My grandmother is a tenacious and vibrant woman who was diagnosed with type 2 diabetes earlier this year. She had uncontrolled blood sugar levels along with other health issues and limited mobility. With no formal educational background, she doesn’t know much about diabetes or possible complications. Her low health literacy makes it difficult for her to utilize diabetes related health care resources. “There are too many rules in my diet!” she would exclaim in Twi, her native dialect. She also has low nutritional knowledge and at times would reduce her consumption of certain staple foods. She assumed that eating less of these foods would cure her body from the disease. Her daily diet in Ghana is mostly starchy and sugary foods with low nutritional benefits. One staple meal that she eats quite often is called fufu: a soft dough-like mix of cassava, plantain, and other flours served with different types of warm soups full of meat and/or fish. Fufu is relatively high in carbohydrates and has a significant and rapid effect on my grandmother’s blood sugar levels.
As my grandmother’s caregiver, I provided diabetes care management and education. My goal was to help her avoid blood sugar spikes keep her blood sugar in a healthy range before she went back to Ghana. Every day I checked her fasting blood sugar in the morning and again two hours after eating. These results were reviewed by her PCP and nurse case manager. I modified my grandmother’s meals and incorporated more green leafy vegetables, fiber-rich foods, whole-grain breads and old-fashioned oatmeal with almond milk and honey for added sweetness. I also introduced her to cooked quinoa and cauliflower rice as substitutes for fufu, white rice, and other fufu-like foods to give her meals a nutritional boost. After a meal, I would encourage her to take a walk to the local shopping plaza or to circle around the neighborhood for an hour. Despite her stubbornness and fiery temper towards changes to her diet, we were able to improve her eating habits by stressing the importance of portion control.
My grandmother does not know how to pronounce diabetes or manage her care on her own, but making sure she understood that her medications, changes to her diet, and daily walks to her favorite consignment stores are effective tools for managing her blood sugar levels were key components to her care plan. My experience as a caregiver was a wonderful opportunity to spend time with my grandmother, and it also highlighted the importance of diabetes education in following a care plan and reducing risk of complications. I also learned how that approaching care in a culturally tailored manner that respects individual preferences, opinions and ideas is necessary for reaching optimal health.