Research Profile

While prevalence of type 1 diabetes mellitus (T1DM) has been rising across all racial/ethnic groups, there is heightened concern for youth of racial/ethnic minority due to significant disparities in disease prevalence, treatment and health outcomes. Youth of racial/ethnic minority or low socioeconomic status (SES) with T1DM consistently demonstrate poorer glycemic control, lower disease self-management and higher rates of diabetes distress. Disparities in access to healthcare, advanced diabetes technology and healthy food options likely foster and exacerbate these suboptimal health outcomes. Culinary medicine, or the integration of food preparation/cooking with the science of medicine, shows great potential to mitigate disparities in youth with T1DM, yet despite its great potential, there is a complete absence of culinary medicine interventions for youth with T1DM. Therefore, the DICE (Diabetes Inspired Culinary Education) intervention has been designed as an innovative community- and family-based culinary medicine intervention to mitigate racial/ethnic and SES disparities in the treatment and health outcomes of high-risk 8-16 year old youth with T1DM.

This project will help youth with T1DM and their families learn to use food, nutrition and healthy cooking as lifelong tools to better manage T1DM. The design of the program will enable youth with T1DM to meet and bond with other youth challenged with this lifelong autoimmune disease and will enable family members to connect, develop relationships and establish a necessary support system. Through the interactive and engaging program lessons, participants should feel more confident in managing their T1DM and improve quality of life.

Having had T1DM for over 26 years, I truly understand the physical, mental and emotional burden the disease places not only on the individual with the disease, but the entire family. For this reason, I have dedicated my career to helping others challenged by this lifelong disease improve their health, well-being and overall quality of life. A top priority in this endeavor is to improve the health and well-being of high-risk youth with T1DM by mitigating disparities in T1DM management, treatment and health outcomes that currently impose heightened challenges for this vulnerable population. Up to this point, my primary faculty responsibilities at Case Western Reserve University (CWRU) have focused on education and teaching. However, the Department of Nutrition at CWRU is currently restructuring and investing in the growth and development of its applied research program. Selected research focal areas for the program include: diabetes; child nutrition; culinary medicine; and food access/security among underserved populations. With this Departmental restructuring, I will be transitioning from a faculty role with significant education/teaching responsibilities to one whose primary focus is research and will use this American Diabetes Association Health Disparities and Diabetes Junior Faculty Award as a catalyst for launching my independent research career. Furthermore, this grant will provide me with the opportunity to disseminate the findings of this study at professional scientific meetings and peer-reviewed journals, which will enable me to further establish my expertise and expand my network of colleagues in T1DM research.

Given the complexity of T1DM being a lifelong autoimmune disease that cannot be treated with lifestyle and behavioral modifications, the ultimate goal is to find a treatment for this challenging disease. For this reason, a primary focus of diabetes research has been on the development of a treatment for T1DM. However, while treatment is the ultimate goal, even once achieved, there will still be an extended period of time until we reach universal access due to the likely high cost and limited access of the new treatment. This unfortunate issue has been observed for over a decade with advanced diabetes technology, including insulin pumps and continuous glucose monitors. Although these devices have been available for over 40 years, there are currently significant disparities in their use, with lowest rates of adoption observed among underserved populations due to the heightened challenges they face. Therefore, in addition to prioritizing research focused on the treatment of T1DM, it is critical to prioritize interventions addressing the greatest barriers to T!D management, especially among high-risk populations and populations facing a disproportionate barriers. These interventions should focus on developing healthy lifestyle behaviors and building confidence in executing these behaviors across the lifespan to optimize T1DM management, quality of life and overall well-being.