Treating the Entire Person: Diabetes Tune-Up Group Provides Support Needed for Improved Diabetes-Related Health Outcomes for Underrepresented Communities

As a practicing clinician, she found that diabetes distress and burnout drove a significant amount of health issues for people living with diabetes. Diabetes distress is the emotional response to living with diabetes, the burden of relentless daily self-management and its long-term complications. It impacts people living with all forms of diabetes, including type 1, type 2, and gestational diabetes (GDM). It can arise from the physical toll of diabetes, the stigma and discrimination from well-meaning people around the person living with diabetes, and the devastating financial burden of diabetes. In any 18-month period, 33% to 50% of people with diabetes have diabetes distress.

“We now know the emotional toll of diabetes can impact health outcomes. It leads to things like skipping insulin doses, not monitoring blood glucose, and unhealthy eating,” says Dr. de Groot. “These factors can culminate in elevated AICs severe hypoglycemia, and an increased risk for diabetes-related complications. Underrepresented groups like aging populations, communities of color, and rural communities who carry a greater burden of diabetes are at even greater risk.”

A Holistic Approach to Diabetes Care

At Indiana University, Dr. de Groot develops research programs for interventions that directly address issues she and others see firsthand as care providers.

Enter the Diabetes Tune-Up Group, a cognitive-behavioral-therapy-based, peer-reviewed, and culturally tailored diabetes education classes for adults with diabetes distress and elevated A1C. The program consists of six weekly group sessions cofacilitated by a diabetes care and education specialist (DCES) and clinical psychologist. In addition to taking a multidisciplinary and culturally tailored approach, the program includes a social aspect that helps participants stay accountable and relieves them of the feeling that they are alone, a common theme in those who experience heightened levels of diabetes burnout.

Through the ADA’s Health Disparities and Diabetes Research Award, and thanks to generous donations from CVS Pharmacy® customers, Dr. de Groot is studying the effect of a new diabetes education curriculum tailored for Black women. “There are very few programs culturally tailored for Black women with type 2 diabetes,” said Dr. de Groot. “They face huge levels of stigma and outside pressures that contribute to diabetes distress and burnout. These are the people I see day to day who need and deserve more support.”

Her hope is that this approach of culturally tailored diabetes management and education will be used for more underrepresented communities who face a disproportionate impact of diabetes.

Dr. de Groot is a strong believer in treating the whole patient, that diabetes care is about far more than just prescribing treatments, and that it’s a health equity issue. Peer-informed diabetes education compliments traditional health care approaches and enhances the quality of diabetes management.

“I feel very privileged to be part of this round of funding that was focused on health disparities,” she said. “No one is ever to blame for having developed diabetes.”

Learn more about how we’re making a difference to the lives of those affected by diabetes, with the support of CVS Health® by visiting



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