Diabetes is very prevalent in Native communities across Canada. November is Diabetes Awareness month, so we felt it would be appropriate to give an overview of the disease’s effects and how to prevent it.

The following information was supplied by the Health Canada website:

What is diabetes?

Diabetes is a condition in which the body’s use of insulin – a hormone that regulates metabolism – is impaired. Insulin is needed by the body to turn the sugar in foods into energy. In type 2 diabetes, which accounts for 90 per cent of cases of diabetes, the body produces insulin but is unable to use it effectively. In type I diabetes, the pancreas makes little or no insulin.

Diabetes amongst First Nations

From a disease that was virtually unknown among First Nations, Inuit and Métis people 50 years ago, the prevalence of Type II Diabetes Mellitus among First Nations is now at least three times the national average. It has been demonstrated that Aboriginal Canadians are experiencing prevalence rates of this condition that are among the highest in the world.

Previously called Adult Onset Diabetes Mellitus, Type II Diabetes Mellitus has begun to affect Aboriginal children. Diabetes is a serious health problem which can result in a number of complications including blindness, diabetes-related heart failure and peripheral vascular complications that may in turn result in limb amputation.

There are a number of theories as to why diabetes is so prevalent among Aboriginal people. Recent research suggests that there may be a link between stress, depression and diabetes. The possibility that these factors are related may be compelling, because the prevalence rates of both stress and diabetes are high among Aboriginal Canadians.

Diabetes in First Nations communities is now considered an epidemic, and rates are continuing to increase.

Although much less is known about diabetes among Métis people, results from the Aboriginal Peoples Survey show rates well above the non-Aboriginal average.

In the past, Inuit people have been the only exception to this pattern of high rates. However, more recent regional data indicate that this too is changing. Data available for some First Nations indicate a high prevalence of complications such as heart disease, hypertension, stroke, lower limb amputations, kidney disease, and eye disease.

There is particular concern regarding two groups within the First Nations population: children and women of childbearing age.

Rates of diabetes appear to be higher on-reserve than off-reserve.

Most of the available information on diabetes among Aboriginal people concerns First Nations communities. However, based on the limited data available, there is still cause for concern among Métis and Inuit people.

Métis people have diabetes prevalence rates higher than that reported among First Nations living off-reserve (Statistics Canada, 1991) and report less access to primary health services compared to the general population. Risk factors such as obesity and physical inactivity are increasing among some Inuit communities (Young et al., 1993; Imrie and Warren, 1988), and the prevalence of diabetes among the Labrador Inuit is greater than that of the non-Aboriginal population (Labrador Inuit Health Commission, 1999).

Access to health care services are key issues where Inuit experience the lowest access to physician and health professional services (Statistics Canada, 1993; Newbold, 1998).

Diabetes is an important issue in the Aboriginal population for a variety of reasons other than high rates of disease. Other concerns include early onset, greater severity at diagnosis, high rates of complications, lack of accessible services, increasing trends, and increasing prevalence of risk factors for a population already at risk.

Because Aboriginal ancestry is a risk factor for diabetes (Young et al., 1990), this disease is of importance to all Aboriginal communities.

Funding

In Canada, the health care costs alone for treating diabetes and its complications may be as high as $9 billion (U.S.) each year.

The Canadian Diabetes Strategy, announced in the 1999 Federal budget, created a five-year, $115 million strategy to begin to deal with the issue of diabetes. Over the five years, $58 million has been allocated to the Aboriginal Diabetes Initiative (ADI) to begin to address the epidemic of diabetes in Aboriginal communities.

Healthy eating + active living = diabetes prevention

Although there is no cure for diabetes, research shows the disease can be prevented or delayed by eating healthfully, exercising regularly and maintaining a weight within the range of normal. If you already have been diagnosed with type 2 diabetes, a healthy lifestyle also will help you manage the disease well and prevent complications.

“Healthy eating and regular activity is good advice for good health and well-being generally,” points out Lynn Baughn, manager, diabetes education programs and strategies for the Canadian Diabetes Association.

In fact, even for those who are already at high risk for developing diabetes because of obesity, advanced age or other factors, a U.S. study conducted by the National Institutes of Health showed that people who exercised for 2.5 hours a week and who lost 5 to 10 per cent of their body weight were able to reduce their risk by 50 per cent.

“In a person who was 50 pounds overweight and who lost five pounds,” explains dietitian Sharon Zeiler, senior manager of nutrition initiatives and strategies with the Canadian Diabetes Association, “cholesterol, triglycerides and blood pressure levels would have all dropped dramatically. That’s a major improvement in health.”

Are you at risk?

You are at risk of type 2 diabetes if you:

• are 40 years of age or older;

• are overweight, particularly if you have an “apple” shape because you carry most of the weight around your torso;

• are physically inactive;

• are of Aboriginal, Hispanic, Asian or African descent;

• have a parent, brother or sister with diabetes;

• developed gestational diabetes while pregnant or gave birth to a baby that weighed more than 4 kg (9 lb);

• have high cholesterol;

• have high levels of blood glucose;

• have high blood pressure or heart disease

How do you know if you have diabetes?

Early diagnosis of diabetes is key to preventing or delaying the onset of complications.

The Canadian Diabetes Association has compiled Clinical Practice Guidelines for the Management of Diabetes in Canada which recommends that everyone age 40 and older be screened every three years for diabetes. Anyone with other risk factors should be screened annually.

Although many people with type 2 diabetes have no symptoms, others experience one or more of the following:

• unusual thirst

• frequent urination

• unusual weight loss

• extreme fatigue or lack of energy

• blurred vision

• frequent or recurring infections

• cuts and bruises that are slow to heal

• tingling or numbness in hand and feet