When Crystal Gonzalez was diagnosed with diabetes in 2023, she felt lost. Balancing parenthood with her job was already a challenge, she said. The diagnosis added a new layer of complexity to her life.
“In the beginning, it was rough,” recalled Gonzalez, 38, of Paterson. “I felt like food was the enemy, just because I didn’t know what to eat or how much to consume.”
Doctors say Gonzalez’s experience reflects what many people face when first confronted with a diabetes diagnosis — confusion, lifestyle changes, and the pressure to stay healthy while juggling everyday responsibilities.
But there is hope.
As November is National Diabetes Awareness Month, one local doctor is highlighting medical innovation and improvements to patient education and personalized care in diabetes management.
“Diabetes care has changed dramatically in the last few years,” said Dr. Jennifer Cheng, an endocrinologist at Hackensack Meridian Health’s Jersey Shore University Medical Center in Neptune.“ There are so many new tools and technologies that empower patients to take control of their health.”
Cheng leads one of the region’s largest endocrinology teams, helping redefine how diabetes is managed and understood and working closely with patients living with Type 1 and Type 2 diabetes.
Her work comes as about 38.4 million people nationwide, or 11.6% of the population, have been diagnosed with diabetes, according to the American Diabetes Association, including 693,000 adults in New Jersey.
Nationally, the disease disproportionately affects Black and Hispanic Americans, who are almost twice as likely as white adults to become diabetic, according to the Office of Minority Health.
Cheng said the higher rates also mean greater risks of complications such as kidney disease, amputations, and blindness, often tied to factors like limited health care access, socioeconomic inequality, and structural barriers.
Understanding the disease
Before her diagnosis, Gonzalez didn’t recognize the warning signs – frequent urination, increased weight loss, fatigue and numbness or tingling in the hands and feet.
“It’s like being in the Sahara Desert — just dry internally,” she said. She was drinking so much water that the back of her car looked like a recycling center. Eventually, her blood sugar became dangerously high, landing her in the emergency room.
Cheng said that a constant thirst is the body’s way of trying to rid itself of sugar, noting the importance of the insulin hormone in breaking down sugar.
“People often think of hormones as just reproductive,” she said. “But insulin is also a hormone, made by the pancreas. It regulates blood sugar by helping your muscles, liver, and fat cells use glucose properly.”
She said diabetes develops when the body can’t make enough insulin or becomes resistant to it, resulting in either Type 1 or Type 2 diabetes.
Type 1 diabetes is an autoimmune disease that often appears in younger patients, in which the body’s immune system attacks the pancreas. Type 2 diabetes is far more common and usually linked to obesity and insulin resistance.
“Type 2 diabetes occurs when the pancreas works overtime,” Cheng said. “It’s still producing insulin, but the body doesn’t respond to it effectively. Over time, that leads to fatigue, weight changes, excessive thirst, and other symptoms.”
Catching it early
After her initial diagnosis, Gonzalez said she turned to the Molly Diabetes Center in Hackensack, where she learned to read nutrition labels and understand how food affects her body.
Through discipline, medication, and a carefully managed diet, she was able to drop her A1C level — a key measure of blood sugar control — from a dangerous 11.5 to 6.1. She also lost 78 pounds. Her doctor even took her off medication in late 2024.
But by February 2025, she said her A1C spiked and her pancreas had stopped producing insulin. Testing confirmed she had developed Type 1 diabetes.
Today, Gonzalez takes insulin injections four times a day. “It’s still a guessing game,” she admitted. “Even now, my A1C has gone back up, but my doctor reminded me — diabetes is for life. There’s no finish line.”
Cheng said early detection can make a major difference, even preventing the need for insulin in some cases.
To diagnose diabetes, endocrinologists rely on three main tests: Hemoglobin A1C, which measures a patient’s average blood sugar over the past 3 months; fasting or post-meal glucose; and the glucose tolerance test.
There’s a new treatment method that can delay the onset of Type 1 diabetes if it’s caught early,” she said.
Cheng said it’s an incredible breakthrough that resulted from years of advocacy and research through organizations like Breakthrough T1D, a leading global organization focused on curing and preventing Type 1 diabetes.
Because diabetes can silently damage organs, Cheng and her team also screen for kidney disease, thyroid issues, and fatty liver disease, which is increasingly common in people with obesity and insulin resistance.
New technology, new hope
In addition to new medications such as Ozempic that help control blood sugar, support weight loss, and improve heart health, Cheng pointed to continuous glucose monitors (CGMs) and insulin pumps as breakthroughs for patients.
“These technologies give real-time feedback,” she said. “Patients can see how their sugar levels change after a meal or exercise. It takes away a lot of the guesswork.”
For Type 1 patients who once needed multiple daily injections, new insulin pumps and weekly injection options offer greater freedom and control. “It’s not a cure,” Cheng said, “but it’s improving quality of life tremendously.”
Looking Ahead
Cheng wants people to know that a diabetes diagnosis doesn’t have to define their lives.
“If you catch it early and stay on top of your care, you can prevent complications like kidney failure, heart disease, or blindness. Good control now means a healthier future.”
Gonzalez said she still indulges in her favorite treats like pizza and ice cream.
For her birthday on Halloween, she celebrated with a pistachio cake.
“I always joke, ‘Get me the diabetic slice!’” she said, laughing. “They taught me not to deprive myself. I just have smaller portions and move on.”
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