The Crees of Eastern James Bay are experiencing a diabetes epidemic. There are three to five times more diabetes in Eeyou Istchee than in the general population of Canada.

As of May 2001, there were 975 people diagnosed with diabetes.

The total number of people with diabetes has more than quadrupled since 1989.

Two-thirds of Cree with diabetes already have some damage to their bodies.

Ninety-four percent of people with diabetes are overweight.

One-quarter of people with diabetes are under 40 years old.

Of the 975 people with diabetes, 624 were women and 351 were men.

Diabetes is a very serious problem in Eeyou Istchee. Many Eeyouch have diabetes, and many of them are having trouble controlling their blood sugars. Most Crees know of at least one friend or relative who has diabetes, and many know someone who has suffered a serious complication due to diabetes: either a heart attack, stroke, amputation, kidney dialysis or blindness. Diabetes is one of the most difficult health challenges facing Eeyou Istchee in the last 25 years. Nevertheless , it is not in the Cree tradition to give up when faced with a challenge. Diabetes, like other challenges faced by the Crees in the last century, can be beaten. What is needed are the right tools to succeed! There are two different issues to this serious health challenge in Eeyou Istchee. The first is to avoid and getting diabetes. The second issue, once you have been diagnosed, is finding ways to control your sugar level and “live well with diabetes.” We are often told that when someone is informed they have diabetes, they are not surprised or upset because they expected it sooner or later.

Taking care of your body is a priority. Making an effort to exercise, eating healthy and living a more balanced life can prevent you from getting the disease. Even if most of your brothers and sisters already have diabetes you can still avoid it. Several large studies in Europe and the USA show that 60% less people were diagnosed with diabetes in groups that had succeeded in making long-term healthy lifestyle changes.

At first, it is not easy to find time in a busy day to exercise, but you can eventually commit to getting out and exercising for 10 or 20 minutes. Notice how much more awake and stronger you feel after even just a short walk like this. Do you have a favorite TV show or bingo game that you make a priority to watch or play every week? Then why not make exercising once or twice a week a priority for you as well?

Learning to eat healthy takes time. It takes time to learn which foods are best for the health of your body. The more questions you ask, the more information you read on healthy food, the more comfortable you will be understanding which foods are healthy. Then you will then be able to make the right choices.

A few simple rules: think about eating smaller portions by using a smaller plate: drink lots of water: and only eat at the kitchen table. Remember, every small change you make is a step towards controlling your health. If you can lose just a one pound a month, you will lose 12 pounds a year, or 36 pounds in three years! Never give up! So what are the tools you need to avoid diabetes?

1) Motivation-. You need to start taking action. Start with a small change and you are more likely succeed.

2) Educate yourself. Speak to the CHR, nurse or doctor to learn more about diabetes, weight loss and chosing goals.

3) FEET ACTION. We are blessed with feet, so use them! Ten to twenty minutes of walking three times a week does a lot to prevent diabetes.

Walking is a Cree tradition: Let’s do it! 4) Think before you eat Jry to eat with your mind. It will * tell you if it is a healthy food choice and help you to avoid what your mouth and stomach are craving for.

According to the Cree Health Board Diabetes Registry, there are fewer new cases of diabetes this year than any of the past five years. This is likely because many Crees are taking control of their own health, exercising and eating better. They have been successful in preventing diabetes, and this is why there are fewer new cases.

Is preventing diabetes a priority for you? What have you done differently in the past few months to try and take control of your body? Don’t sit back and wait for diabetes to knock on your health, take action against diabetes! If you need some ideas or support, make an appointment to see your CHR, nurse or doctor.

Although many cases can be prevented, there will always be some Cree who are diagnosed with diabetes. Remember: diabetes is not your fault. Accepting you have diabetes and taking on the challenge of living with diabetes is the first step in the fight against diabetes. Once someone has diabetes, it does not mean they will absolutely suffer damage from diabetes. Again, studies have shown that for people who have diabetes, controlling blood sugar to healthy levels (as 32% of Eeyouch have succeeded in doing) can prevent many complications.

Learning about how different food, exercise and medications affect your blood sugar level will help you learn how to live a completely normal life while keeping your blood sugar at a healthy level. There is nothing a person with diabetes cannot do. People with diabetes can eat a piece of cake at a feast, hunt, fish, enjoy the bush, or sit all day at a desk job. What is important is to learn how to keep your blood sugar at a healthy level while doing these things. This takes a lot of effort but everybody can learn to do it. Visit your clinic to find out more about “living well with diabetes”, doing all the things you enjoy doing and controlling the disease at the same time.

What is healthy eating?

TOP 7 1. Healthy eating starts with eating three meals at regular hours.

2. Healthy eating is enjoying our food and taking the time to savour it.

3. Healthy eating is eating enough to have energy but not too much to feel full.

4. Healthy eating means buying ingredients and cooking healthy meals for your loved ones.

5. Healthy eating means that you eat wild meats that your family has hunted.

6. Healthy eating means not being afraid to try new foods: it’s a world to discover..,

7. Healthy eating is for the whole family. By giving healthy food to your children, you are giving them a chance to live a healthy life. By giving yourself healthy food, you are giving your children healthy parents. Everybody wins! The 4 essential food groups The four essential food groups are like the four families of food. Eat foods from the four food groups everyday and they will give what your body needs to be healthy: 1. Bannock, breads and cereal This group, also called starches, gives you the energy you need to do your daily activities. The best choices are the whole grain products like brown bread, oatmeal, whole wheat bannock, etc.

2. Vegetables, fruits and berries This group protects your body against many diseases. Try different kinds of fruits and vegetables; add some vegetables to your moose stew; have a fruit salad for desert,…

3. Milk and milk products Milk, yogourt and cheese are good for your bones and your teeth.

4. Meat and meat substitutes These are just a few examples: moose, goose, partridge, chicken, pork, fish. These foods have proteins that keep your muscles and your blood strong. Some substitutes of meat like eggs, beans and nuts are also good sources of protein.

The other food groups Eat in moderation foods that are high in sugar, like regular pop, fruit punch, chocolate, candy, cookies, pies and cakes. Many store-bought foods have hidden sugar and this is why it is a good idea to read the list of ingredients.

Also, eat in moderation foods that are high in fat, such as fried foods, lard, butter, chips, processed meats like Klik and wieners. These foods can contribute to heart disease and weight gain and don’t provide many of the essential nutrients, vitamins and minerals our bodies need to be healthy.

It is all a question of balance! Traditional foods Traditional foods are good for preventing diabetes if we cook it in a healthy way. Moose meat, goose, bear, partridge, rabbit, fish are good foods and are healthier if boiled or grilled rather than fried. Bannock is healthier if it is made with canola oil rather than lard or shortening which are fats that are bad for your heart. Berries are excellent and they are even better when you spend a whole morning picking them because you are active at the same time. What is great about traditional meats is that you have to hunt to get it: you have to be active and that physical activity is good for you.

Reading food labels What is the best way to choose healthy food at the store?

To find out if the food you buy is healthy read the food labels! As a general rule, healthy food is not far from its original source. Compare moose meat to a can of Klik and you will understand that very quickly.

Food labels tell you a lot about what you are really eating. Check on the box, can or bag for the list of ingredients. All packaged foods must list the ingredients used in the product. The first ingredient is the one that is present in the largest amount. For example, if sugar comes first on ajar of raspberry jam and the fruit comes second, it means that there is more sugar than fruit. See for yourself what is in coffee mate. First ingredient: glucose syrup, which means sugar. Second ingredient: hydrogenated oil, which means fat. You are not getting a very good deal for your health.

A word of wisdom If you to prevent diabetes and protect the next generations, a healthy lifestyle (meaning both healthy eating and physical activity) is essential. If you want to give a nice gift to your son for his birthday, choose skates or snowshoes rather than the latest video game. If you want your daughter to be healthy, you will have more success by feeding her good food rather than feeding her poutine and pop. We are what we eat. The only way we can be strong and healthy is by eating strong and healthy food. We have received the gift of life: it is now up to us to take care of that gift.

The following article was in the April 5th, 2002 issue of the Nation. We reprint here as it is worthy of further thought given the diabetes situation in Eeyou Istchee.

One Chisasibi Family’s Experience with Diabetes We dedicate this message to all the diabetic people in all nine Cree Communities.

Written by: The Duff family: George, Alice, Norman, Agnes, Victoria, Catherine, Andrew, Doris, Harry & Mary Duff,

The Chiskamish family: Jacqueline, Matthew & their children: Emma, Jessica, Edith, Katrina and Robbie Chiskamish First of all, we would like to congratulate Edith Chiskamish for completing her Wellness Journey. We are very proud of her. We cannot express the joy we felt upon her safe return to Chisasibi. When she left for Wemindji, it really touched our hearts. We are thanking all the organizers for taking such good care of her. When the journey through Eeyou Istchee took place in 1999, Edith begged her parents to let her go but they didn’t allow her at that time. She knew that the journey was taking place to raise money for the hemodialysis machine to be installed at the Chibougamau hospital. She also knew that her grandmother would soon be hooked up to a dialysis machine. She had said she wanted to help raise money for this machine and she wanted to be allowed to join the next journey through Eeyou Istchee. We could see the disappointment in her eyes when again we said she couldn’t go yet.

This winter, Edith once again asked to be allowed to go, this time on the Wellness Journey that would raise awareness on the Diabetes Epidemic among the Cree people. She asked again if she could go but we didn’t give her a yes or no answer because her grandmother was getting weaker every day. Towards the end of February, she asked again if she could go and this time we gave her our permission. We told her that maybe she could join them the last day of the journey but she wanted to start walking from Wemindji. We, her parents, have considered her one of our special children because she was born with medical problems. She had asthma and a skin condition called eczema, which causes skin infections. We let her join the walkers starting from Wemindji.

Our daughter Edith Chiskamish dedicates her Wellness Journey from Wemindji to Chisasibi in loving memory to her late Grandmother Maggie Sealhunter Duff, who passed away last month, after living a long time with diabetes. She also dedicates her walk to all her relatives who are diabetic and to everyone else who has diabetes. She wants us to stand united in our walk to prevent the Diabetes Epidemic. It is so difficult to see our loved ones suffer from this illness.

On February 1st, 2002, God took our beloved mother Maggie Duff. She died at the Royal Victoria Hospital in Montreal, surrounded by her children, her grandchildren, her sister Sarah and some of our relatives. She was born on November 24, 1934. She had 15 children altogether, nine of whom survived. Four children passed away and two were stillborn. She was diagnosed with diabetes in 1974. Since this time, when the doctors discovered she was diabetic, she suffered from poor health. The last three years were very difficult for our family. Our mother was flown out to Montreal many times.

This is what happened to her: In 1974, she was told she’was diabetic In 1976, she was diagnosed with high blood pressure In 1981, she started insulin injections because of her diabetes In 1986, doctors discovered she had kidney problems In 1989, she had clogged veins in her upper leg In 1991, she had a minor stroke In 1992, she began having eye problems related to diabetes In 1995 and in 2001, she had laser treatments In 1999, in July, she began hemodialysis treatments for kidney failure In 2001, in March, she had an infection in her heart valves Also in March 2001, she started having cold feet due to poor circulation On May 13, 2001, we took her into the clinic because of pain in her toe. The doctor said she would have to have a checkup in Montreal. The next night she had chest pains. Her heart rate was very slow. The next morning, she was transferred to the Montreal General Hospital. She was observed in the emergency ward that night. This was to be first time of many times we would have to stay with her day and night.

On June 26, 2001, a toe on her left foot was amputated due to poor circulation. This was done at the Royal Victoria Hospital On September 10,2001, a part of her foot was amputated due to infections. The antibiotics she was given were not effective.

On September 26, 2001, she was fitted with a pacemaker to help her heart which was beating too slow because of poor circulation On October 7, 2001, she had another surgery to remove an infection on her foot She also had many surgeries on the location of her catheter for her dialysis because of her small veins Many nights, she couldn’t sleep because of the pain in her foot and leg On November 16, 2001, her leg was amputated below the knee On December 4, 2001, she was transferred back here to Chisasibi Hospital even though she was not completely healed On December 12, 2001, the doctor told us her leg wasn’t healing because she wasn’t eating and also she was sleeping all the time A few days later, she began to eat traditional Cree food that people brought in for her and she started to feel better, even though she still had pain because of her amputated leg On Christmas Eve, after her dialysis treatment, we brought her home so she could be home for Christmas On January 16, 2002, she was once again flown out to the Royal Victoria Hospital in Montreal, for a check-up On January 21, 2002, they removed the infection on her leg again and they left the wound open On January 25,2002, she had surgery to close the wound. She had to have two blood transfusions because her blood level was very low A few days later, they reduced the pain medication because she had less pain and was sleeping most of the time. She then complained of an abdominal pain after her pain medication was reduced. She had an x-ray and a CT scan. The doctors thought she might have appendicitis but they weren’t not sure so they inserted a tube to make certain Some of us went to the Montreal airport to pick up our aunt Sarah Lameboy because she was coming to visit our mother. While we were in the waiting room back at the hospital, the doctor came in and told us there was nothing more they could do for her because of a blockage in her intestines and she was having internal bleeding. The doctor told us that she wouldn’t be conscious for very much longer and she even told us that she had only a few hours to live. We all took it very hard because we were being told bad news that was totally unexpected When we went to see her in the recovery room, she was already on life support. The doctor asked us if she could remove the life support but we told her we wanted to wait for other family members who were on their way.

On February 1“, 2002, the doctor once again asked us if she could remove the life support and this time it was removed at 3:20. She could only breathe on her own for 10 minutes after the tube was removed Our mother was a caring, loving, gentle, strong, respectable, generous and patient person. She loved being in the bush before she had medical problems. She gave us faith in God, as well as her love and wisdom. These are lasting gifts that will see us through the sadness of her passing. She will always remain in our hearts. We miss all the love we shared each day, especially her smiles and her laughter. We know we didn’t really lose her and we know she is watching over us every day. We know she is now happy to be with our father, our sisters, our brother and other loved ones who have passed away. We appreciated it when the doctors allowed us to bring her home for Christmas. We knew she was very happy to be home again.

The last night we spent in the recovery room with our mother was one of the hardest things we had to go through in our entire lives. When the doctor asked us if they could remove the respirator, it was a very hard decision for us to make. We accepted the doctor’s decision because we didn’t want our mother to suffer anymore. There were times when she would tell us how much she was suffering and she would tell us to take care of ourselves. We didn’t want her to go but because of our belief in God, we know that we will all be together again someday. We know she is in Heaven, where there is no sickness or pain.

We would like to thank the Good Lord for watching over us when we took all those trips to Montreal to visit her. We would also like to thank all the doctors and nurses at the Chisasibi hospital, especially Patrick, Danielle, Annie and Michel at the hemodialysis unit for doing their best to take care of our late mother. We also thank all our relatives, the Band Office for their financial assistance and all the people who helped us during this difficult time.

Everything that happened to our late mother was because she was diabetic; this is what caused her numerous medical problems. One of the most important aspects of this disease is to take proper care of your feet. If you know you are having foot problems, go to the clinic right away to have them looked after. For those of you living with family members who are diabetic, try to take good care of them and look after them. We often cried because she was diabetic. She fought this disease for many years. But in the end, she couldn’t fight it any longer.

For us, many times it was difficult because of our jobs, but we wanted to be with her during her surgeries in the south, so we just went back and forth. We hope that no one else ever goes through what we went through. We all know there is no cure for this disease so as individuals we have to take care of ourselves. We are praying and hoping that there will be a cure one day.

We are thanking all the walkers for the Winter Wellness Walk Promoting Miiyuupimaatisiitaau. We very much respect what you have accomplished. Your have shown great love and strength because you were thinking of your loved ones. We knew you often found it difficult but you continued because you wanted to finish the walk.

We are thankful that our aunt Sarah Lameboy was able to be near her and that God had given her the opportunity to be there when our mother passed away. She gave us a lot of support and she tried to comfort us as much as she could, even though it was also very difficult for her. We are also thankful that Elsie and Harry Duff made sure they could come down to be able to comfort us at that time.

Our late mother did thank us for taking care of her and near the end, she told us she was no longer in pain.

In closing, we want you to know that we wrote this because we think that it is very important for everyone to take care of themselves. Wachia to all. God bless you.

Symptoms of diabetes include: frequent urination, changes in appetite, extreme fatigue, blurry vision, unusual thirst, unexplained weight loss, irritability and tingling in hands or feet. Not all syptoms must be present to indicate diabetes so if you have any of them get tested at your local clinic. The sooner you get tested the better chance you have.

Over the past five years, 57 people with diabetes have died.

Diabetes is preventable. Get tested early. Get your weight down if you are overweight. Exercise. Eat healthy foods. Learn about diabetes.

Diabetes is a silent disease but early detection can delay or prevent complications.

Here are a few tips to prevent diabetes: • Get tested for diabetes once a year.

Diabetes is a silent disease. It is possible to have diabetes for 10 years and pot know about it. It is very important to test for diabetes. To do this, you must call your health clinic and make an appointment.

• Learn as much as you can about diabetes. Information about diabetes is available at your health clinic and the CHR’s office. Diabetes is a preventable disease. The more you learn about good eating and healthy living, the easier it is for you to make right the choices. If someone in your family has diabetes, educate yourself and live a healthier lifestyle with them.

• Make physical activity part of your life every day. Exercise every day. Exercise will bum the extra energy stored in your body. Physical activity can mean walking 20 minutes a day, three to five times a week. Take a walk with members of your family or your friends. Walk to work instead of driving. Walking is the best exercise you can do to lose weight, and keep your body healthy and working properly.

• Eat traditional & healthy food.

Our body is like a ski-doo. If you are not careful how you treat it, it will eventually break down. You need to eat traditional and healthy foods for your body to function properly. Make small changes in eating habits. For example: eat smaller portions; eat eeyou miichim instead of poutin, Klik or other processed food; choose a fruit instead of chips or chocolate; roast or boil food instead frying; drink water, natural, no sugar added juices or diet pop instead of regular pop, Kool-Aid or Tang.

• Maintain a healthy weight Not all overweight people have diabetes, but the excess weight significantly increases your risk of getting diabetes. By losing only a few pounds (10 to 20 pounds over one or two years) you can significantly decrease your risk of getting diabetes. If you are interested in losing weight, you can make an appointment to discuss this at your health clinic.

• Reduce stress in your life.

Stress is part of life. Too much stress can lead to the body breaking down. Learn to reduce the stress by living a balanced lifestyle. Take time to play and enjoy yourself. Being physically active is a very good way to reduce stress.

• Get involved and help your community The most important part of any successful diabetes program is the community. Work with your community to create a Community Diabetes Task Force. This group can organize support groups, cooking classes, shopping classes, exercise activities, school activities, etc. depending on what your community wants. Nothing will happen if you do not get involved in your own community and take responsibility for action.