When it comes to navigating the healthcare system as an immigrant, there are so many layers that often get overlooked in traditional medical care. Language barriers, cultural stigma, fear of speaking up, and the pressure to take care of everyone else before yourself can all make it harder to get the care you deserve. It isn’t easy, but you don’t have to do it alone. On a recent episode of the Diabetes Digital Podcast, we sat down with Diana Mesa, a bilingual dietitian and certified diabetes care and education specialist based in Miami, to talk about what it really looks like to support immigrant and first-generation families through healthcare. Listen to the full episode here, or keep reading for tips and insight from our conversation.
Trusting your doctor doesn’t mean you can’t ask questions
In many immigrant households, doctors are seen as respected authority figures, and questioning their recommendations isn’t always part of the cultural norm, especially if that wasn’t something welcomed or encouraged in the country of origin. But learning to speak up in healthcare settings can be an empowering step toward receiving more personalized care.
For anyone feeling nervous or unsure, there are small, supportive ways to start. Writing down questions ahead of time can help keep the conversation focused and make it easier to speak up in the moment. Bringing a trusted support person can offer emotional backup and help clarify what’s being said. And practicing simple phrases like “Can you explain that again?” or “I’d like to talk about another option” can build confidence over time.
Stress plays a real role in chronic conditions
It’s not uncommon for Diana’s clients to say they “got diabetes after moving to the U.S.” While it might sound surprising at first, it highlights the reality of how the stress of immigration can significantly influence chronic health conditions. From financial strain and language barriers to social isolation and lack of access to familiar foods, the experience of starting over in a new country can affect everything, including blood sugar.
“Coming to the United States changes everything,” Diana said. “You’re not just changing your address, you’re changing how you live, eat, move, and even how much sleep you get. That all affects your health.”
And the science backs this up. A study from the Jackson Heart Study found that higher levels of cortisol, the body’s main stress hormone, were linked to higher fasting glucose, lower insulin production, and increased odds of having type 2 diabetes, especially among African Americans.
When you combine elevated cortisol from chronic stress with disrupted routines, long work hours, food deserts, and the emotional toll of navigating a new culture, it’s easy to see how stress isn’t just emotional. It’s metabolic.
Stigma can keep people from getting diagnosed or treated
IIn many communities, diabetes is still associated with shame and stigma. Diana shared that some of her clients don’t even realize they’ve been diagnosed; providers might prescribe metformin or recommend lifestyle changes without ever clearly saying, “You have diabetes.” When a diagnosis feels unclear or shameful, people are less likely to talk about it with family or follow through with care. Research shows this stigma can directly impact health. Individuals with type 2 diabetes who feel blamed, judged, or treated differently are less likely to engage in self-care behaviors like checking their blood sugar or managing their medications. The more stigma people experience or internalize, the harder it can be to care for themselves in the way they want to.
In multigenerational households, it’s common to downplay symptoms or stay silent to avoid burdening others. “There’s this need to kind of take care of everybody else and put their needs last,” Diana explained. “Why would they bring up something like a diabetes diagnosis when they don’t want to stress their kids, their partners, or anyone else in the household?”
So how can families begin to break that silence? Create space for open, nonjudgmental conversations. That might look like saying, “I’m learning more about diabetes and how to support you,” or asking, “How are you feeling lately?” without jumping to solutions. For those who feel uncomfortable bringing it up, even sharing a podcast episode or article can help spark a conversation. Reassure loved ones that having diabetes doesn’t mean they failed, it means their body is asking for care and support.
Body image pressure changes as people assimilate
Many immigrants arrive in the U.S. without ever having worried about weight. In many cultures, there’s a deep respect for food, body diversity, and eating for connection rather than control. But over time, the pressure to shrink, fueled by Western beauty standards and weight-focused healthcare, can begin to take hold. This often intensifies with age, especially for women navigating diabetes, PCOS, or hormonal changes.
Research shows that these pressures aren’t just cultural, they’re systemic. In one national study, racial minority men and women reported feeling pulled between multiple cultural expectations and unrealistic appearance ideals. The same study found that sociocultural pressures and appearance surveillance were strongly linked to poorer body image and quality of life, especially among women of color.
Weight stigma, especially when it comes from providers, can lead to guilt, restriction, and burnout. Another study found that individuals with type 2 diabetes who experienced stigma eeling judged or blamed for their diagnosis were less likely to engage in self-care behaviors like checking blood sugar or taking medications consistently.
Despite strong evidence that people can improve blood sugar and feel better at any size, weight loss is still pushed as the first step. A weight-inclusive approach shifts the focus to what truly supports health like consistent meals, joyful movement, and a healthy relationship with food.
Language and cultural nuance matter more than you think
Even when patients and providers technically speak the same language, communication can still break down. Spanish varies widely across regions, and a dish that’s common in Puerto Rico might have a completely different name or meaning in Venezuela, Mexico, or Cuba. Words, phrases, and even body language can shift depending on someone’s background.
That’s why it’s important not to assume shared language always means shared understanding. “Even as a native Spanish speaker, I had to ask patients what certain words meant because they were using terms I’d never heard before,” Diana said. “You have to stay curious and open.”
Even if your provider speaks your language, it helps to share your cultural background, the foods you eat, and the traditions that matter to you. And if your provider doesn’t speak your language fluently, it is your legal right to request an interpreter. Interpreter services are not just about translating words. They help ensure your questions, emotions, and concerns are fully understood.
If you’re helping a parent navigate care, do not hesitate to ask for this service ahead of time. Miscommunication can lead to unclear diagnosis, confusion about medications, and a lack of trust in the care being provided. Everyone deserves to feel heard and understood.
You can still eat your rice and beans
So many people come into care after being told to cut out the foods they grew up with—rice, beans, plantains, pupusas, tortillas. These cultural staples are often blamed for high blood sugar, but that’s not always the case. Food isn’t the problem, and a diabetes diagnosis doesn’t mean you have to give up the meals that have nourished your family for generations.
That’s why it’s so important for providers to understand both the cultural significance of food and how it fits into someone’s daily life. “I don’t tell people to stop eating their foods,” Diana said. “We just look at how to make it work. Sometimes that’s adding protein, sometimes it’s timing. But it’s never about removing your culture.”
Instead of asking people to give up their traditions, care should focus on practical and respectful strategies like pairing carbohydrates with protein and fiber, identifying the nutrients already present in familiar meals, or adjusting when meals are eaten to better support blood sugar. These small, sustainable shifts allow people to care for their health while honoring their culture.
Research shows that for people with type 2 diabetes, adding protein to a carbohydrate-containing meal can help blunt post-meal blood sugar spikes. While the effect is not as dramatic as in those without diabetes, certain proteins like dairy and animal-based options still led to modest reductions in glucose response and meaningful increases in insulin response. These findings support the idea that small adjustments, like adding eggs, beans, or grilled chicken to a traditional dish, can be a helpful and culturally respectful way to support blood sugar balance.
Cutting out cultural foods often leads to guilt and inconsistent eating habits. For many immigrants, it adds to the stress of trying to fit into a healthcare system that already feels unfamiliar. Working with a provider who understands your food and respects your lived experience can make a big difference in how supported and empowered you feel.
You don’t have to figure it out alone
For many first-generation adults supporting immigrant parents, it can be challenging to balance cultural expectations with the realities of navigating healthcare in a new system. Parents may avoid discussing their health or resist help, especially if they still see their adult children as “the kids.”
That dynamic might not completely go away, but as Diana shared, there are still meaningful ways to offer support. “Even if your parents are hesitant, you can say, ‘I’m here to help. Let me make that call. Let me find someone who understands you.’ Sometimes you have to step into that role.”
This might look like attending appointments together, helping with insurance or paperwork, or finding providers who speak their language and approach care with cultural humility. With more providers offering telehealth, it’s easier than ever to access care across state lines. Social media platforms and directories of weight-inclusive, bilingual dietitians are also making it easier to find the right fit.
Transcript
Welcome back to another episode of the Diabetes Digital podcast.
Today we are talking about navigating the healthcare system as an immigrant.
0:09
This is a conversation I don’t think we’ve ever had on the podcast before and it was just a really
good refreshing conversation.
0:17
We were all able to share our stories of working with patients from different cultures as well as
lived experience also from Wendy and our guest.
0:27
So in this episode, we’re going to talk about some of those concerns and layers of complexity when
it comes to navigating the healthcare system as an immigrant, including cultural stigma, language
0:37
barriers, and even pressure to prioritize family over health.
So in today’s episode, we’re sitting down with Diana Mesa, who’s a bilingual dietitian and diabetes
0:47
care specialist, to talk about the challenges that immigrant women, and especially her as an
immigrant Latino woman, face when it comes to getting the care they deserve.
0:58
So we’ll talk about how growing up as the first in your family to navigate the healthcare system can
lead to unique struggles and kind of how to push through them.
1:06
So if you ever have felt unheard or overwhelmed in the doctor’s office, this episode is definitely
for you.
1:12
And also, if you are the children of immigrants and you want to know how to help support your
parents better, we talk about that as well, Yes.
1:22
And a little bit about Deanna.
She’s the founder of In La Mesa Nutrition.
1:26
She’s a bilingual registered dietitian and certified diabetes care and education specialist
providing culturally inclusive care in Miami, FL.
1:35
She’s also a sought after subject matter expert featured in media outlets such as Telemundo, Today’s
Dietitian and Women’s Health.
1:42
Just name a few.
All right, we’re going to hop right in.
1:45
Welcome to the Diabetes Digital.
Podcast, I’m Wendy.
1:49
And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.
Through our telehealth platform Diabetes digital.co, we offer accessible.
1:58
And personalized virtual nutrition.
Counseling for people with diabetes and pre diabetes.
2:02
Visit diabetesdigital.co.co to book your first appointment.
We accept insurance and offer affordable self pay options.
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Now let’s get into today’s episode.
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4:14
Welcome to the podcast, Deanna.
Thank you.
4:17
Thank you so much for having me.
First, can you tell us a little bit about your story when you ended up coming to the US?
4:25
And I also would love to learn, like, some of your early experiences navigating the US healthcare
system and kind of how did that shape your path to becoming a dietitian and diabetes educator?
4:35
Yeah.
So I was born in Cuba in 1990.
4:39
It was the special period, so a little bit after the fall of the Soviet Union, which meant a lot of
food scarcity in in the island and just scarcity period.
4:49
Not just food, but, you know, medical equipment, all sorts of things.
So that drove my parents to leave.
4:57
And my dad first came through Mexico.
He crossed the border like so many immigrants do.
5:03
And then after some time, he sought to bring my mom and I, you know, with asylum.
And I’m not really sure exactly all the legalities of how I got here.
5:15
I just know I was here two years after he left.
So in 1994, we came, we settled in Miami.
5:21
And my parents have a medical background in Cuba.
They were doctors.
5:26
And so my experience in the healthcare system in the United States has been uniquely informed by
that because they have had all of the connections I’ve needed when I’ve been uninsured, when I need
5:38
something and can’t get in with a doctor immediately.
So I’ve been lucky in that sense because if it weren’t for my parents connection, my mom is a nurse
5:48
practitioner now.
She went back to school here.
5:51
My father’s retired, but he also went back to school to become a nurse here.
So they redid their whole careers in their midlife, in their 30s and 40s when they got here.
6:01
So that kind of plugged me into the healthcare system in a way that I was resistant to at first
because I didn’t want to go into healthcare.
6:12
I wanted to be an architect.
I actually studied architecture for two years prior to realizing that maybe Healthcare is my path
6:19
after all.
I have an uncle who is a doctor here.
6:25
He came during El Mariel.
And so he had a head start.
6:29
When you come from Cuba, you can’t renew your your papers, at least not during the time when my
parents came.
6:36
So he was able to in the 80s when he got here.
And so he didn’t have to go to school again or anything.
6:42
He just kind of, you know, validated his licensure in whatever way he could at that point.
But as you know, the relations with Cuba and the United States are very frayed, and that can change
6:56
the status of what’s what in any moment, right, with any administration.
And so that wasn’t the case for my parents.
7:04
If my parents had become doctors here, I would have a very different life.
But my mom was a surgical tech for 10 years before she decided to go back to school for nursing.
7:14
And my dad was a resident under somebody else’s license, which I guess was legal back in that era.
Or maybe it wasn’t.
7:23
I don’t know.
And yeah, so with that said, because they went to school here, I had a little bit of assistance in
7:35
that.
I was in high school.
7:37
I helped them navigate a little bit of what applying look like and helped translate a lot of my
mom’s papers and things when she was doing her undergrad and also when she was doing her graduate
7:47
career.
So I don’t know that my experience as an immigrant with the healthcare system is the same.
7:55
Yeah, as the majority of immigrants, you know, it’s it’s unique in the sense that we had already
that foot in the door because of their medical experience and because of my uncle.
8:08
Yeah, that makes total sense.
And I would love to talk about some of the struggles that you’ve seen when it comes to medical care
8:17
for immigrants for first Gen.
Because speaking from personal experience, like with my parents coming from the Dominican Republic
8:26
and just from what I’ve seen with like family and friends, there is like a fear of authority in a
way.
8:34
And especially with doctors being seen as like the ultimate authority when it comes to healthcare,
just like resistance when it comes to questioning things or asking for clarification.
8:47
Like, that’s something that I would see with my parents, what they would just do as they were told,
even if the medical advice wasn’t really working or if they didn’t agree with things.
9:00
So I’m wondering, like, what are some of the struggles that you’ve seen working with these
communities and how can people feel more empowered to advocate for themselves?
9:10
Yeah, you’re bringing up something that is very true in my experience, and I’ll give you my first
hand experience with my father.
9:19
My father is a medical professional and although he’s been retired for some time and his knowledge
is a little outdated, he is one of those people that still goes by whatever his doctor says.
9:32
His doctor, my uncle, is also quite outdated and probably should have retired maybe 10 years ago.
My father is a person with diabetes and last year he had a few health scares.
9:44
He was in the hospital many times due to low magnesium and low electrolytes because for many
reasons, but in part because of his diabetes medication.
9:57
And my mom, a nurse practitioner, and myself, a certified diabetes educator, tried to intervene and
make recommendations on making medication changes for him so that he wasn’t on, you know, a
10:11
glipizide, which is going to bring his blood sugar down after a meal or whenever he takes it pretty
acutely.
10:18
So even after all of the advocating that my mom and I did, he insisted that he would not change his
medication against his doctor’s advice, no matter what, because he didn’t want to offend his doctor,
10:32
my uncle.
And that experience is very common.
10:38
In my time working in a diabetes clinic here in Miami with a lot of Latinos, it was all Spanish
speaking immigrants, a lot of Cubans, a lot of Venezuelans.
10:48
We talked a lot about how just because their doctor is telling them something doesn’t mean that they
can’t question it, right?
10:59
Because the doctor really only has maybe 15 minutes with you, they’re not going in depth with all of
the lifestyle behavior, you know, factors that exist in these people’s lives.
11:13
And you know, it’s OK to question and ask questions and advocate for yourself if you feel like what
they have prescribed or what they have recommended isn’t working.
11:26
It takes a lot of encouragement and it also takes a little bit of practicing with them, the script
that they’re going to use with their doctors.
11:36
But there’s a lot of resistance because, you know, especially if they don’t have a medical
background, which most people don’t, you don’t know what you don’t know.
11:46
And if you don’t have somebody who does know in your corner helping you navigate, even in me as a
dietitian in the medical field, I still have trouble getting the care I need.
11:57
So imagine somebody who doesn’t have the the lingo, just all of the information that we have as
healthcare providers.
12:04
Yeah.
Thank you so much for sharing that.
12:06
And that is something that I have definitely seen in my practice, especially working with immigrant
populations or even first Gen. populations is yes, this idea of like the doctor is always right and
12:19
that hierarchy and not questioning anything.
They will say that they like got diabetes from coming to the USI don’t know if you’ve heard that a
12:29
lot or like they caught diabetes in the US or just like coming here is where they yeah, where they
started having pre diabetes.
12:37
I would talk to people about this and just learn more about, you know, what they were saying or what
they meant by this.
12:43
And oftentimes what I think it was is like just the stress of being an immigrant in the US and the
impact that that will have on like cortisol and blood glucose levels and how that can actually lead
12:57
to things like diabetes.
And then also, sometimes the food quality is not as good.
13:02
You’re living in potentially food deserts.
So have you seen that with your patients and how do you have those conversations?
13:10
Absolutely.
Especially with Cubans in particular.
13:14
You know, 6% of Cubans in the United States have diabetes.
So it’s it’s not a small number compared to the other Hispanic or Latino subgroups.
13:26
And with the Cuban experience in particular, because there is a lot of food scarcity on the island
and there’s not a lot of variety.
13:34
When they come to the United States, suddenly there is that kind of feast or famine mentality where
we’re maybe more of on the feasting side, which can also, you know, speaking to the lower quality
13:50
foods, the change in the way that they are moving.
For example, maybe they’re walking a lot on the island.
13:57
Maybe they’re riding their bicycle a lot.
That’s how my mom got around with me on a little like wooden.
14:04
I’m not sure what the safety of that was, but like a little wooden attachment to the bicycle, right?
And so they’re on their feet all day moving a lot.
14:13
The stress that they’re experiencing, at least on the island, it’s, it’s stressful, but it is a
different kind of stress when you come to the United States, right?
14:21
Another thing I want to bring up is this idea of stigma and especially I feel, I mean, just in
general, there’s so much stigma around diabetes, but I think also within people of color.
14:33
And I would imagine, you know, the immigrant community as well.
Sometimes it’s maybe not even talked about openly.
14:42
I have seen, you know, people also maybe not realize that they have diabetes.
And, you know, there might be some things that we have to do in order to take care of ourselves.
14:56
It’s kind of maybe just like, oh, I’m fine.
How do you see this stigma kind of affecting people’s willingness to seek care or even share the
15:05
diagnosis with their family?
Right.
15:08
So the stigma around a diagnosis of diabetes, a lot of what I hear from the people that I work with
is that they don’t want to get diabetes.
15:19
And also, they’re hearing from their doctor not so clear messages around whether or not they even
have diabetes.
15:28
Oh my gosh, thank you.
So like a lot of them are like, well, you know, he told me that he was going to put me on Metformin,
15:36
but he didn’t really tell me that I had diabetes.
And then when we look at the A1C, it might be at an 8%.
15:41
And so there’s also just a lack of information that they’re getting from their own care providers on
whether or not they have diabetes.
15:48
So if they don’t know that they have diabetes, they’re definitely not talking about it at home.
But even if they do, there’s that level of shame where like, I did something wrong.
15:59
I brought this on myself.
Especially because of the messaging that they’re getting from their provider, right?
16:04
It’s usually like, well, eat less, move more, stop eating carbs, stop eating sugar.
And they’re not even really getting to know the person.
16:12
So the person already has the stigma, the medical stigma, the cultural stigma of, you know, not
wanting to get a condition that maybe they saw a family member have a really negative experience
16:26
with in their country.
And when they get here, they’re not getting the support that they need from the medical field.
16:33
A lot of times I don’t want to make general statements like that because there are good
practitioners out there.
16:38
There’s also this, especially among the older women, the matriarchs of the family, there is this
need to kind of take care of everybody else and put their needs last.
16:51
And so why would they bring up something like a diabetes diagnosis?
Because they don’t want to stress their kids.
16:56
They don’t want to stress their partner, their husband.
We’re talking about multi generational households too.
17:02
Their mother, their father might live with them.
And so there’s a lot of, like, stress that they are carrying and internalized, you know, shame and
17:13
stigma around the diabetes diagnosis.
So being able to help them understand that it’s not their fault and that they haven’t done anything
17:23
wrong to bring this on themselves can help shed a little bit of that stigma.
Yeah, that makes total sense.
17:30
And I would love to talk about body image in relation to all of this.
I think that body image ideals are very different from culture to culture, even in Latin America.
17:41
Like I feel like for the Caribbean, it’s very different compared to like Central South America.
But whatever the beauty ideal is, usually it does impact food intake and it’s usually tied to
17:54
restriction and trying to get thinner weather just like overall or in certain areas of the body.
And so I would love to hear how you’ve seen body image play out when it comes to Latina women or
18:09
just like women of color and how that affects their ability to manage diabetes, especially now with
GOP is being so popular for people that have diabetes and that don’t have diabetes.
18:21
Yeah, I work in the intersection of like disordered eating and eating disorders and diabetes, so
that comes up a lot in our work.
18:32
I also work a lot with people with PCOS and as you know, they are at an increased risk of developing
diabetes and a lot of them come to me for insulin resistance.
18:41
These populations in general are already at a higher risk of disordered eating and eating disorders.
And when it comes to body image, you know, the literature that we have out available, it’s it’s
18:54
mixed.
And part of that I believe is because the people doing the research are not understanding the new
19:00
ones.
They’re grouping all of Latinos into one big group.
19:05
And as you mentioned, body image is going to look differently in the Caribbean and even among all of
the different skin colors in the Caribbean, right.
19:15
And in Latin America, Central America, South America, because we are such a homogeneous group of
people, it’s going to be diverse period.
19:29
And what I see is that with my mom, for example, never was she worried about body image.
She never dieted as she has assimilated to this country’s culture in her older age.
19:45
Now she’s in her early 60s.
Now is definitely not a time to be dieting and to be restricting.
19:52
And yet the last maybe 5 or 6 years there’s been an obsession with her body size, right?
And what she’s eating and that she can’t have the Bangumbi Fay because she’s on a keto diet.
20:03
And this just drives me insane because I’m like, how, how did we start?
So you know, fine and end up like this.
20:12
So as people assimilate to this.
Cultures, ideals of beauty, the Western, the thin ideal.
20:20
There’s this desire to lose weight, and it becomes also an obsession over health, right?
The conflation of health and weight.
20:28
It’s there already, but especially when they’re receiving messages like, oh, you have to lose weight
in order to cure your diabetes, which is a myth.
20:37
You don’t have to lose weight to improve your diabetes or cure it, right?
There’s no cure.
20:42
They feel that pressure to engage in whatever, whatever it will be, resulting in weight loss,
whether or not it’s beneficial to their health or diabetes.
20:54
Totally.
And you’re bringing up so many things with the weight.
20:58
That was a question that we had to Often times people are told that the diabetes is just about
weight.
21:04
I used to do that myself, like when I worked in a clinic and I would tell people, oh, because I was
citing these certain studies, the DPP studies, diabetes prevention studies, where I’m like, oh, if
21:16
you just lose like this person in your body weight, you’re going to reduce your risk of developing
diabetes significantly.
21:23
I had those studies memorized.
I taught classes in English and Spanish.
21:27
I have since publicly apologized because you know when you know better, you do better.
And it’s not just about the weight.
21:36
And we have so many clients within our practice because we also take a health at every size weight
inclusive approach where they are able to lower their A1C and able to make those positive changes on
21:48
their health and take care of themselves better.
And maybe their weight stays the same.
21:52
Some people maybe the weight goes up, especially if you were severely restricting what you’re
eating.
21:57
So I really appreciate that advice.
Another barrier that I have personally seen is language, and I want to get into this, and I think
22:06
this applies to any, can apply to like any immigrant families or first Gen. folks who are
potentially like helping their parents navigate the system.
22:16
But for people who are speaking Spanish, let’s just say for this example, and they’re navigating
like these complex medical systems, what are some real world strategies for making sure that they’re
22:27
truly understanding their care?
Well, aside from finding a provider that speaks your language, I think that’s number one, right?
22:35
Which is a barrier because especially here in Miami, it’s no problem.
Most providers speak Spanish and some of them don’t even speak English.
22:45
So you’ll be in good hands here in South Florida.
Like my mom, for example, she defends herself enough in in English, but Spanish is definitely an
22:55
area where she’s more comfortable in.
So aside from that, I mean, if you have a family member, and this can be complex, right, because
23:04
some family members, they don’t want to tell you everything they’re translating for you and they’re
like gatekeeping information.
23:11
Or they’re not telling what you said to the provider.
They’re like, no, we don’t like, don’t worry about that, you know?
23:17
Yeah.
Exactly.
23:19
So that wouldn’t necessarily be my first recommendation.
But by law, if you are with a provider that does not speak your language, you’re entitled to a
23:27
translator.
And every medical office has to have a translation service for you.
23:33
So just knowing that that’s a right that you have and being able to ask for that upon scheduling
your visit, like before you even get into that doctor’s office, telling the front desk, telling the
23:44
medical assistant, maybe finding a person in the office who you’re, you know, you might be able to
feel comfortable with communicating that in translating it from Spanish to English or whatever
23:58
language you speak to English.
It’s quite complex.
24:02
Of of course, the gold standard is to find somebody that speaks your language, even if they’re not
from the same cultural background, right?
24:08
Like they could be Haitian and speak Spanish and you from, I don’t know, from Colombia might go to
them and still have a better experience than somebody who doesn’t, you know?
24:19
On both sides, if you’re a provider and you don’t really fully speak the language well enough to
give, especially if you’re doing longer visits, because I’ve seen so many providers with Spanish was
24:33
like, yeah, I speak Spanish and I’m like, girl, no, you’re not giving enough information.
You’re not able to understand what they’re saying.
24:41
I get you.
They don’t want to call the interpreter, But you also have to do like what’s best for the patient.
24:45
If you don’t feel like you can like have a thorough conversation, which I feel happens a lot.
There’s so many interpreters.
24:52
I don’t know if you guys have had this experience too.
It’s so funny where I’m, I’ll say a lot or the patient says a lot and then there’s an interpretation
24:59
that’s like a sentence.
I’m like, you know that I said wait, like no, I said so much more than that.
25:06
Can you make sure?
Because that’s where I think people leave, not getting their questions answered, not knowing that
25:12
they have diabetes or what’s going on, because people are just rushing to the next and they’re not
taking the time to really make sure people fully understand.
25:21
Yeah.
And I think that that’s like a systemic issue, right?
25:24
Like the way that our healthcare system is set up, it’s not setting us up for success.
Providers, if they are on like on an insurance based model, it’s a turn and burn.
25:36
It’s a numbers game, right?
Some providers are seeing 20-30 people in a day.
25:42
How do you have time to, you know, call the translating service, have them the sessions going to
take longer than 15 minutes at that point.
25:50
And it might not even be at the provider’s like preference, right?
It may be the facility that is putting a lot of constraints on the provider.
25:59
So there’s a lot of barriers if, if you’re speaking a language that isn’t commonly spoken here, at
least with Spanish, it’s a pretty commonly spoken language in the United States.
26:12
But with other languages that are spoken in Latin America that aren’t Spanish, you’re going to
encounter difficulty.
26:19
So it I I don’t know what the solution is to that, you know?
No, but I think this is all helpful.
26:27
And and I had so many patients too, who maybe came from Mexico and Spanish was not their first
language.
26:34
Like they spoke indigenous languages.
And so we would have to have those interpreters too.
26:39
Because especially even me, when I first got there, I just assumed like, oh, you came from Mexico.
Like you speak Spanish and then I’d be speaking in Spanish and I’d see like, oh, they’re not, you’re
26:47
not comprehending what I’m saying because like you’re, you’re not as familiar with Spanish.
And so just being able to, yeah, like you said, no, that even though someone is coming from a
26:56
particular country or culture, it doesn’t mean that they’re fully going to understand that language
or that’s their first language or in the language they’re most comfortable speaking in.
27:05
And on that note, Spanish is so diverse when in Latin America, you know what we call, you know,
Calabasa, they call Yao Tia in, in Dominican Republic and we’re both in the Caribbean.
27:19
So I mean, even, you know, beans, they go by many different names across the board, right?
You have in Cuba, we call them by the colors, right?
27:28
We have red beans, we have black beans.
But in Venezuela, black beans are called caraotas.
27:33
And when I first started working in a clinical setting, I’m here thinking I’m fluent.
I mean, Spanish is my first language.
27:42
There were so many words that I was like, what is that?
Can you explain what that is to me?
27:49
And then, you know, they would kind of clarify and little by little you Start learning.
But to make the assumption that because you speak your country’s version of Spanish, that you’re
28:00
going to understand Spanish across Latin America, It’s a pretty like you’re in for a, for a
surprise, right?
28:06
Because there’s just even aguacate, they call it balta in like Peru and Chile and Argentina.
And so there’s a lot of nuances in in our languages.
28:18
I’ll share a quick story.
I think I’m some Puerto Rico and I learned Spanish more so in Costa Rica.
28:27
And again, I haven’t been practicing like day-to-day, so it’s not great right now, but I learned in
Costa Rica and so it’s just different Spanish.
28:35
So I was in Puerto Rico and I was asking for directions and the guy was like, oh, he’s like a la
quierda iquierda or something like that.
28:45
And I was like, huh, He’s like iquierda.
And I may be saying it wrong, but I was like, huh.
28:49
And then finally I was like, oh, esquierda.
So even just like little things like that with the pronunciation, it could make you not understand
28:59
anything that somebody’s saying.
Absolutely.
29:01
And you might even say something offensive, too.
You know, the word for bug in Cuba is bicho.
29:08
And then if you say that in Puerto Rico, they’re going to look at you funny.
Oh, wow.
29:13
So you know, little things like that, that you have to have at least some level of awareness,
especially if you’re working in a place where you have a specific demographic of Latinos coming and
29:24
you have to become acquainted with, with their culture too.
Because you know, Cuba and Venezuela, they’re both similar in the sense that we speak Spanish and
29:33
we’re in Latin America.
But there’s nuances even like in regions, right?
29:38
Like I’ll tell you, Colombia, for example, coastal Colombians, like from Barranquilla, they sound a
lot like Cubans.
29:44
And the only way that I can tell a Colombian like Barranquilla accent apart from a Cuban one is
because they say senora.
29:51
And senora, we’re in, in Cuba.
We’re not that formal unless you’re like in a more formal setting.
29:57
So even that compared to Medellin or there’s going to be differences in the words that they’re
using, in the intonation, in the foods that they’re eating.
30:08
So, I mean, you can’t be an expert in everything, obviously.
Yeah, but you can learn and you can have that humility, right?
30:15
And that responsiveness to other people’s cultures and that curiosity.
Yeah.
30:21
Speaking of culture, when it comes to cultural foods, especially foods like rice and beans, they’re
very looked down upon in healthcare.
30:29
Like usually doctors are like that’s the first thing that has to go.
The rice and beans, the tortillas, the pupusas, the vivares, like the plantains and all of that.
30:38
Similarly, with care being very weight centric, it’s like the weight has to go too.
You have to lose weight.
30:47
And so for someone who wants to eat those foods or doesn’t want to lose weight, but they also feel
uncomfortable speaking up to their provider, like what are some things that they can do to advocate?
0:00
And I don’t know if it’s like letting their doctor know or like, you know, cuz everyone can’t just
31:05
like find another doctor.
Like what are some things that they can do to not feel so uncomfortable with those conversations?
31:13
Yeah, I think being able to use your voice in that in that session is something that a lot of people
need support with, but is very powerful, right?
31:22
Because if they don’t know that the recommendations that they’re making just don’t work with you,
then how can they know they can’t read people’s mind?
31:31
You may not come back even if you can’t find another provider, which is an even worse situation to
be in.
31:38
You do run the risk of the provider getting offended, but that’s our responsibility as providers to
check our biases, to meet our patients where they’re at.
31:50
And so I think being able to to use that voice to express yourself in sessions to let them know
that, hey, this is not how I eat and this is not what I want.
31:59
This is not aligned with what I came here for it.
And I would appreciate other options in case of weight.
32:06
For example, what are you telling people who have diabetes and you know, are not in a larger body?
You know, I don’t want to lose weight because culturally that’s not aligned with with, you know, my
32:20
husband’s not going to like it or whatever the case is, right?
It’s hard, right?
32:25
Because you have to as a provider, you have to be able to build that rapport to make that person
feel comfortable to talk to you about those things.
32:33
But also as a patient, you have to let go a little bit of the people pleasing that a lot of us come
with and be able to, to, to say what, what you’re really feeling.
32:45
That’s something that you got to work on because, you know, I, I work with clients all the time on
the people pleasing aspect to the extent that I can, obviously in partnership with their therapist.
32:55
It does take having an advocate and that could be like a, a child, right?
An adult child.
33:01
That could be like, for example, if my dad took me to his doctor’s visit, my uncle would hear some
words from me.
33:08
But even if it wasn’t my uncle, right, he, I would still be like, well, listen, I am a provider as
well.
33:14
And this is what I’m kind of like calling here, right?
This is my father.
33:21
And this is how we want the care to be delivered.
So you have to have somebody in your corner if you’re not feeling comfortable yourself.
33:28
Yeah, that was my next question.
I know that this podcast obviously is in English, so people who are listening, well, I think there’s
33:36
a lot they can take from this, right?
But I think that they also may have family members, parents who they’re, you know, wanting to get
33:44
help, support.
And seeing that the parents are struggling.
33:46
How can you as, let’s say like a first generation immigrant, you have immigrant parents?
How can you best help them navigate this system?
33:56
Yeah, my parents like to keep their medical stuff kind of hidden from me.
There’s a little bit of that, seeing me as as a child, my whole life, no matter how grown I am and
34:07
no matter how many degrees I have and certificates I have.
But really having to to push back on that, right.
34:13
And having aging parents is hard because then you have to start kind of parenting them at some
point.
34:21
But even throughout their resistance, it’s important for you to come from a place of compassion.
And maybe if they’re resistant, helping them understand instead of being, instead of that typical
34:34
child’s parent dynamic where there’s maybe a little bickering or whatever, helping them understand
that they’re not getting the care they need and that they need that support and going with them to
34:47
doctor’s offices if possible, or even sourcing, helping them find.
I have so many people who call me for their parents, right?
34:54
Like they, they find me and they’re like, I need a dietitian who speaks Spanish and who specializes
in diabetes because my parent has diabetes.
35:02
And helping them navigate that, making sure that they are a good fit for my parent so that my parent
is not the one responsible for sourcing that.
35:12
So it might take a little bit of like, OK, mom and dad or Thea or Thea or whoever it is that you’re
advocating for, like, have a seat.
35:22
I got this.
You know, being able to step up to that plate and, and handle the situation like the adults that we
35:28
are instead of being kind of pigeon holed into that.
You’re always going to be my kid relationship.
35:34
That’s great advice.
And for people, do you have like resources for where I know that you’re in Miami, but just like a
35:41
good starting port for someone that wants to find a culturally grounded provider, maybe even someone
who’s weight inclusive and they live in another state.
35:51
Like, what are some good tips that you have for finding a provider that resonates and yeah, that
feels good for someone?
35:59
Yeah.
Well, the good news is that now we have telehealth and so we can be so much more accessible than we
36:07
were before, right?
Like I may be in Miami, but I have a location in Oregon and I see people across 28 or 29 states now.
0:00
And I know that, you know, a lot of providers are doing that now and it’s so much more accessible
36:22
because I see people from California, I see people from Arkansas, from Kentucky, from places where
like, I mean, California is not a good example.
36:30
But Arkansas and Kentucky, you wouldn’t immediately think of those places as having a lot of Spanish
speaking dietitians, right?
36:36
But there are Spanish speaking populations there.
And so being able to offer those services virtually is great.
36:44
And so just a simple Google search like weight inclusive, you may not find a lot of weight inclusive
Spanish speaking dietitians, but we’re here.
36:52
We’re out here.
Yeah.
36:54
Spanish speaking bilingual dietitian.
A quick Google search will definitely unveil a lot of us because we are out here and we’re trying to
37:03
make that care more accessible across the country.
So yeah, all it takes is curiosity.
37:10
Instagram is a great place too.
You know, social media.
37:14
I have a lot of clients that started follow me on social media and they’re like, I really like your
stuff.
37:20
And I feel like I would be comfortable with you because you understand my culture, right?
And because I like your approach.
37:25
Because you’re not focusing on weight loss, because you’re including my Arrocom, you know, Arichuela
or frijoles or whatever they’re called in my country.
37:33
Yeah.
Oh, my gosh, I love that.
37:35
I think, yeah, I just love what you’re doing.
I think that our audience is going to get a lot out of this conversation.
37:41
And can you let people know just, you know, if they want to work with you in particular where they
can find you as well as I know you’re active on Instagram?
37:51
Yeah, so on Instagram it’s all the same.
If you Google in La Mesa Nutrition, I will pop up in many different forms, right?
37:59
So my website is www.inlamesanutrition.com and La Mesa Nutrition is my Instagram handle as well.
If you want to connect with me on LinkedIn professionally, you can too.
38:09
I’m not super active on like the TikTok or, or what’s this other one?
Twitter X Those, those ships sailed for me.
38:20
Yeah.
Goodbye.
38:24
Yeah.
It’s just too much.
38:26
It really is.
But yeah, they they can connect with me online.
38:30
And if I’m not a good fit or if my books are full, I’m happy to refer to somebody who is.
And I have a long list of people who speak Spanish who focus on all different specialties who are
38:44
weight inclusive.
I think it’s, it’s hard to find on my list somebody who’s not weight inclusive at this point.
38:50
So that might be a barrier for somebody who really does want to lose weight and doesn’t is not open
to that weight inclusive approach.
38:59
But other than that, like you know, the directory is very long.
Yeah, I love it.
39:06
Well, thank you so much.
This is really a great conversation.
39:10
And next time I’m in Miami, I’m definitely going to hit you up.
Yeah.
39:16
So thank you.
And we’ll catch y’all next time.
39:20
Thank you so much.
Thanks for joining us for.
39:25
Today’s episode if.
You’re interested in nutrition.
39:27
Counseling with one of our expert dietitians to help improve your pre diabetes or diabetes.
Visit us at diabetesdigital.co.
39:35
Also, if you found our conversation helpful, do us a favor and rate and review this podcast on
iTunes, plus share with someone who might find this helpful.
39:45
You can also connect with us on Instagram at Diabetes Digital.
Families don’t have to figure it all out alone. Whether it’s translating a diagnosis, helping a parent feel more confident speaking up, or simply offering a steady presence in the exam room, support can show up in many meaningful ways.
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