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Abstract:
Many newly diagnosed individuals assume they’ll receive clear, end-to-end guidance on diabetes. In reality, confusion is common, literacy is uneven across the health workforce, and misinformation fills the gaps. In this conversation, UCL doctoral researcher and THSA Chief Science Educator, Alex Ruani, explains why The Health Sciences Academy developed the Diabetes Health certification: to build diabetes literacy, align practical diet and lifestyle strategies with medical care, and strengthen self-management.
The discussion covers more than type 2 diabetes, touching on the breadth of diabetes types, insulin resistance, and prediabetes, plus day-to-day factors that influence glucose control, including meal composition, sleep, stress, physical activity, chrononutrition, and substance use. Alex also highlights real-world scenarios, from hypoglycaemia during training to managing sick days and travel, and why structured resources, checklists, and workbooks can help clients, patients, and professionals navigate the system more effectively. If you support clients, patients, or family members with diabetes, this interview outlines a practical, evidence-informed path to clearer decisions and better coordinated care.
If you work with clients at risk or already diagnosed, this conversation shows how to close the gaps in diabetes care with structured follow-up, tailored nutrition, and coordinated support.
Below is the full interview transcript for you:
Maurice Castlejin
Chief Executive Officer, Co-founder
Alex Ruani
Chief Science Educator, m
Maurice Castelijn:
Welcome, Alex. Great to see you again. And I’m excited to talk about diabetes health. Now, it’s a certification that we’ve been working on for quite some time here within the Health Science Academy. So I’m really curious to hear why diabetes health?
- Why did The Health Sciences Academy create a Diabetes Health Certification?
Alex Ruani:
That’s an important topic, right? Perhaps we’ve been ignoring it for too long. And I had a bit of a wake-up call. About three years ago, when we started working on the certification. I was attending a wedding with my husband and it was the wedding of one of my best friends and among the guests there was this gentleman who was diagnosed with type 2 diabetes and I had this assumption that when you receive a diabetes diagnosis that a healthcare team, a medical team will look after you from every angle and you will be well looked after and you would understand exactly what to do, what not to do, what to eat, what not to eat. I was shocked because he mentioned to me that although it’s been a few months since he’s been diagnosed, he still didn’t know what to eat, when to eat. He was so confused.
And he said to me, do you have a certification in this space? Because if you do, I need to join. I don’t know what to do right now. And I keep going back and forth with doctors and trying to make an appointment with a dietitian. And it’s been really difficult for this person to manage it. He had a blood glucose monitor attached with which he showed me some of the data. He said, I still don’t know how to interpret this data. What it really means is confusing me. Sometimes I do the same things and I get different readings.
I was really confused and I could not believe that. I thought once you get the diagnosis, you will get that level of support where it becomes a lot easier for you to manage. And that’s when I realised we need to do something in this space, especially because this person asked me in person. directly, I need help.
- Are people with diabetes really getting the support they need after diagnosis?
I was really confused and I could not believe that. I thought once you get the diagnosis, you will get that level of support where it becomes a lot easier for you to manage. And that’s when I realised we need to do something in this space, especially because this person asked me in person. directly, I need help.
And I wish I had the tools back then. So, with a team we’ve been working really hard on this certification for a few years, and it’s not just type 2 diabetes. There are over 20 types of diabetes. We also have insulin resistance, prediabetes, so much more to it. So yeah, it was about time that The Health Sciences Academy devoted resources to this space. And then of course, other motivations resulted actually from interactions.
I encountered a few additional stories. So for example, the father of one of my best friends, had to be hospitalized soon after a party with her granddaughter. And apparently he had an insulin shot and he went hypoglycemic and that wasn’t managed by himself. Nobody around him really paid attention. Everyone was excited about the party. And some of those things are preventable.
So what systems do we need in place to self-manage a little bit better? Of course, we do have family members who can help us, but there are ways for us to take a little more control and not feel that we’re constantly having to be alert or worried. So those are things that really concerned me. And another story, all pretty much happened along the same period. I met a health coach and she told me that she developed type 1 diabetes after a severe infection. And she could not believe it.
She was in her mid -20s. very healthy, very healthy and developed type 1 diabetes, which is very different from type 2 diabetes as a result of that infection. So I had a conversation with her and I said, so how does your health coaching help you personally with all of that? And she was still very confused trying to navigate these. And she herself said, I wish I had the resources to learn more about this topic, because right now I’m also feeling like I’m being a little bit like ping pong in a ping pong situation back and forth between doctors and specialists and not knowing exactly how to self manage so self management.
- Why is self-management so critical in diabetes care?
This has been a very big focus of ours from the beginning of our research and we even looked at research on self -management, on diabetes literacy and we looked at research amongst medical doctors, nurses, anyone in the healthcare system involved in diabetes and how confident they will feel to support patients with certain strategies. We looked at the level of knowledge amongst medical professionals and we were quite shocked that the level of knowledge is relatively low in the space, that level of confidence and understanding is not quite there yet. So I completely underestimated the capabilities and the competencies of the medical system in this space. So this course is 100 % helpful whether you are somebody who is within the medical system and you want to elevate your diabetes literacy, you want to understand more about management, how to support patients and perhaps incorporate some of the behavioral perspectives, but also self -management. If you have been diagnosed with diabetes or prediabetes or insulin resistance and you’re concerned about something, understanding how to self -manage this can be very, very helpful.
And then of course, Nigel, we had a conversation with Nigel who is in one of these video series and Nigel explained he was healthy and athletic and obviously with his nutrition background, completely immersed in a healthy diet and healthy eating, and then all of a sudden he gets the type 2 diabetes diagnosis. And I recall he once mentioned that his GP recommended to him to check out information from the “Gut Goddess” to help manage his diabetes, which is no, do not do that. There are influencers without training in this space and some of the advice that they may give can be harmful. So we have to be careful. There are also different types of diabetes, different situations. Not one case of diabetes will be the same.
So we need to account for those differences. So it’s been quite a journey and I’m very pleased because we have the help of dietitians supporting us with the development of this certification. Obviously, Dr. Michelle de la Vega, PhD and VP of Science and Education in our team, you know, she’s been working with so many people, she interviewed so many professionals, even patients trying to understand where the deficits are and how we can help tap some of these into some of these gaps and provide something that is really comprehensive, not just understanding biological and physiological mechanisms, but also the practical aspects, diet, lifestyle and everything that goes around that.
Maurice Castelijn:
Wow. So one of the things that I picked up from that, and I didn’t even know this, and I bet lots of people didn’t know this, is the fact that you can get type 1 diabetes from an infection. Because usually what people hear is, oh, you can get type 2 diabetes from lifestyle or from other kind of situations. And type 1 is typically something that you would inherit. So that, I think, is really interesting.
The other thing that you mentioned is around that this certification seems to be very geared towards people themselves as opposed to purely the professional. So it’s also for the general audience to get an understanding in terms of what diabetes entails and what kind of strategies you can put in place. Can you tell me a little bit more about that, you know, what to expect once you go through a certification like this?
- Can you tell me a bit more about what to expect after completing a certification like this?
Alex Ruani:
Absolutely. If you’re somebody who is concerned, for example, about blood glucose regulation, controlling your blood glucose, influencers are blurring out all sorts of dangerous statements around blood glucose control. So we tap into some of those more basic or common questions, not basic answers. You have complex answers to simple questions. But we look into, for example, carbohydrate consumption, carbohydrate quality, quantity, dietary fat, protein balance, physical activity, stress, sleep, mental well-being, chrononutrition, meal timing, meal sequencing, food order, all of that, the actual research, different types of diets in connection to blood glucose control, food additives. We’re seeing more research coming up with UPFs (ultra-processed foods) and diabetes.
So what’s the deal with all of that? Supplement use, you know, should we take any supplements? like what’s safe or what’s not safe, what’s contraindicated, what’s not contraindicated. You will also have individuals who will be concerned about family members, for example, somebody in the family who consumes alcohol, or there is some substance use, or exposure to hazardous chemicals from the environment, hazardous industry workers, which have a higher risk of certain hazardous exposures and how some of these factors may also influence blood glucose control. Inflammation levels, stress levels can also influence glucose control, micronutrient deficiencies as well, gut health and microbiome is all connected. So it’s important that we look at all of these different elements, not just the diet.
Of course, diet is the central point in the entire certification, but also look at all of these other elements that may support blood glucose control, whether it’s in instances of insulin resistance or prediabetes or if you have a diabetes diagnosis. There are differences between type 1 and type 2, so all of that is covered. And then, of course, gestational diabetes, so pregnant women developing diabetes during pregnancy.
And even after pregnancy, if there is anything that they should consider, right, in terms of remission, will they have susceptibility or risks for something else? So understanding and navigating all of these and helping somebody to navigate all of these, either personally, or if you are a health professional, a medical doctor, a dietitian, a nurse, a coach, and you have these interactions with patients and clients asking you certain questions, and we should not immediately dismiss those questions, but within the allotted time that we have, there is value in developing resources. That’s why we create so many handouts and practical worksheets. So even if you’re a really busy nurse, you still have no excuse to hand out some of these practical materials and resources for your patients or your clients, so they can learn more, they can help, you can support them with that self-management. So there is a bit of coaching integration as well, with certain behavioural components embedded throughout the certification. So knowledge in the head, that’s always translated to changing behaviour in our everyday life.
So we try to bridge that gap. That disconnect as well. So it’s a fascinating certification. And personally, over the past three years with the team, I personally learned so much about diabetes that I assumed so many wrong things. I’m like, wow, that’s not true. How come?
So it’s been quite a learning journey. And I’m so excited about putting this knowledge out there, because I don’t feel that is mainstream enough. And I think we need to do a lot more to support those who are concerned about their blood glucose levels in prediabetes or during a diabetes diagnosis, and even in cases of remission. We also look into all of that.
Maurice Castelijn:
One of the things that keeps kind of coming out is the diagnosis, this moment when somebody gets diagnosed. And then I presume the doctor will hand them a leaflet, go here, here’s some further information. There’s obviously various bodies, lots of information available on the internet. Then do a little bit sort of more reading or browsing. Then they’re going to end up on social media. Then they’re going to maybe go to the likes of AI and ChatGPT and what have you and try to find answers.
So what would you say to people who are in that position when they are first diagnosed? What thing do you suggest they should do?
- What advice would you give to someone who’s just been diagnosed? What steps should they take first?
Alex Ruani:
So taking a proactive approach, obviously when you get a diagnosis is not the end of your journey. You do need to advocate for yourself and seek the help of different professionals within the medical community. And as you navigate the medical system, and it’s not easy because you have to schedule appointments and get referrals, it’s arduous work. That is an important step because when you meet these individuals, you can then ask the right questions. We have developed workbooks to help you navigate your diagnosis with questions to ask different specialists, your medical doctor, before, during or after diagnosis, before, during or after treatment. What are the right medications?
Do I really need medication? Will I need medication forever? Is there anything I can do in terms of lifestyle to support the efficacy of these medications or to mitigate some of the potential side effects or things that can go wrong? Is it more complicated than just sitting with a diagnosis and not knowing where to go. So it can be quite hard. It’s hard when you get a diagnosis.
It doesn’t feel like, oh gosh, what did I do wrong? And sometimes we cannot pinpoint just one simple thing. Diabetes tends to, unless it’s a major event took place such as a viral infection, the development takes time. It’s not an overnight thing. So navigating the medical system is daunting. So if you have these materials, you can then feel that confidence
Okay, now I know I need to speak with this type of specialist. Oh, I need a second opinion on that or this medical professional has not been very helpful. Maybe I need to swap and change practice and change the GP practice or go with another team that may be a little more patient with me. So again, it really depends on your journey, your age, your resources, but we thought about the entire journey, like how can we make a difference with this person who’s just been diagnosed, not knowing where to go, what to do, that panic. So, yeah, giving the practical side of things and the confidence that, you know, you’re not alone. You know, you do deserve a medical team that supports you in this space.
So how can you navigate that? And it’s challenging. And the appointments don’t end with your diagnosis. You also need frequent checkups and meeting with nurses to potentially do some of these checkups, source certain types of medication, raising concerns when something may go wrong and becoming aware of that process and what it may entail through the certification can perhaps give you that level of clarity on what the next step should be or could be and what you actually deserve in terms of care. And obviously the medical system will not have all the answers like yes, we have science, we have medicines, brilliant, what we can access, we have technology that can support diabetes management. But if we don’t know how to utilise or leverage all of these, it’s just overwhelming, it’s just too much.
And we try to help with all of that to mitigate the blow. Also, if you are so concerned about a specific type of food or physical activity that you’ve been doing and you don’t have all the answers, your doctors may not even have the answers. So lots of questions like that, that are not that obvious, that you may start having in your head, we look into all of that. Pretty much all the controversies in diet and nutrition, we look at them and we navigate them. research on some of the things and questions that are floating around in the online space.
Maurice Castelijn:
Well, I’m really excited to actually dive in and learn more about it now. What would you say to somebody who is considering this? What’s kind of the final couple of words I can ask from you to make them sort of realise how this certification will help them, even if they don’t want to necessarily become a professional in the space, or maybe if they want to add it into their existing practice. So we’ve got those two. So what would you say to each of those?
- What would you say to someone thinking about taking this certification?
Alex Ruani:
Let’s say you’re a personal trainer. The chances are you are going to get clients of yours who potentially have a diagnosis or a risk of developing diabetes, and you’re in a training session, and all of a sudden, your diabetic client goes hypoglycaemic right in front of you. I have no idea what to do.
So, there are certain circumstances that we have covered in certification as well. Maybe you’re a dietician, and you’re looking for continuing education in this space. We’ve looked at so much of the recent research as well, that will help support that development because what we’ve learned 10 to 20 years ago in a dietetics degree may not still be applicable today. So dietitians need this continued education as well.
If you’re a medical doctor, equally, you need to know what kind of diet myths are floating around and what questions may fly your way and how you may manage some of these in an elegant way. If you’re a nurse, we’ve seen that diabetes literacy amongst nurses tends to fluctuate and vary in some instances with very low literacy levels amongst some specific types of nurses. So if you’re a nurse and you really want to understand and elevate that level of knowledge in terms of diabetes and how to support patients is very important.
If you’re a coach and you focus on the behaviour side, you can support a diabetic patient or client depending on the environment where you operate with the behavioural strategies that we incorporate in the course in particular self-management so somebody who doesn’t have the self-management resources, the resources that they have for that are quite low in terms of competence, knowledge, not knowing what to do, the practical side of things, so you can support them with that layer.
And personally, if you’re concerned about this, perhaps you have a child who has been diagnosed with diabetes or yourself or a family member, your husband, your mom, your father, a colleague, anyone that in your life is coming to you for help in this space, Yes, we need to refer when we don’t have that knowledge, but this certification will show you what to do in those instances. If you refer, what will different specialists do, how they will get involved in different aspects of a diagnosis and how you may support that person in that journey, either through the workbooks of questions you ask your doctor or through the worksheets.
So it’s a really beautiful combination of the science that we need to know, the myths that we need to debunk and understand better, how things really work, and the behavioural components to self-manage and to have a care team that helps you with that self-management plan as well. It’s not all on you. There are different self-management strategies depending on the type of diabetes that you have and which medications you may or may not be taking.
Maurice Castelijn:
Thank you very much, Alex. I look forward to the launch on the 10th of October.
