Episode Summary

It can feel like people with type 1 diabetes (T1D) are fighting for their lives in a system built to wear them down. The twist is that clinicians often feel the same weight as they fight to provide care.

In this episode, host Scott Johnson talks with two highly-skilled healthcare professionals from University Hospitals in Cleveland, Ohio: Natalie Bellini, an endocrine nurse practitioner and program director for diabetes technology, and Quiana Howard, a PhD candidate and clinical nurse research specialist.

The conversation delves into the systemic struggles that prevent people with T1D from getting the support they need to live well with diabetes. The guests, including Natalie, who also lives with T1D, discuss the gap between what people need (like insulin access, education on carbs/fat/protein, and psychosocial support) and what they typically receive (a little information and a website).

They highlight the critical role of organizations like Blue Circle Health in providing holistic, wraparound support that addresses social determinants of health—going beyond glucose numbers to help with insurance, mental health, and food/housing security. Quiana also shares her research on social vulnerability and the surprising frequency of T1D misdiagnosis among minority and underserved populations. Ultimately, the discussion emphasizes the need for a community approach, recognizing that no single clinician or system can be the "do-all end-all" for T1D management.

What You'll Learn

• Why the healthcare system struggles to get people with T1D what they need.
• The essential needs at T1D diagnosis: insulin, psychosocial support, understanding insurance coverage, and education on diet and exercise.
• How clinicians like Natalie and Quiana meet people with diabetes where they are—sometimes even outside the clinic—to build trust and break down cultural barriers.
• Why Blue Circle Health is considered a "system breaker" for providing wraparound support beyond glucose numbers.
• The challenge of misdiagnosis, often due to prejudice or assumptions based on race, age, or weight.
• The shocking level of judgment and assumptions people with T1D face from others, and even clinicians.
• Why clinicians must recognize that their system isn't designed to support every need a person with T1D has.

Key Quotes

• "It can feel like we're fighting for our lives in a system built to wear us down. And here's the twist. Your doctors, your clinicians, feel a lot of that same weight as they fight to take care of you." – Scott Johnson
• "I have to talk to you as if we're equals and we're in this together, and I'm not going to leave you here alone... We're not going to talk at you; we're going to talk with you..." – Quiana Howard
• "There's no box. If we never had to think about any cost, what would we give to a person with diabetes? And that's what we get with Blue Circle Health." – Natalie Bellini
• "Blue Circle Health is a health equity model. They break down the systems that often prevent people from achieving the best outcomes when managing their type 1 diabetes." – Quiana Howard

Resources & Links

• Community Partner Spotlight: This episode highlights diatribe, a small nonprofit focused on education and advocacy around T1D, including fighting stigma and raising awareness of Time in Range.
• 🌐 Visit: diatribe.org to learn more and subscribe to their newsletter.

What is Around the Circle: Living Well with T1D?

People with type 1 diabetes fight two wars: one against a relentless 24/7 condition, and another against a healthcare system that makes it difficult and expensive to stay alive. Around the Circle: Living Well with T1D brings together voices from across the type 1 diabetes community to share real stories, expert insight, and practical support for living well with T1D.

Hosted by the team at Blue Circle Health, a U.S.-based program transforming type 1 care, this podcast helps people go from just surviving to truly living well with type 1 diabetes. https://bluecirclehealth.org