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For last week’s practice question, we quizzed participants on TIR (Time of Range) of 89% , and what is your concern. 62.2% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
JZ is proud of their Time of Range of 89%. You notice their time below range is 7%. JZ uses a rapid-acting insulin pen 4–6 times daily to keep glucose in target range and occasionally increases the glargine dose when evening glucose is elevated.
What is your primary concern?
Answer A is incorrect: 7.56% chose this answer, “Is JZ consistently rotating injection sites to prevent lipohypertrophy?” Injection site rotation is important for preventing lipohypertrophy and absorption variability, but not the most immediate safety risk.
Answer B is incorrect: 24.4% chose this answer, “What is JZ’s rationale for adjusting the glargine dose?” Basal insulin is generally titrated based on overnight and fasting blood glucose levels, not reactively based on the evening glucose. This is clinically relevant, but still secondary to hypoglycemia risk.
Answer C is correct: 62.2% chose this answer, “How is JZ feeling about their frequency of hypoglycemia?” Since JZ is experiencing hypoglycemia more than the target below target range of 5%, we want to explore their feelings around their diabetes and diabetes distress.
Answer D is incorrect: 5.84% chose this answer, “Does JZ adjust insulin for physical activity?” Adjusting insulin for exercise is essential for self-management, yet the first priority is identifying whether dangerous lows are occurring.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
The world of diabetes technology is advancing at a record pace. There is no doubt that technology intends to make life with diabetes a bit easier. In the United States, over 50% of adults living with diabetes have experienced some level of diabetes distress.¹ The impact of diabetes technology on mental well-being is complicated. Diabetes technology, including insulin pumps, continuous glucose monitors (CGMs), and connected insulin pens, can either lessen or aggravate diabetes distress.
The American Diabetes Association (ADA) defines diabetes distress as “significant negative psychological reactions related to emotional burdens and worries specific to an individual’s experience in having to manage a demanding chronic condition such as diabetes.”.² Diabetes distress is a natural reaction to the daily burden of managing diabetes. Signs of diabetes distress can include avoiding blood glucose monitoring, omitting medications, and struggling to achieve personal hemoglobin A1c targets.
The ADA recommends screening for diabetes distress at least annually. More frequent screening is recommended if clients are not meeting treatment goals, develop diabetes-related complications, and during times of life transitions.²
To access these validated diabetes distress screening tools in English and Spanish, I encourage you to visit this helpful website, DiabetesDistress.org
Let’s explore how diabetes technology can have a positive impact on diabetes distress.
✅ CGMs: With current CGMs, fewer fingerstick readings are needed to make treatment decisions. CGMs provide information on blood glucose trends and impending hyperglycemia or hypoglycemia, creating more peace of mind.
✅ Record Keeping: Various forms of diabetes technology can log blood glucose values, insulin doses, site changes, and total daily doses of insulin. This eliminates the need for clients to worry about detailed record-keeping.
✅ Automated Insulin Delivery: Automated insulin pumps can decrease decision fatigue by making automated adjustments to both basal and correction insulin doses. This approach to insulin delivery can also benefit individuals with an active lifestyle. Utilizing wearable insulin delivery devices and algorithms can reduce the mental burden of diabetes self-management.
✅ Connectivity: Remote data sharing supports communication with parents, caregivers, and friends to create a diabetes support team. Connectivity with healthcare providers enhances communication with the care team, allowing adjustments to treatment plans between clinic visits.
✅ Empowerment: The data trends can empower individuals living with diabetes to take control and gain confidence in making and evaluating medication and lifestyle adjustments in response to changes in glycemic control.
As diabetes healthcare professionals, it is important to understand how diabetes technology can negatively impact diabetes distress.
❌ Information Overload: Diabetes technology generates an enormous amount of data. This can cause distress by constantly feeling the need to monitor glucose trends and numbers throughout the day and night, leading to feelings of anxiety and overwhelm.
❌ Alarms: Alarms on diabetes technology are rooted in safety, but for those living with these devices, this can lead to diabetes distress. Alarms can disrupt sleep or bring unwanted attention from others in public. Erroneous alarms for hyperglycemia or hypoglycemia can cause stress, frustration, and alarm fatigue.
❌ Perfectionism: Diabetes technology provides a continuous insight into glycemic control, which for some can create a need for perfection. Some clients feel like they fail when they don’t reach their time-in-range goal each day.
❌ Physical Impact: Wearable devices not only carry a psychological burden but can also cause physical distress. Skin irritation and allergic reactions to adhesives cause physical pain and embarrassment. Those who wish to keep diabetes private, wearing a CGM, insulin pump, or other wearable device that puts diabetes on display, causing distress.
❌ Technical issues: Losing connectivity with CGMs or an AID system can cause frustration and make it challenging to achieve optimal glycemic control. Insurance coverage, prior authorizations, out-of-pocket costs, and access to supplies for diabetes technology can all contribute to or worsen diabetes distress.
The 7A’s Framework provides a useful interview tool when assessing for Diabetes Distress:
Here are some other actionable tips you can use to help those with diabetes distress:
Alexander, D.S., Saelee, R., Betsy Rodriguez, B., Koyama, A. K., Cheng, Y. J., Tang, S., Rutkowski, R. E., & Bullard, K. M. (2025). Diabetes distress among US adults with diagnosed diabetes, 2021. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 22(E07), 1-7. https://www.cdc.gov/pcd/issues/2025/24_0287.htm#:~:text=Among%20US%20adults%20with%20diabetes%2C%20an%20estimated%201.6%20million%20(6.6,income%20compared%20with%20their%20counterparts.
Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more!
After the initial assessment JM is scheduled for an individual visit instead of a group DSMES class.
According to Medicare guidelines, which of the following would NOT justify providing individual DSMES instead of group DSMES?
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Announcements
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Healing through Connection for Healthcare Professionals is available in:
Like me, I am sure you have experienced moments of intense frustration when you wanted to scream or give up!
Maybe you had to show up when you were emotionally spent and felt like you had nothing else to give.
I see you and I celebrate you—the hardworking healthcare professional who shows up day after day with heart and courage. In my book, Healing through Connection, I honor your journey and share strategies to help you care for your own well-being as you care for others.
Join a Virtual Conversation and Interview with Coach Bev on Feb 20th at 11:30am PST to delve into the healing power of creative endeavors.
If you can’t make the interview, enjoy this excerpt from Chapter 6, that dives into the Healing Power of Self-Expression and encourages you to dive into your creativity for healing, rejuvenation, and pure JOY.
Even if you can only commit to engaging creativity for a few minutes or half an hour a week, it makes a difference. Stop thinking about all the reasons you can’t do it, and instead, listen to that internal hum, get in the metaphorical car, turn on the ignition, and drive.
Within you lives a quiet, creative spark waiting for attention and care. When you tend to it, you renew your capacity to show up with presence, compassion, and strength, for yourself and for those in your care.
Healing through Connection is both a reminder and a roadmap; an invitation to care for yourself with the same compassion you offer others. It provides a rare perspective on mutual healing.
As we heal ourselves, we expand our capacity to help others with healing. Within the pages of this book, you’ll find a toolbox for exploring your truth, tapping into your emotions, and cultivating creativity. Together, we’ll explore the often-overlooked connection between your own lived experiences and those of the individuals in your care.
Continue reading to discover how making time for creative expression might offer you some unexpected benefits and opportunities for joy!
Did you know that Nobel Prize recipients are nearly three times more likely to engage in creative hobbies than their scientific counterparts?
Theoretical physicist Albert Einstein often played the violin when he encountered challenges in his theoretical work. He believed that music helped him think creatively and tap into his subconscious, enabling breakthroughs such as the theory of relativity.
Marie Curie, a two-time Nobel laureate for physics in 1903 and chemistry in 1911, went for frequent walks in the countryside, which allowed her to reflect and rejuvenate. These moments of tranquility likely helped her maintain focus during the grueling work of isolating radioactive elements.
It’s because they’re simply more open to having hobbies. They are more open to novel experiences and often turn to their creative endeavors when working through challenges. These seemingly unrelated scientific pursuits and personal hobbies can open doors for scientists to crosspollinate ideas across different fields, enabling them to gain fresh perspectives and uncover new insights.
Now, you may not be working toward securing the title of a Nobel laureate. Still, you might be interested in learning the secrets of expanding your mind, creating new connections, and better integrating the two sides of your brain hemispheres to provide better care or nurture your inner life.
You may be wondering how having an artistic hobby or winning a Nobel Prize in science relates to excelling as a diabetes specialist or healthcare professional. As a healthcare professional, you have likely lived through difficult experiences or witnessed profound suffering firsthand.
Plenty of science supports the idea that engaging in creative pursuits offers an outlet to express complex emotions that are not accessible through words alone.
The act of playing an instrument, taking an art class, exploring nature, or playing the bongo drums may provide a gateway to address unrequited trauma or pain, helping you to become more fully aware and present with your feelings. Did you have a childhood or adult hobby you loved doing? One that made you lose track of time as you entered the zone referred to as “flow”? Have you given yourself permission to make time for that hobby and lose yourself in that creative process?
You may want to take a ceramics or writing class, join the local choir, or start a band. Perhaps you found an old camera and want to learn more about photography or realized you’re good at painting. It can be hard to start as a beginner and potentially look silly or unskilled.
Here’s my advice: Let go of those sky-high expectations. No one expects you to paint like Monet in your first art class.
My motto is, if something makes me uncomfortable, I know I’m in the right place—because that’s where growth happens.
I encourage you to take that leap of faith and tolerate the momentary discomfort for long-term gain. It gets better, and before you know it, you will blossom in ways you never expected.
Download this worksheet to explore 20 creative endeavors that may spark inspiration within you. You may already be practicing some of these—or perhaps you have new ideas to add. Wonderful—keep going!
As a dance teacher for the past twenty years who can still balance a sword on her head, I am reminded every day that it is never too late to rediscover your joy.
Coach Beverly is honored to invite you to this special gathering and intimate conversation. During this virtual book launch, a special guest interviewer will join Coach Bev for a heartfelt conversation about why this book matters now and the real stories from clinical practice that inspired it.
Coach Bev will also share the personal journey of writing Healing through Connection and how she discovered her voice along the way. We will conclude with an interactive question-and-answer session and allow time for connection.
Come celebrate connection, healing, and the power of story as we honor the shared human experience at the heart of healthcare.
Thank you for YOUR support and commitment to promoting healing and connection every day!
For last week’s practice question, we quizzed participants on which of the following responses is the least appropriate (i.e., the WRONG thing to say) to Maria. 58.54% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Maria, a 52‑year‑old woman with type 2 diabetes for 8 years, attends a follow‑up visit. Her A1C has risen from 7.8% to 9.2% over the past year. She reports feeling “overwhelmed” and says she didn’t want to start the medication her clinician recommended at the last visit. She explains, “I’m scared of side effects, and I feel like needing medication means I failed.”
Which of the following responses is the least appropriate (i.e., the WRONG thing to say) to Maria?
Answer A is incorrect: 15.3% chose this answer,“ It sounds like you’re feeling overwhelmed. Can you tell me more about what worries you most about starting this medication?” Appropriate — Person centered, exploratory. This response uses reflective listening and invites the patient to share her concerns. It aligns with ADA Standards of Care recommendations for collaborative communication and supports assessment of diabetes distress.
Answer B is incorrect: 11.57% chose this answer, “Many people feel this way. Let’s look at your options together so you can make a choice that works for you.” Appropriate — Normalizes feelings and supports shared decision making. This option reduces stigma by acknowledging that many people experience similar emotions. It reinforces autonomy and partnership, which are core components of effective diabetes self management support.
Answer C is correct: 58.54% chose this answer, “I understand that this is challenging and overwhelming. However, if you don’t start this medication, you are choosing to risk complications like kidney disease or blindness.” Incorrect — Stigmatizing, blaming, and fear based. This statement uses threat based language (“you are choosing to risk complications…”) and implies personal failure. It increases shame, undermines trust, and can worsen diabetes distress. It does not incorporate person first language or collaborative care or help identify barriers and personalized solutions. Oh, and it probably won’t be very successful!
Answer D is incorrect: 14.59% chose this answer, “It’s completely understandable to have concerns. Would it help if we reviewed what the medication does, talk about the pro’s and the con’s, and about what alternatives exist?” Appropriate — Validates concerns and offers. Information without pressure. This response acknowledges the patient’s emotions and provides an opening for education and shared exploration of options. It supports autonomy and reduces the sense of failure associated with medication use.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
In this course, William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, examine the powerful role of psychosocial factors in diabetes self-management. Through innovative strategies, participants will learn how to recognize and address common barriers to effective self-care and cardiometabolic medication initiation and maintenance, while fostering respectful, stigma-free clinical encounters.
Through a collaborative and person-centered approach, the course emphasizes communication strategies that enhance motivation, build confidence, and reinforce the value of self-management. Participants will develop skills in diabetes-focused action planning, addressing medication hesitancy, and providing ongoing support and resources to sustain behavior change over time. The goal is to help clinicians make diabetes care more doable, meaningful, and effective for people living with diabetes.
Dietary fiber is a complex carbohydrate and bioactive food compound that has an important role in diabetes management and cardiometabolic health. High-fiber dietary patterns are associated with a lower risk of type 2 diabetes, cardiovascular disease, obesity, gastrointestinal disorders, and certain cancers. ¹,²
In individuals with diabetes, fiber-rich eating patterns have been shown to improve glycemia, reduce postprandial glucose excursions, and improve lipid profiles. ¹ A recent meta-analysis found that for individuals with type 1 diabetes, a high- fiber diet not only supports A1c reduction but is also associated with reduced hypoglycemia risk due to its role in slowing digestion and absorption. ³ Despite this evidence most adults fail to meet recommended fiber intake guidelines, presenting an opportunity for nutrition interventions.
The Dietary Reference Intake (DRI) for fiber, established by the Institute of Medicine, along with the 2026 ADA Standards of Care ¹ , recommends 14 grams of fiber per 1,000 Calories, corresponding to an Adequate Intake of approximately 25–38 grams per day depending on age, gender, and energy needs. 4 Higher-fiber dietary patterns greater than 35 grams per day ³ and up to 50 grams per day 1 may provide additional glycemic benefits for individuals with diabetes.
Both the 2020–2025 and 2025–2030 Dietary Guidelines for Americans 5 emphasize fruits, vegetables, whole grains, and legumes as primary fiber sources; however, the recommended portions of these food groups differ between guidelines. The newly released 2025–2030 guidelines place greater emphasis on overall dietary patterns and whole-food sources, with reduced total grain servings, increased emphasis on legumes, and a prioritization of reduced processed foods rather than focusing on fiber as an isolated nutrient.
However, the Scientific Report of the guidelines does reference an optimal fiber intake range of 25–29 grams per day. ² Aligning with ADA Standards of Care, the focus shifts from individual nutrients to overall eating patterns, supporting health professionals to encourage food choices that help individuals meet evidence-based guidelines for fiber recommendations.
Despite serving-size guidance and scientific evidence on the benefits of fiber, average intake in the United States remains far below recommendations. Fewer than 5-7% of adults meet daily fiber requirements. 5 Disparities in intakes among groups have grown over time, with data from the 2017–2018 USDA Economic Research Service showing that, within Hispanic populations, fiber consumption was highest at about 9 grams per 1,000 Calories, compared with
7.7 grams per 1,000 Calories among non-Hispanic White individuals, and 7.0 grams per 1,000 Calories among Black individuals 6 .
Although the amount varies across groups, most individuals reach only 58% of the daily fiber recommendations. Inadequate intake stems from not only food preferences but tolerance, food cost and access, time constraints, nutrition literacy, as well as, other social determinants of health. To help the U.S. population meet fiber goals, practical strategies consider not only culturally relevant nutrition interventions but food assistance programs, systems planning, and community resources that improve access to fiber-rich foods.
Therapeutically, the type of fiber matters, with insoluble or soluble providing different health benefits. Insoluble fiber creates bulk within the stool and can promote bowel regularity and reduces risk of certain cancers. Whereas, soluble fiber forms a viscous gel in the gastrointestinal tract and provides metabolic benefits, including reduced postprandial glucose responses and lower cholesterol levels. 7
While not specific to type, understanding fiber claims on food labels is a practical entry point for guiding individuals toward higher-fiber food choices. According to FDA labeling regulations, foods may be labeled a “good source” of fiber if they provide 10–19% of the Daily Value per serving (≥3 grams), while an “excellent source” of fiber provides greater than or equal to 20% of the Daily Value per serving (≥5 grams). 8
Additionally, the FDA has approved the use of “will reduce the risk of coronary heart disease” health claims
on food packaging due the cardioprotective effects of high soluble fibers β-glucan (found in oats and barley) and psyllium. 9 Emphasizing dietary patterns, food quality assessment, label literacy, and considerations for additional functional fiber supplementation can support individuals with diabetes to make informed food choices and shifts in their intake.
Practical strategies to promote higher fiber intake are outlined in the 2026 ADA Standards of Care¹ (Check out Nutrition Behaviors to Encourage ¹ within section 5: Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes) and can be reinforced through simple, actionable “High-Five for Fiber” tips.
These tips are a catchy way to encourage health behaviors that may help individuals gradually add fiber (slow addition improves gut tolerance) to meet daily recommendations. Ideas can include having individuals choose at least one “high- fiber, excellent source” daily (which has more than 5 g fiber per serving), discover high soluble fiber foods, strive for five, or more, servings from vegetables and/or fruits each day, and/or “take five” to plan meals that include whole grains, fruits, vegetables, legumes, and/or nuts and seeds each week. These tips encourage choice, helping individuals find foods that fit their personal preferences, affordability, cultural traditions, and lifestyles ¹ while supporting sustainable, health-promoting dietary patterns.
References:
Focused. Flexible. Proven.
Basic & e-Deluxe CDCES Boot Camp Bundle Includes:
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Get exam-ready with confidence.
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level-up their clinical knowledge and skills.
✔ Learn at your pace with expert-led, exam-focused content
✔ Everything you need—organized, practical, and in one place
✔ Perfect for self-directed learners who want complete, person-centered content for clinical practice and exam prep.
✔ Build knowledge, sharpen test-taking skills, and prepare with confidence—on your schedule.
We receive so many great questions from our community about carb counting, so we’ve gathered all of our favorite, most trusted carb counting resources in one place for you.
Our goal is to make counting carbs simpler, clearer, and less overwhelming. We hope this collection answers your questions and gives you the confidence to manage carb counting with ease!
A concise overview of serving sizes and carbohydrate counts for common foods. An excellent study tool to help you review key concepts and feel confident going into the exam.
We created this Carb Counting Quick Reference sheet based on the ADA handbook.
We created this Carb Counting Quick Reference sheet based on the ADA handbook.
Includes curated food database with nutrition information, including many fast-food chains and restaurants.
The American Journal of Preventive Medicine ranked this app, which has no free version, number 1. It boasts an intensive and easy-to-follow educational component in addition to features for monitoring blood glucose, carbs, net carbs and more. Easy to see the big picture with daily and weekly reports. For some, it may be worth the extra expense.
Undermyfork automatically combines glucose data from CGM, FGM, or BGM with the meal pictures and calculates postprandial Time in Range for each meal. Tag meal photos with keywords to compare your glycemic response to the same meals and situations.
Formerly known as Diabetes Logbook Manager. Simple to navigate, Glucose Buddy helps users manage their blood sugar, insulin dosages, and carb intake. Other features track exercise, blood pressure, and weight. Sync data to print it out or view online.
Digital diabetes personal assistant, developed with insulin using people with diabetes in mind, to increase time-in-range. Allows tracking data in a personal logbook and gives suggestions on carb amounts and insulin doses with a food database designed by nutrition experts.
See our latest cheat sheet on helpful apps for diabetes self-management.
By: Beverly Thomassian
Gung Hay Fat Choy.
Every Chinese New Year brings a wave of gratitude for Alex and Ying, who welcomed an akward 14-year-old into their family-style restaurant and made her feel loved and cared for. Their generosity and belief in me left a lasting imprint on my heart.
I invite you to enjoy this excerpt from my recent book Healing through Connection for Healthcare Professionals. Join Coach Beverly for an intimate virtual interview on the writing of this book on Feb. 20 at 11:30am PST.
When I was fourteen and a half, I found refuge in an unexpected place—a small Chinese restaurant tucked between a Kinney Shoe Store and an Italian eatery in a strip mall in the San Fernando Valley. While my home life was unraveling, I was quietly being stitched back together behind the counter at Ying’s Kitchen.
I didn’t know it then, but this restaurant would do more than offer me a paycheck. It would shape my work ethic, show me what being part of a team meant, and serve as a foundation for the healthcare professional I would one day become. In that busy kitchen filled with the scent of onions and sizzling oil, I learned the beauty of hard work—and the profound healing that comes when someone believes in you.
Finding Refuge in Ying’s Kitchen
As the latest in the long line of high school girls, my job was to answer phones, bag the food, ring up the orders, and answer customer questions for $1.25 an hour. Barely a teenager with no restaurant experience, I approached my assigned tasks with a combination of diligence and confusion.
Early on, I stumbled. Anne, a high school senior in charge of training me, told me, in no uncertain terms, that I was “not keeping pace with the training program, and they might let me go.” This awkward coaching session is seared into my brain. It pushed me into high gear, and I became determined to be the best Ying’s Kitchen employee ever! That moment lit a fire in me. I doubled down, became the fastest phone answerer in the West Valley, and soon trained the new hires myself. It was more than pride, it was survival. A sense of belonging, and a safe place to grow.
Beyond being my employers, Alex and Ying looked out for me. Alex asked me about my day at school and practiced Chinese with me. Before closing, he would ask me if I was hungry. My favorites were the pork fried rice and the egg rolls, and on special nights, he would make me moo goo gai pan. During the summer, Alex coached me on the importance of drinking hot water to cool down. He asked me about my boyfriends and made sure I was keeping up with my homework. Best of all, he always smiled, showing his one gold tooth when I walked through the door.
His wife, Ying, only spoke a few words of English, but she had a way of letting me know she saw me. During springtime, she would call me over and take one strand of my hair, wrapping it carefully around a Jasmine flower from her yard. As I walked through my work shift, I could smell the scent of jasmine and know that I had a found family who treasured me.
Post-Traumatic Growth in Practice
In their book What Happened to You, Oprah Winfrey and Dr. Bruce Perry describe how post-traumatic growth can emerge when safe adults and healing relationships interrupt a cycle of pain. I am living proof of that truth.
Working at Ying’s Kitchen didn’t erase the pain of my past, but it gave me the structure, accountability, and connection I needed to believe in a future beyond it. It became the cornerstone of how I eventually built Diabetes Education Services—a company whose mission is rooted in decreasing shame and blame in diabetes care. The resilience, empathy, and grit that carried me through adolescence now fuel my passion for advocating person-centered, trauma-informed healthcare.
What This Means for Healthcare Professionals
As healthcare professionals, we may look for sophisticated solutions to complex human problems. But sometimes, the most transformative interventions are also the simplest: a steady routine, a safe space, and someone who believes in you.
This is especially true for people living with diabetes and other chronic conditions. Many carry unspoken histories of trauma. When we show up with kindness, curiosity, and consistency, we’re not just delivering care—we’re becoming part of someone’s healing journey.
Whether you’re precepting a student, mentoring a colleague, or counseling a patient, consider the ripple effect of your presence. Like Alex and Ying, you might be offering more than a service—you could be anchoring someone in a storm.
From Survival to Service
Looking back, I see how Alex and Ying laid the groundwork for how I lead today. Those years at Ying’s Kitchen profoundly shaped how I built and now manage my company. The lessons of diligence and love became my guiding light, helping me navigate even the roughest waters and steer my ship toward calmer horizons. The discipline I learned behind that counter still guides how I show up—whether teaching a course, writing a book, or sitting with someone in their hardest moment.
While my early life was shaped by adversity, the safe haven of Ying’s Kitchen taught me that healing often begins with being seen. That’s something we can all offer, no matter our title or training.
Sometimes, the most profound lessons in healing don’t come from textbooks—they come from trusted adults, jasmine flowers, and the quiet grace of being loved into wholeness.
Why Join?
Because you deserve a space to rest, reflect, and reconnect — not just with others, but with yourself. Together, we can remind one another of the humanity behind the healthcare, and rediscover the power of connection in healing.
Your presence matters. Your story matters. And we’re honored to walk this journey with you.
