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As part of today's program, we want to pause and center the patient's voice. While we've been discussing guidelines, screening strategies, and treatment approaches, it's equally important to understand how these concepts are experienced by people living with diabetes every day. To help bring that perspective forward, we're joined by a patient advocate, Anne, representing Diabetes Sisters, a nonprofit organization dedicated to improving the health and quality of life of women living with diabetes. Thank you so much, Anne for being with us today. Oh, it's my pleasure. I'm always happy to share my experiences with others. Great. So to start, could you briefly share your journey with type 2 diabetes and when kidney health first became part of the conversation? Well, I've been dealing with this for over 25 years, and The diabetes came 2nd, uh, as far as symptoms. I had a heart attack. Oh my gosh, almost 25 years ago. And at that point, I didn't know I had type 2 diabetes. And I had no idea there was any connection. So, one thing uh was affecting the other, and so, um, I wasn't even told that there was a connection, so I just was dealing with uh my heart issues, and then when I learned I had 2 diabetes, I was treating that as a totally separate health issue. It wasn't until, I don't know how many years later, quite a few years later, that the chronic kidney disease came into play, and that was, you know, through my having blood tests on a regular basis to see how everything in my system, you know, in my body was working, and I found out those things were not working. Thank you for sharing that. And it really highlights how kidney health often becomes part of the diabetes journey over time rather than from the very beginning. Uh, before your care team discussed kidney health with you, what did you understand about how diabetes can affect the kidneys? I'm embarrassed to say I didn't know. And again, this was uh over 25 years ago, and I don't know if it was discussed with patients, um, saying that one thing could affect the other. I had no idea that by not managing my blood sugar levels, it caused inflammation in other parts of my body. So, it affected my heart, and from what I also understand is that diabetes could be there for 10 years before you know you have it. And so in that case, it means that my heart was being affected and my kidneys were being affected, and it wasn't until the extreme occurred that my real education journey began. Mm That perspective is really helpful, and it underscores how much of this information isn't always clear to patients early on, which is of course very natural. Uh, do you recall having tests like blood work for kidney function or urine tests as part of your diabetes care, and how were these explained to you at the time? Well, the diabetes care started after the heart attack. And so that's when I started having blood tests and finding out different things that were going on. At that point, I had no kidney issues. So I also think that in my situation, the um appearance of a kidney stone exacerbated things, and I wound up And I, I don't know if this was about 10 years ago, that one of the kidney stones embedded itself in my kidney. You don't feel it if it's not moving, and it caused an infection. And when I had the infection, again, you don't feel it. So, I didn't know that my kidneys were being affected. There was maybe a slight elevation of my uh creatinine level. I mean, very slight, not to the point where I had to worry about it, but once I had this infection and it was raging through my kidneys, it threw me into a much higher level of kidney disease. I mean, when I found I had it, I think I was already at stage 3, which is also not uncommon. I mean, since it's a silent disease, as is diabetes, unless you're on top of it and knowing what to look for, These things can progress. Thank you for really describing that experience for us. And I guess it really shows how important clear explanations are when routine tests are ordered. Uh, looking back, what helped or made it harder for you to understand the importance of kidney screening? Well, that came along, as I said, after I had the infection. I was already part of a group called Diabetes Sisters. Because I knew I had diabetes, and I was very lucky to meet somebody that was already part of the organization, and she invited me to join and check out a meeting. These were in person at that point, and my education really began then. It was a huge It was just a giant plus that this came into my life and I was needing and, and talking with other women through diabetes sisters. So, I was able to branch out my education and start learning more about what I needed to do to keep my blood sugar, blood sugars at a To manage them, cause I can't control them, but I can manage them. And by managing my blood sugar levels, it keeps my kidney healthy and because I didn't mention this, and we didn't get to this part yet, but the chronic kidney disease advanced to the point where I did need a kidney transplant. So I have been through everything from heart attack to diabetes, to then having to absolutely need a kidney transplant. I was very lucky in that my son was a a um perfect match. So I was able to have him be my donor. So, Again, that's when I also turned to the National Kidney Foundation. So, working with diabetes Sisters, and then being uh becoming familiar through Diabetes Sisters with the National Kidney Foundation, it rounded out my education, and I realized I had a lot of work to do to try to keep myself healthy, and all the information was out there, but I never knew it before. Mhm. These are very important insights and it really highlights how community, which you've mentioned, and communication and timing can make a real difference in patients understanding. Um, when treatment options were discussed, how involved did you feel in decisions about your care? Very. I had an amazing nephrologist, and as a matter of fact, I did a um a Zoom session with him for the National Kidney Foundation. They wanted to have a, a patient speaking to their nephro to a nephrologist, and it just so happened my nephrologist was available. So he was able to ask me very guided and pointed questions, so that anybody that was listening to this particular uh session. wouldn't know what to do. And so, that was an incredible help to me because I, I learned even more during that session. But peer group support, uh, again, with diabetes sisters is what led me on this journey and made, oh my gosh, it made such a difference, and I was able to speak with others that had already experienced some of the same things. And journeys may be different. We may get to certain places at a different pace, or through, you know, just different health issues, but if we're able to share our experience and learn something from someone else, it just makes a world of difference. Thank you for sharing that. Your experience here really reinforces the role of shared decision making in helping patients feel engaged in their care. Um, if you could share one message with healthcare professionals caring for people with type 2 diabetes, what would you want them to understand from the patient's point of view? Well, I, when it comes to understanding what we need to do, um, it would be great if the, the doctor approached it in such a way that it didn't scare off a patient. I know that may sound extreme, but if someone's not really familiar with diabetes, type 2 diabetes, uh, specifically, they hear that and they get scared. It's like, oh my gosh, what did I do? People blame themselves, and it's important for people to know, it's not.