FNQLHSSC - Health - Fields of intervention

Diabetes

THE SITUATION

For First Nations, diabetes is a major health issue: this problem impacts quality of life and reduces life expectancy. The prevalence of diabetes is two to five times higher in the First Nations communities than it is in the rest of Quebec and Canada. Aside from lifestyles, poverty is a determining factor of the high prevalence of diabetes.

14.5% of adults (18-54) and 33% of Elders (55 years and up) are diabetic, compared to less than 7% among the Quebec population. Women are more at risk of this disease than men: 16.4% compared to 12.5%. The tendency over previous years confirms the recrudescence of the plague, mainly because of the changes in nutritional habits, sedentary lifestyles and a different way of living. Some communities are more at-risk than others because of the diversity in terms of lifestyles, poverty, genetic heritage, the non-availability of nutritional foods, the absence of sports infrastructure, etc.

WHAT IS DIABETES ?

Type 1 Diabetes: Also called “Insulin dependent diabetes” (IDD) or “juvenile diabetes”, type 1 diabetes appears when the pancreas either no longer produces insulin or doesn’t produce enough. This type of diabetes is mainly prevalent among children and young adults, although incidence among adults does seem to be growing, which sort of renders the term “juvenile diabetes” obsolete. It affects approximately 10% of diabetics.

Type 2 Diabetes: type 2 diabetes is characterised by the fact that the body becomes resistant to insulin. This problem generally appears among people who are 40 years old and up, however the prevalence is strongly increasing among the younger people. This type of diabetes, which is by far the most common, affects approximately 90% of diabetics.

Gestational diabetes: This kind of diabetes is defined as any form of diabetes that manifests during pregnancy – most commonly during the second or third trimester. Gestational diabetes is only temporary and disappears soon after giving birth, but can cause certain complications for both the mother and the baby.

Type 2 diabetes in one of the fastest spreading diseases in Canada – there are more than 60 000 new cases each year. The good news is that it is possible to avoid this type of diabetes or delay its appearance by choosing to adopt a healthy lifestyle.

SYMPTOMS

Regardless of the type of diabetes, the symptoms remain the same. They are often more insidious in the case of type 2 diabetes.

Excessive urination (getting up at night to urinate is a common occurrence);
An increase in thirst and hunger;
Loss of weight;
Weakness and excessive fatigue;
Blurred vision;
An increase in the occurrence and recurrence of skin, gum, bladder, vulva or prepuce infections;
A slowing of the cicatrisation process;
Numbness or prickling of the hands and feet;
Unexplained weight loss.

For type 1 diabetes, the symptoms generally progress rapidly and are often noticeable. As for type 2 diabetes, the symptoms progress more slowly.

However, it is important to note that many people who have type 2 diabetes do not have any symptoms. These individuals may find out that they are diabetic when they visit their doctor for another problem that is not related to diabetes.

THE HEALTH RISKS OF TYPE 2 DIABETES

Diabetes is a permanent state. A high level of blood sugar over a period of time can cause the following problems:

Blindness;
Heart disease;
Reduced blood flow to limbs that can lead to amputation;
Effects on the nervous system;
Erectile dysfunction;
Cerebrovascular accident.

RISK FACTORS THAT ARE RELATED TO TYPE 2 DIABETES

Age: 40 years and up;
Being overweight (particularly abdominal obesity);
A member of the family who has diabetes;
Having had gestational diabetes;
Having given birth to a child that weighed more than 4kg (9lb) at birth;
At-risk ethnicity.

Aboriginals are three to five times more at-risk of developing type 2 diabetes than the general Canadian population. Type 2 diabetes is currently being diagnosed even among Aboriginal children while this disease generally appears among older people.

REDUCE THE RISK

Do not smoke;
Reach a healthy weight and maintain it;
Be physically active;
Limit the consumption of fat and sugar;
Eat balanced and regular meals that include the four food groups that are described in the Canada Food Guide.

(Source: It’s your health, Health Canada)

ABORIGINAL DIABETES INITIATIVE (ADI)

The Aboriginal Diabetes Initiative (ADI) that was announced in the 1999 federal budget was part of the Canadian Diabetes Strategy in order to develop measures to counter the diabetes epidemic in the Aboriginal communities. The federal government allocated, over a five-year period, an amount of $58 million for the ADI initiative.

In 2005, a national budget in the amount of $190 million over 5 years was announced in order to improve the ADI.

The diabetes initiative is composed of two large components that each have their own funding formula and distinct purposes:

ADI ensures access to First Nations and Inuit members who live in the communities to the following types of programs:

Prevention and promotion;
Care and treatment;
Support related to lifestyles.

For the First Nations, Métis and Inuit who live outside of their communities, ADI supports the development of primary diabetes prevention and health promotion programs.

A regional ADI committee representing the First Nations and Inuit communities was created in order to ensure efficient operations. The role of this committee is to:

Review and approve the ADI regional plan;
Supervise the activities related to the Aboriginal Diabetes Initiative;
Examine and approve community plans;
Supervise the financial activities of the Initiative;
Collaborate in the development of an adequate evaluation tool;
Report on the ADI activities to the FNQLHSSC General Assembly and the First Nations and Inuit Caucus.

The ADI funds a total of 54 communities in Quebec: