Jeffrey Mechanick Part 7, Summit Findings and Conclusions of Research

In part 7, the conclusion of this Exclusive Interview, Dr. Jeffrey Mechanick talks with Diabetes in Control Publisher Steve Freed during the AACE 2018 convention in Boston, MA about his key takeaways for healthcare providers and how they can incorporate cultural awareness in diabetes treatment.

Dr. Jeffrey Mechanick, MD, FACE, FACR, FACN, ECNU is the Clinical Professor of Medicine and Director of Metabolic Support in the Division of Endocrinology, Diabetes and Bone Disease at the Icahn School of Medicine at Mount Sinai, NY.

Transcript of this video segment:

Freed: What were the overall summit findings and the conclusions?

Mechanick: Well, there were several findings from our Diabetes Care Across America. First of all, we need to change the way clinical investigation is done – we need to have more of an active recruiting strategy for Latinos, African-American, and Asian-American populations to be more representative so that the findings can be more generalizable. Second, there is an issue of trust. Many of the minorities, many of these cultures and ethnicities, have lack of trust in their physician. What we have learned is, and there was a study presented at the American College of Cardiology with provision of care by the barber shops and the pharmacists working with the barbers, that agents in the community, either in a community facility or a church – if medical care in some fashion, can be discussed, not necessarily dispensed comparable to what you would find in a doctor’s office, but could be a place where people could go where they would trust the messenger. That would be another issue. Other issues would be changing the eating patterns, recognizing the eating patterns, the language barrier, and taking care of food deserts. So, when we were in Houston, we learned about food deserts for the lower socioeconomic class, who did not even have access to the healthy foods even in the franchised, large stores where food was made available for purchase – they were not able to find fresh fruit and vegetables. A lot of times there was spoilage. [We can] teach the children – work on the children so when the children come home, they can educate the parents and the grandparents who are all living together. In short, we learned a lot. We’re actually now in the process of putting all this information together, curating the information and developing a position paper on transcultural diabetes care by AACE.

Freed: So, if there are a couple of points you want the medical professionals to walk away with, with a true understanding, what would those points be?

Mechanick: I think, firstly, to recognize that there are differences – people are different, drugs work differently, and that lifestyle needs to apply differently. How can this be done in only a 15-minute visit? Listen. Establish that rapport, recognize some space issues – some people like you to be close, others require that space. Be respectful of the cultural aspects for that particular patient. Once you establish that rapport and that connection, the message is going to be much better heard. Number two would be to read. Read about the differences that exist in the literature. If you see a study that is coming out that is in India and would be more applicable to your patients who are from India, than for your patients from Mexico, for instance. Lastly, stay tuned. A lot of this is really in its infancy and I wish I had more science to be able to convey, but that is one of the aims of this program.

Freed: Well, I don’t want to take any more of your time. Enjoy the rest of your stay here and it was a pleasure seeing you again.

Mechanick: Great, thanks Steve.  

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