Diabetes treatment takes wider scope in aboriginal programs

As diabetes plagues aboriginal Canadians at rates up to five times higher than the rest of the population, health projects across the country are using a unique world view to bring those numbers down.

One of those projects will be highlighted Thursday at the national conference of the Canadian Diabetes Association being held at Vancouver's Convention Centre until the weekend.

Jane Harrison, manager of primary health, research and diabetes with Anishnawbe Health in Toronto, says a 2011 research project recommended that aboriginal people with diabetes not be treated in isolation. In practice, this means a nurse, dietitian, foot specialist, social worker and traditional healer could meet in a sharing circle with patients and their whole families to discuss solutions.

"It's encompassing mind, body, spirit and emotion. It's not just accessing a therapist over here and they're going to do one thing. It's a wraparound team. Our recommendation ... is for the system to recognize the interconnectedness," Harrison said in a telephone interview from Toronto earlier this week.

Anishnawbe Health sees about 4,000 clients each year, at least a quarter of whom have diabetes. "You can't just treat the symptoms because it's not just the symptoms, it's the connection of everything together," she said. "Everyone's afraid to talk about spirituality, to say I need to be spiritually healthy.

... If your spirit is not well, then your body and your mind and emotions are not well."

That approach is reflected in the work of the 11-year-old ADAPT - Aboriginal Diabetes Awareness Prevention and Teaching - program on Vancouver's Downtown Eastside. Its program manager, dietitian Sandra Bodenhamer, says a visit to a typical diabetes clinic will be of limited help to someone who has to figure out how to eat healthy food while living on social assistance without a proper kitchen.

ADAPT's approach has been recognized by its major funder, Health Canada, for two particular aspects: using peer leaders from the community who have diabetes or are at risk of diabetes; and cultural content geared toward First Nations taught by resident elder, Corinne Mitchell. It has seen 211 people since June who have taken part in its sessions on weight loss, exercise, community gardening or traditional healing.

"That's why it really helps working with the peers because they've lived through it, they know it and they can give some helpful suggestions (to clients) ... like where can they go and get healthier food, where can they go to get cheaper food that's still healthy, what can they do with limited resources. And where does that fall as a priority when people are struggling with housing, money, addictions, mental illness," says Bodenhamer.

Organizations in Kelowna and Edson, Alta., will be meeting with workers from ADAPT to learn from their techniques, she notes. Aboriginal people are more likely to get Type-2 diabetes because of a genetic predisposition, poverty accompanied by a poor diet and obesity, and a lack of exercise. Their numbers are also higher for complications from diabetes - brought on by uncontrolled blood sugar - such as kidney failure, foot amputations, blindness and heart disease.

Sheila Jack, an aboriginal student support worker with the Langley school district and a spokeswoman for the Canadian Diabetes Association, says treating her food as if it were medicine marked her turning point in dealing with diabetes. She lost more than 100 pounds and was able to stop taking medication for her Type 2 diabetes. "I had to look at what was more traditional for us to eat and take out the foods that are causing us to gain weight."

ADAPT is holding a public information session called Live Well with Diabetes at the Sheraton Vancouver Wall Centre from 2 p.m. to 5 p.m. on Sunday, Nov. 11. For more information go to evadc.net.

eellis@vancouversun.com


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