DiAview: a Type 1 diabetes Divabetica. Meet Fabulous Fabi!
- LOD Diaviews
- 4 days ago
- 6 min read
Diabetes wellbeing coach, Fabiana Couto, has recently moved from Sao Paulo, Brazil, to Southampton. From a Masters in Clinical Psychology to hosting Fashion Shows, Fabi's 32 years of living with Type 1 diabetes embodies a movement of highs and lows, physically and mentally, that has built a burning passion to support education with empowerment for "everyone living with diabetes and their family members."
When you were diagnosed with type 1 diabetes, how much of a shock was it for you or your family?
"I was diagnosed back in 1993. The reality around diabetes education and technology was completely different back then. I started my treatment with NPH and regular insulin, and I remember living a roller coaster of blood sugars most of the time; and mood swings.
We didn't do carb counting; actually as far as I know this tool didn't exist back then. However, the aspect that impacted my family and I most was certainly the emotional side of T1D. I remember feeling lost, angry and alone; I didn't have anyone to talk to, as I didn't want to worry my parents -- they were going through their own hardships.
Looking back I certainly see that what we missed was a community to share experiences with. I remember I didn't know anyone like me who had T1D until I was 27 years old, so this was about 14 years after my diagnosis. It was a lonely and uneasy road until then."
What did you find the hardest to readjust your life to in that time after your diagnosis?
"It was the psychological and social aspect of diabetes. The fact that I would hide my diabetes from others was a huge deal when it came to my management.
I didn't want to show others my disease as I felt like 'there was something wrong with me.' So I didn't check my glucose in front of others; I wouldn't let them know if I was having a low and needed some help. This lack of acceptance and fear of rejection led me to neglect my diabetes.
Back then it was also recommended to 'stop eating sugar' - which was very hard for me, making me feel different to others. This led to developing compulsive eating; then bulimia; then diabulimia. Those were definitely the hardest days I had with diabetes."
Tell us about 'Movimento Divabetica' - which you actively support the diabetes community through!
"Movimento Divabetica, or 'Divabetic Movement,' was created in August 2017. I had this epiphany of doing a diabetes event with a fashion show; publicly showing our diabetes devices.
That idea came from when I heard about Sierra Sandinson, a model living with T1D who won the Miss Idaho contest while wearing her insulin pump. This was to me, an act of courage, self-acceptance and self-love. It seemed a beautiful way of embracing diabetes. So in November 2017, with the help of friends and family, I organised our very first event with inspirational talks about diabetes and the fashion show to conclude it.
It was such a huge success that it continued over time -- we have now completed the 9th event in Brazil, with last year also being the first time we have done it overseas during the League of Diabetes T1D Festival in London!"
Why did you feel the importance of showcasing the diabetes devices, and how has the event been received?!
"Sierra Sandinson was the initial inspiration, to celebrate who we are not only despite but also because of diabetes. Showing your device, either a glucose meter, sensor, insulin pen or pump, represented an act of embracing rather than denying or rejecting diabetes. A way of empowerment and self-acceptance.
Every year we have a theme, for example, a recent one in Brazil was “Start Over,” and the power of resilience and starting over every day if necessary; the idea that we are not doomed by diabetes, and there are always second and third chances. Last year was, “Achieving more Freedom,” focused on ways to make diabetes less of a burden in one's daily life, such as learning easier carb counting, new technologies (and more accessible in the market), peer support, emotional management and more."
With your journey into clinical psychology, what do you feel doesn’t perhaps get so clinically considered about diabetes management and psychological well-being?
"I believe that there are a couple of factors. One is that in type 1 diabetes (and also in type 2) when diagnosed, there is not 'much time' to think about the psychosocial aspects of it, because the medical and practical demands are urgent. So we learn about insulin, carbs, blood sugars, but there is little room (unless it's something introduced by the person's healthcare team) to deal with the emotions.
Yet, we all know that they play a huge role in diabetes management and at some point (earlier than later) this should be addressed. But, besides the practicalities of diabetes, we also must remember that, unfortunately, mental health is not yet taken so seriously in our society in general, so public policies and programs are needed from the public to drive more accessible care in this area."
Having travelled, studied in the US and recently moved to the UK, how challenging has it been to adjust to new health systems surrounding your diabetes care?
"Tell me about it! Honestly, the healthcare systems in Brazil, US, and UK are very different. It is very hard to adjust, especially if you are having an emergency. I moved from Brazil to the UK two months ago and had an episode that my pump stopped during the night because it lacked battery. Long story short, I woke up the next morning with very high blood sugars and ketones too. I thought it would be better to go to the hospital and only by being there started to understand better what their procedure was. It is scary; you feel quite vulnerable and every country has its own system. On the other hand, the diabetes community and my support network have always supported me, as I am in touch with groups and people living with the condition everywhere I go. This helps a lot!"
How does the health system in Brazil work for people with type 1 diabetes?
So in Brazil, we have SUS -- our public health system that entails the “Universal Health System”. SUS is a true blessing to everyone in Brazil and also people with diabetes. It was inspired on the NHS model and offers a range of services.
They give for free the test strips, glucose meters, fast-acting insulin, and NPH insulin (*still in the process of incorporating the pro-longed acting analogues), so even though we still have a long way to go, mainly regarding the technology devices, Brazil offers a decent treatment for type 1s. However, the main problem of the system is that there can be a lack of resources and an ineffective administrative structure that makes people suffer from the lack of medication and supplies sometimes months in a row. That's where the diabetes community in Brazil makes a real difference with donations and support. The diabetes community has been the biggest blessing that came from this condition - being on hand to help each other if/whenever it is required.
There is still a long way to go to improve public and private health in Brazil, and that's why I am also a co-founder of another project called 'Diabetes Influencers Movement,' that we use the online media and voices from influencers in Brazil to raise awareness and fight for access to diabetes education and advancing treatment (our profile is @influencersdiabetesbrasil)"
What message would you like to share with others on their journey with this condition, from all your experiences?
"Never give up on yourself. If you are feeling tired, stop. Rest. Reach out to others - because you are not alone and you are worth it.
You can't do diabetes alone, and you should not do it alone. There are several events, communities and people out there who are supportive - just look at League of Diabetes, or with our channel of Movimento Divabetica, and so many others. We know diabetes can be a struggle, and believe that there is always a better way. Do not bottle it up in silence; ask for help. It's no shame to do that, it's an act of braveness, self-love and self-care.
When you get to know the diabetes community and start engaging more, your life will become better and you will feel like you have found a new family to be part of."
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