It has become a disease that is referred to as an epidemic
amongst the Aboriginal populations. One out of every seven Aboriginal people has diabetes. In the Cree communities of Northern Quebec the number is even higher. Out of a population of roughly 14,000 people, 1,076 people have been diagnosed with the disease. 15% of those over the age of 20 have diabetes, one out of every two women between the ages of 60-69 has diabetes. Amongst the Cree, almost two-thirds of the cases are women, while in the rest of Canada, 60 per cent of the cases are men. The age of those being diagnosed is getting younger, where as it used to be a disease that affected those over 50, now one in three cases are below the age of 50.
These are the cases that are known. The World Health Organization (WHO) says that for every known case of diabetes, there is one unknown case. WHO also predicts that within the next 25 years, diabetes will become one of the world’s main disables and killers. Those are pretty scary facts. Which is why something like National Diabetes Awareness Month cannot go by unnoticed. It is a disease that affects all of us either directly or indirectly and therefore something we all need to be aware of.
There was no known case of diabetes amongst Aboriginals in Canada before the 1940s. In the Cree communities, the first known case was even later, coming in the 1970s. The rise in the number of cases is directly associated with changing lifestyles, after the whole reservation idea came into reality. People went from one extreme lifestyle to another in 30 short years. Back in the day, everything involved a lot of physical labour, from morning until night. From having to chop wood to stay warm, fetching the water for cleaning and drinking, hunting and gathering for meals to survive. Now we only have to turn up the thermostat, turn on the tap and open the fridge. Our dependency on all these so-called luxuries has put Aboriginals at risk for this potentially deadly disease.
The best thing about this disease is that it can be controlled. A slow change in lifestyle again and one can stay healthy and live a long life. The key is education: awareness and the eradication of the negative stereotypes and stigmas that are associated with the disease. Diabetes is a disease in which the body cannot properly use and store sugar (or glucose) needed by the body for energy. Sugar needs insulin to enter the cells in the body so that it can be turned into energy. If the pancreas gland is not working properly, then insulin cannot be made. If there is no insulin, then the sugar stays in the body, building up in the blood or flowing through the kidneys into the toilet. Hence, the sugar is not being transformed into energy and one feels sick. The tricky thing about diabetes though is that sometimes it can’t be felt in any detectable way and many people are not even aware that they have the disease for years.
You can’t catch diabetes like you do a cold or the flu, you can’t get it through body fluids as you do sexually transmitted diseases. Sometimes genetics has it programmed within you from the day you were conceived and sometimes an unhealthy lifestyle will bring the disease on. There are four major underlying factors that pertain to Natives and the Cree that put us at a higher risk of being diagnosed with diabetes: 1 – inactivity, 2 – obesity, 3 – being of aboriginal descent, and 4 – a direct family member having diabetes.
Finding out if you have the disease is as simple as one little blood test. Here are 5 signs that you might have diabetes. 1. Always being thirsty; 2. Having to use the bathroom a lot; even at night; 3. Always feeling tired; 4. Blurry vision, and; 5. Numbness in hands and feet. If you have one or more of these symptoms, then you should get tested! The sooner you know if you have diabetes, the sooner you can start taking care of yourself to prevent the progression of the disease. It can lead to serious health consequences, such as blindness, kidney failure, heart disease, amputation and impotence.
The most important thing to realize if you do have diabetes is that it is not your fault; it is nothing to be embarrassed or ashamed about. You can fight the disease by taking your insulin, eating healthy, being active and being aware of what diabetes is, how it affects you. Establishing a good support network is key. If someone you know has diabetes, then learn about it and learn how you can help.
In 1998, the federal government announced The Canadian Diabetes Strategy. It was a five-year, $115 million strategy to begin to deal with the issue of diabetes, which was seeing a real surge in numbers at that time. Of that, $58 million was allocated to the Aboriginal Diabetes Initiative (ADI) to begin to address the epidemic that Native people were seeing in their communities.
In the Cree communities, there is a Regional Diabetes Initiative (RDI) that is run by the Cree Health Board. The RDI is at work right now in all nine communities. Their goal is to get the information and holistic treatment programs into the communities through the clinics, CLSCs and healing centres. They help the patient understand the nature of the disease. RDI, although very much under-funded, has taken on the task of educating the public and raising public awareness. With nine communities to serve, RDI has to tailor their approaches to fit each community.
What works well in one community may do nothing for another.
RDI manager Paul Linton says the major obstacle is the lack of proper information that the patients are receiving from their doctors. He says the hardest part is “educating the patients, telling them that its not their fault, it’s just that their pancreas doesn’t work. We need to sit down and take the time to explain to each individual what is going on, what the insulin does, why they need to take it. We need to take the whole family into consideration so they can all work together. We need to have a consistent and understandable message to give the population.”
RDI has been very active raising awareness in the communities.
Besides the annual Wellness Walks, they have started a 100 Mile Club, in which one has to walk a hundred miles in a hundred days. There is a Healthy Living, Active Living program in Mistissini, where 15 to 20 people meet on a weekly basis to discuss issues they have about the disease. RDI is encouraging communities to build and maintain safe walking and hiking trails to get people moving. You may have noticed some place mats in the restaurants promoting awareness and providing some healthier lifestyle tips. RDI began a food-labelling program in stores, with signs pointing out healthier choices with healthy messages.
For this year’s awareness month, there will be posters, radio ads, a radio show and a newsletter that will be available in clinics and band offices. They are currently working with the cooks of the restaurants in the Cree communities to bring in healthier methods of cooking. Something as simple as frying in vegetable oil rather than lard reduces fat intake. They are also going to be approaching the restaurants to encourage them to offer healthier alternatives. This November will also see a diabetes website aimed specifically at the Cree; check out www.creediahetes.com sometime soon for anything you may want to know about the disease.
It is overwhelming to deal with disease, which is why RDI has a holistic approach to diabetes. It’s not just about taking the insulin shots or regular testing or only eating healthier or walking some more. All these things need to be done together. And family support is extremely important, community support is important too. It may be difficult to change your own lifestyle simply because someone you know has diabetes, hut there is strength in numbers. If the whole family decides to eat healthier and get more active because one family member has diabetes, then the whole family benefits.
Linton says he has seen a lot of progress in the past 18 months within the communities. “People are walking more, I see them out on the streets more. The morale is up, people are talking more open, they are willing to talk about it, there’s more interaction. In general more people are taking responsibility for their health. Overall the RDI program is going well, but it needs to be expanded with more resources going into it.”
Of that $58 million allocated to the Aboriginal Diabetes Initiative, the Cree received only $206,000 this year. Divide that by the 1,076 known cases and it works out to $191 per person this year to help them. That’s not counting all the education and awareness for those who are not diagnosed. Linton estimates that they are $1.6 million short of the funds they need to really do their job well. His voice lifts when he mentions that at least the Grand Council is aware of the problem, a small step for now. He encourages everyone to take the little hit of time to get tested. Call your local clinic, CLSC or healing centre and they will set up an appointment for you. It’s better to know than to worry!
Some healthy tips when eating!
Choose baked bread or bannock rather than fried. Choose bread or bannock made with whole-wheat flour or oatmeal rather than white flour. Choose fruits and vegetables that are a variety of different colours, and remember that _ cup fruit juice is one serving of fruit! Don’t peel the skins off those fruits and vegetables that don’t need to be peeled, this is where most of the fibre and vitamins are found. Choose low fat milk – 1 % or even skim milk. Choose lower fat or fat free milk products such as fat free yogurts, less than 20% M.F. cheese and 1 % cottage cheese. Trim the fat off all meat; eat wild game more often than store bought meats. The little things like jams, syrups, honey, sugar, Kool-aid, Tang, butter, donuts, candy, cream and chocolates should be consumed sparingly. Use vegetable oils instead of lard when frying and when possible bake instead of frying. Don’t order pizza or fried chicken at the restaurant, look for healthier alternatives, request some if none are available.
Positive thinking goes a long way in matters of health too. So stay positive, acknowledge your achievements, even if it’s as simple as choosing a fruit juice over a soda pop or walking to the store instead of driving. The little things add up. You are your own superhero! You can do anything!