the ICUs or the ED.
And it's nothing wrong with working on med surg. That's a specialty all into itself, not something that we expect you to stay there.
But take whatever you got to do in your clinical, take it in as an experience.
And when you do find someone that wears many hats, who is very open, and they will provide constructive criticism in a way that they mean it in love, because they want you to be successful and they want you to be safe first and foremost, and cling on to those people and take what you can from them. So I'm glad that you mentioned that. Thank you. Now, I gotta ask, what were some of your challenges that you faced during your nursing journey?
[00:12:07] Speaker B: Okay.
So early on, when I was a nursing student, and I think this was probably the end, yeah, I was getting close to the end of the program. When I was in undergrad, I had one instructor that told me because again, I had already said I wanted to be a nurse practitioner. I knew I wanted to work as an RN after. I wanted to get those skills and everything. But my long term goal was to be a nurse practitioner. And I had an instructor that told me that I would be better suited to be at the bedside on the ep. Now, let me say this. First and foremost, there's nothing wrong with being at the bedside at all. Because sometimes that's where God called us to be. And like, as long as you are there and you are taking care of those patients, there's absolutely nothing wrong with that. But that was not my goal. And so, mind you, I was graduating magna cum laude. I was second in my nursing class at the time.
[00:13:08] Speaker A: Come on.
[00:13:09] Speaker B: Yeah, but I'm telling you all this to say she told me that. And so I was hurt. I was crushed. And I really didn't understand that, you know, especially you're young, I'm young, and I'm like, you know, why would she say that? Maybe I'm not good enough or whatever. But I didn't let it faze me because I knew, especially with those nurses that I had as an extern, like, they helped me, and I knew I was like, gonna be a good nurse. That's what I felt. And so that, that kind of was a challenge because sometimes, because I even read an article not too long ago about like, bullying and nursing.
And I know how sometimes they'll say, like, nurses, the older nurses eat their young or something like that. So that was kind of my first and maybe only thing I Had bars with that because, again, I worked at an extern, and then I went and worked on the same floor. So I didn't really have that experience. But that I think in undergrad, that was a challenge in nursing school. So one thing I would say, you never let anybody else tell you what you shouldn't do or wouldn't be good at. And I, to this day, I don't know her reasoning for that, but at the same time, because I did say where I went to school. So I want to say, even when I went back to school, and I kind of. Now that I really think about it, I don't know why I went back to asap, but I did. And at the same time, I had an amazing Instructor, amazing professor, Dr. Gilbert Palmer. Was she there when you were there? I'm not sure.
[00:14:40] Speaker A: Okay.
[00:14:40] Speaker B: But she was amazing. And everybody didn't want her because they heard she was hard. She was this. But I wanted that because that was a challenge.
[00:14:48] Speaker A: And so she was very.
[00:14:49] Speaker B: No, no, nonsense. Very just, this is what we're gonna do. And I'm that same way. So I think that's why I liked her. And so it was a very different contrast, you know, from experience.
Yes, yes, yes. And so. So that was a challenge. But I think nursing, far as the RN part was, maybe when I became a pcc, I was younger than a lot of people that I was over. So that was a little bit of a challenge. And then when I became a nurse practitioner, a challenge is not thinking as a nurse, but thinking more as a provider. So that's like, when you're early on in your career, you just have to change your mindset on how you provide care. You still have that compassion. You still have that education that we do as nurses and all that. But it's different because your mind is thinking as a provider. How do I diagnose this patient? What do I need to prescribe this patient and follow up? And different things like that. So I think with each role, there was a challenge. However, you just got to be ready to face those challenges on and just be like, come on with it.
[00:16:01] Speaker A: Oh, man, that's. I'm glad that you shed light on so much, even in the first so many minutes of this episode. I love it because these are. These are real challenges. And I love that you still were able to go back to asu, get your master's, because it wasn't asu. It was a person, you know, that said that. It wasn't the whole entity, the whole organization. So that's good. That you didn't let that one challenge defeat you and keep you from pursuing your degree, whether it's at the same university or another. And so I commend you for that. And I think a lot of people need to hear that, because one of my last guests, Dr. Ashante Coleman, she had someone told her that, you know, she would never get into nursing school. And the same person signed her acceptance letters. I mean, you just never know. You never know.
So I, I'm glad that you are able to share that experience on here with us now. How do you stay motivated, especially as a provider? And one thing that you touched on, because we do have nursing, like even in, when I was coming through nursing school, I had classmates that we had graduated high school together and their goal was to be a nurse practitioner. And you do have other professionals that may frown on, oh, she's so young. But if she's getting the education and actually going in, getting the bedside experience and to further her degree, to become a provider, what kept you motivated as you started to transition into that provider role?
[00:17:37] Speaker B: Really not sure.
I just knew it was something that I wanted to do.
I don't know what kept me motivated. I know most of my friends and my family, like even the guys in my family, they always say, well, you're so strong, you're so determined, you could, you know, you're so disciplined. And I just look at it as, like, it's just something I want to do. I don't even look at it as being disciplined. I don't even look at it as being strong, Will. It's just something that I want to do and I, I guess I just do it. So I really don't know what motivated me. I just, I guess I just knew I wanted to do it. I know when I was getting close to graduation, this is so crazy. It's like a material thing. I had screensaver of a car that I wanted. I still didn't get that car because once I got out of school and all that and got another, I wanted that car. But it was a car that I was like, okay, well, I'mma strive to this. So I don't know if that was it, but that clearly wasn't it. But that was just something I was like, okay, I'm gonna get this once I get out of school. And still didn't. But just knowing that this is what I wanted to do.
[00:18:45] Speaker A: It sound like he had a made up mind.
[00:18:47] Speaker B: I guess so, yeah.
[00:18:49] Speaker A: And sometimes that's all you need, a made up mind. Because one thing I'VE learned about being motivated. Motivation will come and go, but consistency is what produces results. It's just listening to you, it sounds like you had a made up mind, like, this is what I'm gonna do. And you just, and going back, you said, like, you're just, you're a person who, hey, you are a person who loves structure. Like you say, no nonsense. So being that type of person alone, I think they do come with a lot of discipline because, you know, I can't do XYZ if I'm trying to accomplish xyz.
[00:19:28] Speaker B: Yeah, yeah. Even my mom said, you're so disciplined, you can do this, you can do that. My mom always says, because I'm on her about health choices and all this stuff. And so I guess it's just how you look at it.
[00:19:41] Speaker A: And that's probably what make you a good educator or provider for diabetes management because it takes some discipline and some ownership. If I had to assume because I don't have diabetes. So I can't speak for a person with the diagnosis of diabetes.
So getting right into diabetes and diabetes management and diabetes care. Tell us more about your clinic, your diabetes care and wellness clinic. And let's just talk all things diabetes.
[00:20:22] Speaker B: Okay. So I opened my practice, Diabetes Care and Wellness. It's in West Memphis. I opened the practice in 2022. So we hit the two year mark. And so when I initially opened it, we were both, I was working, excuse me, practicing two days a week and for a few months while I was working at another office. And then I was just like, I can't grow my business by growing someone else's business. So then I, in January 2023, I started practicing there four days a week.
And still, I mean, I'm open four days a week and on that I have a Thursday that's off and it's still working because we have to do admins things and all that. So practicing five days a week, might as well say open for four days and practicing all the days. Let me just say that because when you. Another thing that I've learned with opening a practice or working for yourself, you're never off.
You're never off. But I enjoy it. It's the only office, diabetes office or where you can see a specialist in Cretin county area. I opened in West Memphis, Arkansas because there was a need there. So the people that are living in West Memphis either have to travel across the ridge to Tennessee or an hour and a half trip to like Jonesboro, either Little Rock. And so that's pretty far for people. I've always practiced in Tennessee, but there was a need there. My parents live in West Memphis. I actually, I was went to school in Memphis until I was in the ninth grade. And then we moved to West Memphis. And so I graduated from West Memphis High School. So I'm familiar, you know, with the area. I'm familiar with people there and all that. And so it's kind of home. So I wanted to help improve healthcare disparities there. I wanted to increase access to care in that area, and I've been loving it. I have some of my patients from Memphis who travel to my West Memphis office and getting new patients in West Memphis.
At our practice, of course, we specialize in diabetes management. We also provide obesity management and chronic disease, like high blood pressure, high cholesterol management as well.
[00:22:41] Speaker A: Okay. And I learned at the bedside, and I had a doctor give it a certain term, but he was just saying like that, like a triad, like a triage, or a triad, like a three fold. When you have hyperlipidemia, hypertension, and diabetes, those patients are at higher risk for stroke and heart disease and things of that nature. And so I was like, oh, I never looked at it like that.
[00:23:06] Speaker B: Yes, for sure. So that's one thing with diabetes management. When I'm looking at patients, I'm not only looking at their A1C or timing range of blood sugars. I'm looking at their blood pressure, I'm looking at their cholesterol, I'm looking at their kidney function. Because we want all those things to be well managed, because we know when your diabetes is above gold or some may say uncontrolled, that increases the risk of heart attack, stroke. And so if you also have high blood pressure, again, that's causing the vessels and everything to close off. If you have high cholesterol again, the blood vessels and all that come too thick with plaque and cholesterol buildup. So all those things increases the risk of heart attack, stroke, kidney disease. And then also people with diabetes have higher risks of blindness and periodontal disease. So when I see my patients, I'm like saying, hey, when's your last Thai exam? When's your last dental exam? So I'm asking all these things, and they're like, well, you want to know all that? Yes, because I want to take care of all the things for you so we can decrease some of these complications. Not that I can take care of an eye exam or a dental exam. I want to make sure that you're getting those things so you can be well rounded and overall healthy. So all those things play into diabetes. Yes.
[00:24:23] Speaker A: I think that is awesome that you're even. Cause you can't treat one without making sure that you are addressing the others.
[00:24:31] Speaker B: Yes, yes.
And one thing, one thing I do. I mean, I don't like, step over the primary care providers, like, whatever they're doing. However, this is something that we need to do together. And so especially if the primary care provider, excuse me, has referred to me, I'm going to, you know, if the blood pressure still is uncontrolled, I'm going to increase the ARB or whatever medication or I see the kidney function is failing, I'm going to place them on some kind of medication, then just send a note. You know, even with nephrologists, like the nephrologist that's in the area, you know, I'll say, hey, I put this patient on xyz, they don't have any problems with it. But just keeping that line of communication open as well so we can all work together to make sure our patients are. Get into that common goal of being healthier.
[00:25:17] Speaker A: Oh, man, that. That speaks volumes in itself because a lot of times people are kind of just doing their own thing. And it's like, how often do you see, like, even in the hospital, like, nobody's talked to the other person. And it's like as a provider and even the nurse, I try to tell the nurses at the bedside, you are like that center of communication. And so it's one thing if you document that you spoke to a physician and he gave you a medication for one thing, but then you didn't tell the. But the other specialists don't know that you had to call and get this medication for this issue. So it's like to make a progress note or a nurse's note sometimes helps give you a seat at the table to let everyone know what was needed for that patient. And me being in a hospital setting, I don't work at the bedside. I work as an educator now. But I still try to help them think about those things and help anticipate the needs of the patient.
And that's what I love about what you're saying about diabetes management. You anticipate their needs and holistically, like, I can help you with your diabetes. And one thing I like that you said, instead of saying uncontrolled diabetes, you said above goal. Is that what you said?
[00:26:28] Speaker B: Yes. Yep.
[00:26:29] Speaker A: I wanted to make sure I heard you say that again. I love how you didn't give a negative annotation to that in general, that's.
[00:26:40] Speaker B: Why it's so important with diabetes management, because language is important. Once you hear, and I'm assuming once people hear that they have diabetes, they think the worst and not even say I'm assuming. A lot of times they tell me I'm going to have to get my leg cut off, things like that. I'm going to have to be on insulin. So it's scary. The diabetes comes, especially type 2, comes with a stigma.
You cause this to yourself. You know, you're, you have this because you're unhealthy, you have this because you don't eat well. So we need people with diabetes and providers, we need to make sure that we are giving people diabetes hope, letting them know that you still need to live well, you still want to enjoy your life. But there's certain things, yeah, of course you're going to have to modify, you're going to make some changes. But if we all work together and can do it together, stop the stigma that's associated with it. And then it's hard. Anytime that you have a chronic disease, it's hard to try to manage those things. So you don't want to come in saying, oh, you did this, or you're bad at this or you ate bad. You know, things like that. You want to take that negative language away. So try not to say uncontrolled. You try to say like, if it's even the blood pressure is above goal, your diabetes is out of range rather than uncontrolled or so. Because it does. It's a lot, it's a lot to hear that word diabetes because you're thinking all the bad things.
[00:28:08] Speaker A: So for someone who may be just recently diagnosed or they hear the term, you're pre diabetic.
Because as I was telling a coworker as I was walking out of the hospital this past week, I said, oh, I got my next interview coming up and we're going to talk about diabetes management. And she was like, yeah, my doctor told me I had that, that pre. And I said that you're pre diabetic. She's like, yeah, you know, And I was like, okay. And so when you hear, when they hear that term, what can you give light to what pre diabetic is versus having diabetes?
[00:28:44] Speaker B: Okay, so pre diabetes is when your A1C and A1C is a blood sugar test. It measures your blood glucose levels over three month period. So pre diabetes, if your A1C is anywhere between 5.7 to 6 to, then the, your provider may put you in that Pre diabetes range. And so that just means that your blood sugars are higher than they should be, but not that high to where we would say you have type 2 diabetes or so. Because most time, if you have prediabetes, if you develop diabetes, it's going to be type 2. The difference between type 2 and type 1. Type 1 is an autoimmune disease. And so it happens when the body attacks itself, the beta cells are no longer producing insulin. Type 2 occurs when there's a lot of different things that goes into type 2, but most things we tell people the body's not producing enough insulin or it's not working like it should. So with prediabetes, your blood sugar levels are somewhat elevated. So there are some things that you can do to try to delay or Prevent prevent type 2 diabetes. And if you're overweight or have obesity, the main thing is to lose weight and keep the weight off. So you want to sustain that weight loss that you lose, and that can help decrease the risk of type 2 also eating healthier. Not to say you gotta have to cut out all carbs, all things. And I don't even tell my people with diabetes that they have to cut out all carbs, because that's nonsense. You have to have carbs to live. But if you have been diagnosed with prediabetes, you want to make sure that you're exercising, you're eating healthier. Now, there are some risk factors that we know, like if you have family history, if you're overweight, have obesity, if you're a woman and you've had gestational diabetes, or you have a baby that's over nine pounds, certain race factors put you at higher risk of diabetes. And sometimes even if you've done those things, you know, you're eating healthy, sometimes genetics and all that plays a factor. And you may develop type 2, but it doesn't mean it's the end of the world. There are some great medications now, great technology, even from when I was first starting in diabetes management.
So much has changed. And even now with the weight loss medications, if you have prediabetes, and hopefully insurance plan will cover, like the weight loss medications that can help, you know, decrease insulin resistance and help keep weight off as well. So with pre diabetes, it's just mean, hey, I may need to do some things so I can delay or prevent type 2 from occurring. Okay, I hope that won a whole lot. So I apologize.
[00:31:18] Speaker A: It was a whole lot, but it was good.
[00:31:20] Speaker B: It was good.
It's just like, I just go on and on.
[00:31:25] Speaker A: That was a whole lot. But one thing that we can break down that you. Thank you for sharing that, because you basically identified the three types of diabetes, you identified type 1, which again, like you said, is more is an autoimmune disease, meaning nobody did anything to cause it. It's the body attacking itself. And we usually see this in younger people. Am I correct?
[00:31:50] Speaker B: Yeah. But we're starting to see a lot in adults as well. So it's no longer. That's why it's no longer called juvenile diabetes or child onset diabetes, because we're seeing a lot in type one in adults. And then we also have something that's called LADA that you develop later on in life as well. So the three main types, type 1, type 2, and then gestational diabetes. Yep.
[00:32:14] Speaker A: Yeah.
[00:32:15] Speaker B: And I wanted to clarify.
[00:32:16] Speaker A: Go ahead.
[00:32:17] Speaker B: You were about to say, no, diabetes occurs when you're pregnant. So if you have diabetes beforehand, that's not gestational diabetes, that is diabetes while pregnant. Now, if you don't have any diagnosis of diabetes, your healthcare provider may check you. I think it's 24 to 28 weeks screening for gestational diabetes. And if that's positive, then, you know, you may be treated with medication, may be treated just like with diet only just depends on those numbers. And now what they're doing. It's like when people are pregnant, they go ahead and screen them, like early on, not for gestational, but they screen them, they check them to make sure that they don't have diabetes because gestational can only be between like 24 and 28 weeks. So if you have it before then it's probably that you had diabetes. It just wasn't diagnosed.
[00:33:04] Speaker A: Oh, wow.
Yeah, that's good.
Speaking of, I got some statistics here because I have to bring statistics.
[00:33:12] Speaker B: Okay.
[00:33:13] Speaker A: Just talking about prevalence of diabetes. According to the CDC, more than 38 million Americans have diabetes and about 96 million Americans have pre diabetes. And so I thought that was a lot. And for undiagnosed cases, it says that approximately 8.5 million people with diabetes are undiagnosed. And like you said, some people just don't know they have it. And so I thought that was a lot. And then just looking at the economic cost, it says here that diabetes costs the US healthcare system and employs 327 billion annually, including $237 billion in direct medical costs and 90 billion in reduced productivity. So I'm not here to get into the politics part of it, but sometimes I think people don't understand the impact of something until they know numbers. Like some, some people are just numbers people. And then some people are like, no, just give me. Just give me other facts. Give me the definition. And they're good with that. And complications of diabetes. Diabetes, like you said, is the leading cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputations.
And just going back to just personal experience and hearing patients or family members say, because a lot of times people go by what they, what they have experienced through other people or somebody else's experience that so. And so had to get his cig cut off because he was diabetic. You know, and so a lot of times people are fearful and there's this gloom and doom, like you kind of mentioned, because of what they saw somebody else go through. And so what would you tell someone who is diagnosed with diabetes? And I know, like, we've already talked about the positive, you know, using the correct language, but what would you tell someone and what would you encourage. Also, what would you. How would you encourage new nurses to. Or to just nurses in general? How, how can we approach patients who are newly diagnosed?
[00:35:29] Speaker B: Okay, that's a good question. Yeah. First, you just want to break down the basic things about diabetes. You know, I find a lot of times that people may have diabetes for, for years and they truly don't know what an A1C is. That's why every time that I'm talking, especially if I know it's going to be for the public and see it, always explain what an A1C is. So do those basic things, let the patient know about things that they can do on their own to help empower themselves. So, you know, we could tell them about checking their feet, you know, making sure that they're not walking barefoot, just educating them on those things, letting them know what their blood sugar goes or blood sugar levels should be, just giving that information because a lot of times they don't know. And a simple thing also, what I found is that sometimes more we're getting into the, like CGMs, the continuous glucose monitors, but I have found that sometimes people don't even know how to use a blood glucose meter. So as. As a nurse or as a healthcare provider or whatever, those are just basic, simple things that we need to show patients how to do or what to do. And even, like, if there is a provider, as far as the nursing aspect, if you're putting a patient on a medication, explain to them how it works. Explain to them possible side effects because, like, when they know how something works, when they know Possibly what to look for. That's going to make sure. Hey. Well, Dr. Sellers told me this may cause this, and, you know, it may not last long, so I'm going to ride this out. You know, it may only be a few days, and so. But now the few days is over. I feel much better. My blood sugars are much better. So just let them know. I'm a big proponent of educating.
So at our practice, they know. My patients know, in my front desk know. Your first visit is going to be long because I want to see what, you know, I want to see what we need to do. Labs. We're going to talk about diabetes and everything else. So that first visit is always long. And that's one thing that I love about being in practice for myself, because I can control that. And I think that's very important because there are a lot of things that you need to know with diabetes and. No, you can know everything in one visit. And I don't expect them to. But what I want to do is make them feel comfortable enough and then just give them those basic things. Are they going to need to hear it again? Yep. Because that's how we learn. We didn't learn ABCs in one time. You know, we learned it through hearing it over and over again, but just giving people that opportunity. So I would say to nurses, just take that time and just educate people. Educate your patient.
[00:38:15] Speaker A: Yes. And on top of that, I tell them, always tell them you're educating the patient in general or if you know. Because a lot of times we see this, too. There's a delay in discharging someone, because as the provider or as the nurse, we kept doing it like we were doing their. We were sticking their finger. We were checking their blood glucose. And then on the day of discharge, they don't know how to work this meter. Like you said, it's like, how do you empower them to get comfortable or incompetent to start sticking themselves with the resources that, you know they're going to go home with? And so I'm glad that you said that. Like, being able to empower them, like, we could even start that if they happen to be hospitalized. Cause a lot of times I feel like they find out you're in a hospitalization, like, that's the reason for coming in. And so how do we empower them to be confident to do those things before they actually get discharged? Yep. So that's good.
[00:39:14] Speaker B: Yeah.
[00:39:15] Speaker A: I feel like we just tell you.
[00:39:17] Speaker B: A story about a patient really quick. I had a patient, their PCP referred them to me. And so her, she was on the leap on the continuous glucose monitor. And like her blood sugar still was 300. 300. So I put her on like this. Insulin therapy.
Yeah, I think she was on insulin therapy because I think her A1C was like 14 or something like that. And so on the CGM, you could just still see, you know, numbers not changing, numbers not changing. And then so I. This was like a first visit. And then on the first visit, I added a GLP one. And so she got all this stuff or. No, no, no, no, I didn't add the GLP1. She was on insulin. She was on GLP1 already. Okay, okay. So I had to come back in. I just increased the dose. So I'm like, okay, well, are you taking it? Are you sure you're taking it? She's telling me she's taking it. So I believe we had to come back in in a week. Number still like 350.
[00:40:09] Speaker A: 350.
[00:40:10] Speaker B: So I told her, and I'm gonna say, I'm saying this so hopefully it can help some other nurses, help some other providers. I told her, I said, bringing your medication with you. I said, show me what you're doing.
She never took the cap off the insulin or the GLP one.
[00:40:26] Speaker A: Wow.
[00:40:27] Speaker B: She took like the protective cap off, but there's another cap that you have to take off off of the needle. She never did that.
[00:40:35] Speaker A: Wow.
[00:40:36] Speaker B: And so that's why her numbers, because I'm like, you're not taking this. You can't be taking this, you know? So that's why I was like, well, bring yourself in. Show me what you're doing. Yeah. And that was it. So we just take our time and talk to these patients. Don't just brush it off and be like, they're not doing it. They tell me that they're taking the insulin. They're not doing it. You know, they're just telling a tale or whatever. Sometimes we just got to talk to these patients, just see what's going on. Just take time. That's good.
[00:41:03] Speaker A: Instead of writing her off as non compliant. Yes, yes, she's non compliant. And then throwing another medication on there.
[00:41:10] Speaker B: And look, we do success stories for November. She's one of the success stories course is coming up in November.
[00:41:15] Speaker A: Yes.
[00:41:15] Speaker B: Yeah, yeah.
[00:41:17] Speaker A: Yes. Kudos to her.
[00:41:19] Speaker B: Yeah.
[00:41:20] Speaker A: And to you for even.
[00:41:22] Speaker B: Thank you.
[00:41:22] Speaker A: Yeah.
[00:41:23] Speaker B: But she had to do the work. But. And that's what I tell patients. Like, I can't go home with you, so I'm proud of you. They're Saying like, oh, you know, you did this. You didn't know. You got to do the work. I'm just here to help. You don't gotta go home do it. So, yeah. So just sharing it for nurses and providers and also.
[00:41:42] Speaker A: That's good. That's good. And I think even with teaching patients, and I've learned a lot just being in my educator role.
[00:41:50] Speaker B: Right.
[00:41:52] Speaker A: So one thing I've learned is that when you teach patients something, you ask them to show you or tell me what you just heard me say, and then you will realize that is not what I say.
You will realize because they're going to go home. Like, even if you have a caregiver in the room and the patient, everybody hears something different.
[00:42:15] Speaker B: Yes. Yes. Yeah. Oh.
[00:42:16] Speaker A: So they end up right back in the hospital because nobody heard the right thing.
[00:42:20] Speaker B: You are absolutely right. Yep.
[00:42:22] Speaker A: So it's just amazing. Like, you have to make sure. Like, take that time to make sure that patients truly understand what that means for them. Whatever, whatever we're teaching them, whatever they have to learn for themselves, like, make sure they know what it means for them and help them own it. You know, Help them own it. Help them own it. I tell them, don't. Don't try to. Don't try to provide care on the fly. Like, honestly, when you're in that room with that patient, anticipate other things because they may be in with a stroke. But just saying, if they have diabetes, we still have to be mindful of what do the. What does their feet look like? What would healing look like if they were to get wounds? And so it's like, you have to help them own their own care, you know, depending on how well they're able to rehab, if we're talking about a stroke and all. But, you know, it's just like, help anticipate those things so that patients don't go home. They get treated for one thing, and then come home, come back because they have a foot, a wound on their foot. And it's like some stuff we can just prevent. We can prevent while they're in our care. Thank you so much. Thank you.
Let me see what my next question is.
[00:43:31] Speaker B: Okay.
[00:43:32] Speaker A: Okay. So with patients with diabetes, what are some common challenges that patients face in managing diabetes and how can they overcome them?
[00:43:43] Speaker B: Okay, so what I hear from patients a lot is, you know, especially with making those lifestyle changes, sometimes with taking multiple medications, especially if you never had any type of conditions or anything like that, or chronic diseases, if you have to start taking medications, you have to remember to take the medications or if you start on an injectable like insulin or something like that, people knowing that they have diabetes or like they have to be on a meal time incident, sometimes they shy away from people knowing that they have diabetes or have to get this injection.
But that's why I was saying earlier about the stigma. So we have to get away from that stigma that's associated with it. But the good thing about diabetes management now is that a lot of my patients, this is patients with type 2. I don't have a whole lot of patients on mealtime insulin anymore because those GLP1 injectables or even the oral medications have helped people lose weight, they help people control their blood pressure. And so those medications and some of them even have an indication for preventing cardiac deaths. And I think now they're looking at trying to the possibility of having an indication for kidney disease and everything. So those medications have really been a game changer. And so like we could take patients off of like insulin. That's what I've done in my practice. You know, this people, type two, of course, because people with type one have to be on insulin therapy. So that's one of the things then also knowing that, okay, well, I'm out with friends and so, you know, I may can't eat everything that they do. But I always tell people you can eat just about anything you want. You got to have a little bit of, you know, discipline and just some sense about what you're eating though. But you don't have to like go to an event and just be shunned away or not enjoy things. So that's one thing I always just try to tell my patients you still can. Just like Thanksgiving is coming up, you know, get a small piece of, or a small helping, a portion of dressing. You know, try this if you're still hungry, maybe get more of the turkey, you know, things like that, more protein, get more of the green salt or spinach, whatever the green leafy vegetable is, but still enjoy some things. And then okay, maybe I'm not getting all this macaroni and cheese, but I'm going to get a little portion of it because I want little slice of sweet potato pie. As long as you're drinking your water, you're not drinking your carbs, you know, like your soda, whatever, go ahead and do this. It's still time to enjoy and enjoy life even if you have diabetes.
So I think that's part of the challenges is like the family members holding them hostage, saying, you can't do this, you can't do that. And even when family members come in with their patient, with their. With their. With the patient, I try to explain to them, too, hey, we all going to work this together. You know, you all, husband and wife can go walking together, because, I mean, walking is good for all of us. Even if, you know, you don't have diabetes. We all could go walk, and it helps our heart and help keeps weight off and all that. So there's things that, even though it may be a challenge, there's things that you can do as a family and everything as well. So I hope that answered your question.
[00:46:59] Speaker A: Yes. That's good. That's good. And some of the things, like you said, that we're. That we as family members want to hold our family accountable for is like something that we can all really do together.
[00:47:09] Speaker B: Yeah, yeah. And there's nothing wrong with holding accountable, but I think it's when you try to shame or just do overboard, I think we all need to hold each other accountable just in life, but just don't, you know, shame and get them into different things like that.
[00:47:27] Speaker A: Yeah. You know, you can't have that. You know, you're not supposed to be treating color.
I got it. Thank you.
Thank you. Now, as far as educational insights, what kind of training and education is required to become a certified diabetes specialist?
[00:47:45] Speaker B: Okay, so that's a good question. I'm so glad that you asked that, because I feel like we need more educators, especially certified diabetes care and education specialists, because you do get that educational background, and then you really are able to help patients, and you come up with an individualized plan. So it's the National Certification Board, or diabetes educators, that holds the certification. And so to receive the certification, there is a test that you have to take aboard a certified exam. And there's so many hours that you have to have as providing diabetes education.
You can be an rn.
You can, I think, a pharmacist.
I think anybody with a bachelor's, I believe, are the requirements. But I know you have to have a certain amount of hours as a diabetes education educator, and then you also have to, of course, take the exam. And so I think for me, when I was studying to take the exam, I did courses through the Diabetes Care and Education Specialist organization, because I'm a part of that organization now. So there's classes I took there. They're also. I went to a conference that was provided by Diabetes Education Services. Beverly Tomasian. She's a great diabetes educator. I just love her. And a couple of years ago, I got to meet her and now we like talk almost all the time on LinkedIn. So I'm like, hey, I know. Anyway, and so she told me she's proud of me. So that was like a moment there being whole. I took her course and that, that would really help me. I believe pass. Pass the test. Because it's not an easy test but long as you're studying for it and all that, you have passport, you know, this is something that you really want to do, study for it. Because like I said, I really think that we need more and I really feel like becoming a diabetes educator really helped me have like the compassion to provide individualized care. Just look at it, look at diabetes differently when I became, excuse me, when I became an educator and started studying. And then for board certification I know that you have to have a master's degree for that. And I think pharmacists, anybody that provides care, so pharmacist np, Maryland palace can get, can be board certified in advanced diabetes management. But rd, rn, so can have a certified diabetes education specialist which is formerly known as the cde.
[00:50:30] Speaker A: Okay, cde, thanks for shedding light on that. Now, what advice would you give someone that is considering a career that involves diabetes management?
[00:50:42] Speaker B: Come on, we need you. That's my advice. Yeah, well, again it's just studying, you know, really staying up to date on the current guidelines. Every year the American Diabetes association comes up with our standard of medical care for diabetes. And so you can stay abreast on the clinical guidelines that the ADA provides. Knowing how to again provide that person centered individualized care patients, because all patients are not cookie cut, you know, they're not the same. So you want to look at each patient and see what may work best for them. So if they have heart disease, you might want to put them on a medication that's going to help heart disease, kidney disease, so forth. They're overweight, you know, you put them on a medication to help that. But if you're interested in diabetes, I say go for it.
I love it. So I don't know if you're tell from the interview that I, I love it. I love what I do. I love helping people. I love when people's A1C or 16 and we can get it down to six or so and you know, they feel better, they are healthier, you know, they're happy with their management.
So if you want to do it, I just say do it, you know, because we need more people. Even when I started out, it's still in, it's still not a lot of Diabetes providers. But it's more than when I started out, so that's a good thing. So I say come on, because the diabetes we know is a pandemic, you know, it could be epidemic as well. And so it's not going anywhere. But there's some things that we can do to try to help our patients, you know, to prevent diabetes. It's a good thing that now they're doing more type one screening. There's a big pushed on type, Type one screening, especially with people who have siblings or family members with type one. So we're trying to do things to help increase awareness about type one, then type two. We're trying to do things to help prevent type two. So if you're interested, I say come on and jump on board.
[00:52:50] Speaker A: Oh, thank you. Thank you. I think we've covered a lot.
Covered a lot. I think one thing that I forgot to ask was about resources. What resources for patients who have diabetes? What other resources? Because I know you also have a couple of resources on your website as well, just like articles, things like that. But what resources are made available for patients with diabetes?
[00:53:18] Speaker B: So it's so many things are out there now. And so just say if you're on a certain medication, we'll just say like a SGLT2, which may be something like our CGS or so a lot of times they have on their websites to where if you're on that medication, you can go become like a part of a plan. They educate you on things or just like medications like the Ozempic, Manjaro, they have where you can go scan a QR code and you can become like part of like support groups with that. Even like the CGMs, the continuous glucose monitoring. I know that there's different apps that you can go on and be a part of that. The American Diabetes association has different resources for patients. Also have cooking recipes and everything that would be good. The association, excuse me, diabetes care and education specialist also has resources for patients handouts and things as well. And what I will say that people with diabetes. One thing that would be great is to see a diabetes care and education specialist. So most of the time insurance will provide that. They would provide so many visits that you can see an education specialist and a registered dietitian. So you can also get that medical nutrition therapy through your insurance as well. So that's important when you first diagnose for diabetes. If you have any changes in your diabetes plan or changes like in your A1C, you can always go see an educator. And so that's going to be very important. That's one of the best resources I could say for anybody that has diabetes.
[00:54:57] Speaker A: Thank you. So I got that. You get diagnosed with diabetes to ask for a ecstasy, a diabetes education educator specialist, and a dietitian.
[00:55:10] Speaker B: Yep, yep. And insurance should cover that.
[00:55:13] Speaker A: Okay. I'm so glad I asked because I'm trying to think in the mind of someone who may need something.
So thank you for sharing that. Now, as we wrap up this episode, Dr. Sellers, what final thoughts do you have for our listeners?
[00:55:28] Speaker B: For our nurses? Make sure that you know what you want to do. Don't let anybody tell you that you can't do it. And, you know, with discipline and hard work.
And make sure that you are continuing your education as far as attending conferences. If there's any type of certifications that you want to get, you know, go ahead and start studying for those things. If your employer has any, like, free educational classes, if they pay for you to go back to school, go ahead and jump on those opportunities. And also, I would say to nurses, make sure that you encourage another nurse. Make sure that you, if you see something in somebody, empower them. Let them know, hey, you're doing a great job. That you just never know that you could be helping the next person become the next Beverly Tomasian or whoever. That's one of my good diabetes educated nurses. So you could be helping that person, empowering that person. So believe in yourself and also empower other people. For patients with diabetes, you know, hey, diabetes didn't occur overnight. Your unhealthy lifestyle didn't occur overnight. So those changes won't occur overnight. Give yourself some grace and take each day one day at a time and continue to live well.
[00:56:46] Speaker A: Awesome. Thank you so much.
Sounds good. Thank you.
[00:56:50] Speaker B: Thank you for having me. I enjoy you.
[00:56:54] Speaker A: Thank you. Thank you. It was my pleasure. It was my pleasure.
How can our listeners connect with you?
[00:57:02] Speaker B: Okay, so if you are a patient and you have diabetes or a family member have diabetes, if you want to, you know, come to our office. Our office is located at 512 Graham street in West Memphis, Arkansas 72301. Our phone number is 870-551-4409 and our website is www.mydcwellness.com. and for any nurses or anybody else, we do have a Facebook. I think it's diabetes care and wellness. I also have a platform called the Diabetes Wellness NP on Instagram and Facebook. So any nurses, especially if you're interested in becoming a diabetes care and education specialist in diabetes management, feel free to message me or anything. I'll be happy to help.
[00:57:53] Speaker A: Yes. And I will also add her contact information on ways that you can connect with Dr. Sellers with the episode as well. And as for me, your host, Nurse Chanel, you can find me on Facebook under all one Nurse. You can find me on Instagram Allone Nurse underscore nursechannelle. Or it just may be allone Nurse underscore Chanel. And you can find me on TikTok as allone nurse. And so until next time, bye.
