Type 2 Diabetes, Guided Imagery, & the Hispanic Connection

I’ve known my good friend, Dr. Jane Jeffrie Seley, DNP, MPH, BC-ADM, CDCES, for over 25 years. She’s a dedicated nurse, professor and researcher, a creative program innovator, and a die-hard health care advocate, provider, and counselor, who’s spent decades showing people with diabetes how to optimize their health, reduce their symptoms, and take ownership of self-care. This is my friend’s passion.

Over the years, I’ve seen her, time and again, go the extra mile (or two… or ten…) for patients and their families. She’ll literally stop what she’s doing to give whatever time, effort or advice is needed from her monsta supply of expertise. For Jane, it’s never been about the honors, positions, awards, degrees, or revenue she’s earned. It’s always about the patient – whether rich or poor, old or young, motivated or utterly dispirited, my dynamo pal Jane is all in.

Here she is, talking about guided imagery, diabetes, and some of the unique challenges encountered in Hispanic and Latinx communities.

Most of the risk factors for developing type 2 diabetes (otherwise known as T2D), such as weight, blood pressure and a sedentary lifestyle, are within our power to change. But other factors are not - age, family history, race, and ethnic background.

According to the Center for Disease Control, if you are of Hispanic/Latino descent, your chances of already having T2D is 17%, as compared to non-Hispanic Caucasians, who are at an 8% risk. And if you don’t already have T2D, the lifetime risk for adults of Hispanic heritage is 50%, as compared to 40% for all US adults.

And that’s not all. Hispanic/Latino populations develop diabetes at a younger age and complications hit harder.

The risks also vary by country of origin. For instance, people from Puerto Rico are twice as likely to develop diabetes as those from Venezuela.

Fortunately, there are more and more treatments and tools available to help people manage their diabetes and stay well.  Self-care activities such as healthy meals, being active, and taking medications all work together to help people achieve blood sugar targets of 80-130 mg/dl before meals, and 80-180 mg/dl for the rest of the day and night.

Many apps support the performance of diabetes self-care as well, such as CalorieKing, MyFitnessPal and mySugr.

As a diabetes care and education specialist, my role is to guide and support people with diabetes, and to help them learn how to perform self-care during their busy lives.

We have known for a very long time that prolonged stress raises blood sugar and ultimately A1c levels (a measure of average blood sugar over 2-3 months). Prolonged stress also negatively impacts cortisol levels and can impair the immune system.

Over recent decades, we’ve learned three things about guided imagery and diabetes:

  1. Guided imagery is a simple, user-friendly, efficacious tool for reducing stress1. 
  2. In other studies, guided imagery has been found to improve blood glucose and hemoglobin a1c measures.2 And perhaps equally important,
  3. Guided imagery can be highly motivating for self-care3 with a narrative that lifts the spirits, gives a sense of hope and optimism about the future, and supports the notion that we have some agency over our health.

For those 3 reasons, guided imagery can be one powerful adjuvant therapy for people with diabetes.

For over 25 years, I have been recommending Belleruth’s Health Journeys guided imagery recordings to help my patients cope with the strains of living with diabetes, along with other life stresses.

Some of the audio programs that my clients have found the most helpful are Manage Diabetes, Weight Loss, Healthful Sleep, and Relieve Stress (especially the tracks for the Walking Meditation and the Affirmations). I’m eager to put a newer title, Embracing a New Medicine to work with my patients – that’s a topic that is made to order for people with diabetes.

I’m very happy to see that now many of these meditations and more are now available in Spanish for people who would feel more comforted and relaxed to hear these positive images and messages in their native language. This is a tremendous addition to the tool chest for the disproportionate percentage of people living with diabetes, for whom Spanish is their native language.

Jane Jeffrie Seley DNP MPH MSN is a Nurse Practitioner, Diabetes Care & Education Specialist and Clinical Assistant Professor of Medicine at Weill Cornell Medicine in New York City. She is board certified in diabetes care and education (CDCES), advanced diabetes management (BC-ADM) and as a diabetes technology clinician (CDTC). Dr. Seley is an active clinician, researcher, speaker and author who is committed to patient & professional education, innovative patient-centered diabetes management, and advancing diabetes technology as a tool to assist people living with diabetes and the clinicians that care for them. She has a special interest in integrative healthcare and has studied guided imagery, aromatherapy, reiki and therapeutic touch which she highly recommends to people with diabetes for stress management and general wellness.

1Krau SD. The Multiple Uses of Guided Imagery. Nurs Clin North Am. 2020 Dec;55(4):467-474; and Weigensberg MJ, Provisor J, et al. Guided Imagery Council: Feasibility, Acceptability, and Preliminary Effects of a Novel Group-Based Lifestyle Intervention in Predominantly Latino Adolescents. Glob Adv Health Med. 2019 May 7;8:2164956119844477.

2Gelernter R, Lavi G, et al. Effect of auditory guided imagery on glucose levels. J Pediatr Endocrinol Metab. 2016 Feb;29(2):139-44.

3Whitehead LC, Crowe MT, et. al. A nurse-led interdisciplinary approach to promote self-management of type 2 diabetes: a process evaluation of post-intervention experiences. J Eval Clin Pract. 2017 Apr;23(2):264-271. And Wichowski HC, Kubsch SM. Increasing diabetic self-care through guided imagery. Complement Ther Nurs Midwifery. 1999 Dec;5(6):159-63.