Wendy Rapaport helps diabetes patients feel better about their disease — and themselves

Dr. Wendy Satin Rapaport was a hospital social worker when she met the patient who sparked her interest in the psychological component of diabetes care. “He was a 16-year-old whose mother had died, who would repeatedly stop taking his insulin and end up in the hospital,” she says.

Rapaport suspected that the hospital had become a haven for the teenager, who also struggled with depression. “Everyone loved him there, and he would get a lot of attention and special care,” she says, adding that at the time the emotional aspects of diabetes were not widely recognized. Therapy and antidepressants eventually helped get the young man back on track — and put Rapaport on the path to becoming a psychologist.

In 1977, while taking courses at night, she joined the Diabetes Research Institute at the University of Miami Miller School of Medicine as a clinical social worker. “Because I was working full time, it took me 10 years to get my degree,” says Rapaport, who was 40 when she received her psychology doctorate from Nova University in 1988. “But I didn’t mind because working at the medical school let me apply everything I was learning to diabetes.”

Over the years, she practiced individual, family and group therapy, always focusing on the emotional and behavioral aspects of diabetes care and answering diabetes questions whenever possible. “Diabetes is a loss of a healthy self that everyone grieves,” she says. “But it takes more work for some than others.”

"When you have diabetes, you learn a lot about your body and how it responds to different situations. Having that knowledge and being competent about your care are things to be proud of."

Initially, patients often struggle with anger, fear and resentment of their diagnosis, or shame, frustration and depression over what they see as the potential impact on their lives. Those feelings can affect their management of their care and their desire to perform the diabetes testing required for maintaining their levels. “It’s not just willful negligence that makes people not take care of themselves,” explains Rapaport. “A teen going through the hormonal changes of puberty, for example, may think, My levels are high no matter what I do, and stop testing. Or someone anxious about perceptions of diabetes may avoid testing or treatment during a social event. Since high or low blood sugar can lead to anxiety or depression, any lapse in care is likely to exacerbate the very problem that led to the lapse.”

Rapaport counsels patients to face their feelings about their care and gain a sense of power about it. “When you have diabetes, you learn a lot about your body and how it responds to different situations,” she says. “Having that knowledge and being competent about your care are things to be proud of.”

In addition to working with people with diabetes and their families, she has helped doctors and nurses address the emotional component of diabetes with their patients. “The challenge is not to be disappointed when it gets too hard for someone,” says Rapaport. “Rather than say, ‘You have to take your medicine,’ a doctor or a parent can ask, ‘What are you concerned about?’”

It’s a topic that Rapaport, whose husband has type 2 diabetes, knows firsthand. “I ask him, ‘Is being married to someone in the field a blessing or a nightmare?’” she laughs. “So far, he’s always said that it’s a blessing.”

Over the course of her 30 years working in the field, Rapaport has written numerous articles on the psychological aspects of diabetes (many available at diabetespsyche-drwendy.com), as well as the book When Diabetes Hits Home: The Whole Family’s Guide to Emotional Health (American Diabetes Association, 1998). In addition to running her private practice in Boca Raton, Fla., she has served on committees for the American Diabetes Association and on the Centers for Disease Control’s Diabetes Advisory Council.

She also continues to work with the Diabetes Research Institute as an adjunct professor and consultant, most recently training and mentoring participants in its Parents Empowering Parents program. “We train mothers of kids with diabetes to become mentors to newly diagnosed children or children going through developmental changes, such as going to college or entering adolescence,” Rapaport says. “The idea is to bring support and competence to families coping with diabetes, whether it’s in person or by phone and e-mail.”

It’s a goal that fits well with her personal philosophy for working with people with diabetes. “I work with individuals and then try to bring what I learn along the way to the world through my public speaking and writing,” she says. “Being able to be there for people and help them feel competent is a privilege, a gift.”

Social worker and psychologist Wendy Rapaport helps diabetes patients feel better about their disease — and themselves.

For more information about the relationship between diabetes and depression, see our story Beating the Blues.