For Dr. Diana Sherifali, her mother’s diagnosis with type 2 diabetes is forever tied to the 1984 Olympics. That year was a big one in her house, as the event was hosted in Sarajevo. Her family is from the former Yugoslavia and seeing the event held in their homeland was a source of great pride for the family. “What took away from some of the pride and joy was my mom’s health issues,” recalls Sherifali.
Even as a young girl, Sherifali took helping her mother manage her health issues seriously. She attended medical appointments to translate, and learned how to prepare foods that would help her mother stay healthy. This lived experience of being a caregiver to someone with diabetes inspired an interest in nursing, and eventually led her down the path of diabetes research.
“I always saw myself going into occupational nursing. If you asked me whether I was going to be a researcher, I would say no,” says Sherifali. However, her personal connection to the disease and her desire to better understand it nudged her in that direction.
After landing what she calls a “dream job” in a diabetes clinic, Sherifali encountered a complex case. Discussing it with the endocrinologist on staff, she realized there were many questions he couldn’t answer—there wasn’t research in that area. The doctor suggested she could go find the answers. “I thought, what does he mean by find the answers? But, really, what he was doing was planting the seed to say, “Well, if you can't find the answer, do the study,” she says.
Sherifali sat with the idea for several days. Diabetes Nurse educators who do research are rare, and there were few role models for her. In the U.S. it was more common for diabetes nurses to pursue PhD and postdoctoral work, but it was relatively rare in Canada. Still, she was intrigued by the idea. She decided to pursue a Master’s degree at McMaster University in Hamilton with an eye to doing advanced clinical nursing if research didn’t work out. Once she got into school her desire to ask questions and her program’s emphasis on problem-based learning clarified that her heart really was in research. “I love the curiosity piece, I think that's what pushed me into graduate work. Research is being able to be curious. In my role, I can constantly ask questions.”
As luck would have it, she was also working and studying just down the hall from one of the world’s leading experts in clinical research, Dr. Hertzel Gerstein. After completing her Master’s and PhD work, she sent Gerstein an email, asking if he would consider her as a postdoctoral student. Sherifali was the first nurse to ever hold a post-doc role in his lab. “Collectively, we came up with a program of research that really spoke to my knowledge, my skills, my experience,” she says, noting that the program focused on self-management in diabetes.
The partnership has continued long past Sherifali’s postdoctoral position. She and Gerstein continue to work together and Sherifali has made a name for herself as one of Canada’s most recognized diabetes nurse researchers. She has focused much of her work on self-management, including updating the Clinical Practice Guidelines to better support self-management at the patient, clinical and population levels.
She has also done important research looking at diabetes and health coaching - in particular supporting people with diabetes to self-manage in the community. Building on her research done over the past decade, her diabetes health coaching trial found improvements in blood sugar control, as well as in quality of life. “Coaching can improve peoples’ lives and their diabetes control by offering regular support and timely insights,” she explains.
Sherifali’s work is also drawing attention to the unique challenges of an aging population living with diabetes and frailty. While many care providers are adept at managing type 2 diabetes, the unique challenges of type 1 diabetes are often unknown to them. Once a person with type 1 diabetes can no longer self-manage, they may move to a residence where no one has the skill or knowledge to support them. “In retirement homes or long term care, this may get overlooked and people say, ‘Well, they're on intensive insulin therapy, take them off and put them on oral medications.’ That's a lethal combination for someone with type 1 diabetes,” says Sherifali. Her research has also supported guidelines for nutrition and physical activity in frail older adults.
While her research area spans all types of diabetes, Sherifali’s goal of helping and supporting others is just as clear as it was when she was a little girl translating for her mother at the doctor’s office. She hopes her work will make life better for those living with diabetes and that, as a research nurse, she will inspire others in the profession.
— Written by Krista Lamb