UTEP’s Diabetes Garage Helps Men Get in the Driver’s Seat to Better Health
Last Updated on June 14, 2021 at 12:00 AM
Originally published June 14, 2021
By Laura L. Acosta
At age 50, Ricardo Ramos was blindsided when his doctor diagnosed him with diabetes in 2019. Ramos knew that being Hispanic put him at greater risk for diabetes but because the disease didn’t run in his family, he didn’t think it was something he had to worry about.
After his diagnosis, Ramos assumed he would have to take insulin and stop eating tortillas and other foods he enjoyed cold turkey. Although, he worried about his blood sugar levels rising too high, he was not aware that diabetes could affect his heart, liver and kidneys.
“I used to chalk it up to just getting older,” said Ramos, who lives in San Antonio, Texas. “I noticed I would get tired, or I would feel a little weak. I didn’t know the early signs of your blood sugar dropping or being too high.”
Instead of insulin, Ramos was prescribed a medication to treat his diabetes. He also took his doctor’s advice and ate smaller portions of the foods he liked and switched to using artificial sweetener in his coffee.
But Ramos, the father of two sons, felt that there was more he could do to manage his diabetes. His wife Sonia Ramos, who works at The University of Texas Health Science Center at San Antonio, introduced Ramos to The Diabetes Garage, a diabetes management and self-care program for men at The University of Texas at El Paso.
Developed in 2018 by Jeannie Belinda Concha, Ph.D., assistant professor in UTEP’s College of Health Sciences Department of Public Health Sciences, The Diabetes Garage applies automotive maintenance and repair analogies to help men in El Paso County learn how to manage their disease. In August 2020, the program began offering online workshops to men in San Antonio and Harlingen, Texas.
“(My wife) said this would be the perfect thing for me to do get educated (about diabetes) because I was totally blindsided by this news,” said Ramos, who will retire from law enforcement after 21 years of service in July 2021. “I had no idea what the consequences (of having diabetes) could be.”
Hispanic men such as Ramos are most at risk for diabetes and for developing chronic health problems associated with the disease such as heart disease and stroke.
According to Concha, research indicates that Mexican American men have less diabetes knowledge, are less likely to visit a diabetes specialist or adhere to treatments and are more likely to have complications compared to women. She said Men’s Health Month in June and Father’s Day on June 20, 2021, are a good time to remind men to take steps to improve their heath.
“There is so much misinformation out there and The Diabetes Garage is a safe space for men to open up and talk about their diabetes with other men,” Concha said. “They really struggle because they have so many questions about their diabetes and their medications and why they can't get their sugars in target range. We really help them figure those things out and their reaction is ‘Oh, I didn't know that! That helps! Now I know why this is happening.’ And these are questions that people have who are not getting diabetes education.”
Maintenance and Prevention
The Diabetes Garage was designed to engage men in diabetes education and support sessions by using automotive concepts such as “Check your Gauges,” to teach men the signs and symptoms of low (hypoglycemia) and high (hyperglycemia) blood sugar levels. The four-week program involves weekly two-hour sessions taught by certified diabetes care and education specialist educators. In 2020 the program started offering their workshops online due to COVID.
Topics include “Using All Your Gears,” to motivate men to exercise, and “High-Performance Fuel,” which focuses on proper nutrition. Participants learn how to manage their glucose and prevent diabetes-related complications, such as limb amputations, impotence, blindness, kidney failure, heart attacks and strokes.
“A lot of things could be prevented if we just do the preventive maintenance on our bodies,” said Ramos, who appreciated how the sessions allowed the eight men in his group to open up about how they felt when they were first diagnosed with diabetes and their struggles learning how to eat properly.
“I was very vocal because I know that us as Hispanic men, we are very private,” Ramos said. “We don't want to tell people we have diabetes. Our culture just doesn't help us to be open and learn about things like this and I think we have to get out of that.”
Staying on Track
As of May 2021, 98 men have participated in the Diabetes Garage, which boasts an 86% retention rate.
Satisfaction surveys completed by The Diabetes Garage participants indicate that the automotive comparisons helped them understand the importance of managing their diabetes.
Concha’s work on The Diabetes Garage has resulted in her being recognized by the American Diabetes Association with the Young Investigators Award for her abstract “The Diabetes Garage: Using Automotive Maintenance Analogies to Engage Mexican-American Men to Participate in a Diabetes Self-Management and Education Program.” The award will be presented at the 81st annual ADA’s Scientific Sessions on June 26, 2021.
Carlos Roberto Jaén, M.D., Ph.D., chair of the department of family and community medicine at UT Health San Antonio, said society needs to stop blaming men for their diabetes and instead focus on other factors such as poor working conditions that often prevent men from receiving the proper health care they need.
Although, Jaén is not involved in The Diabetes Garage, he said the program’s automotive concept provides men a supportive place where they can be in charge of their health by providing them the resources on where to go or what to do about their diabetes.
“It’s not because they don’t want to do it, it’s because they haven’t had the opportunity to be exposed to the education in a way that makes sense to them,” Jaén said. “And I think that The Diabetes Garage (is) a great way to make that happen.”
Based on the positive feedback that Concha has received, the program has expanded its services in the state with support from the Texas Department of State Health Services (DSHS). To date, DSHS has awarded The Diabetes Garage two grants totaling $470,000 in support of the program.
In 2021, Concha received a $240,000 grant from DSHS to launch a new initiative to offer five health care providers in El Paso County an $1,100 grant to become certified in Diabetes Self-Management Education and Support (DSMES) services. UTEP will cover the $100 cost to existing DSMES programs that want to add an educational site.
DSMES is a cost-effective tool provided by the American Diabetes Association (ADA) and the Association of Diabetes Care and Education Specialists (ADCES) to teach people with diabetes how to take the best care of themselves.
“Research shows that people who attend DSMES programs have better diabetes management outcomes compared to those who do not receive diabetes management education,” Conca said.
Concha will host two webinars in June titled, “Improve Diabetes Patient Outcomes and Get Paid for It!,” for health care professionals who are interested in becoming DSMES provider. For information, visit https://www.utep.edu/chs/news/improve-diabetes-patient-outcomes-and-get-paid-for-it.html
Ramos said The Diabetes Garage was one of the best decisions he has ever made for his health. He hopes that the program can be applied to helping men open up about other critical health issues such as colonoscopies to prevent colorectal cancer.
“I think we're making that turn in being more open about our health, and I think a project like The Diabetes Garage is really a good place to start,” Ramos said. “Today is about diabetes and tomorrow it may be something else that we can talk about.”
For more information visit The Diabetes Garage at www.diabetesgarage.org.