standing strong against diabetes: maskwacis health services diabetes conference, november 2012
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BRAID Research, University of Alberta www.braiddm.caTRANSCRIPT
Dr Ellen TothDr Ellen Toth
University of Alberta University of Alberta
Standing Strong against DiabetesMaskwacis Health Services Diabetes Conference,
November 2012
Standing Strong against DiabetesMaskwacis Health Services Diabetes Conference,
November 2012
Maskwacis Diabetes Health Conference 2012, E. Toth
Plan for today
Introduction
What is diabetes
Standing Strong
Maskwacis Diabetes Health Conference 2012, E. Toth
Dr Ellen Toth Department of Medicine University of Alberta – Diabetes specialist
Doing clinics in Hobbema monthly.. every 2 weeks…. for 10 years
Because there is a lot of diabetes in Hobbema
Because it is not easy for people from Hobbema to get access to good diabetes or other Health Care
Maskwacis Diabetes Health Conference 2012, E. Toth
Dr Ellen Toth BRAID Research: www.braiddm.ca
Since 1999: “diabetes epidemic in aboriginals”
main focus of work
SLICK/CHIPP in 2001,
ACADRE in 2002
MDSi
in 2003
BRAID since 2002, BRAID kids 2008
CIRCLE in 2009
ADSS
Present grants:
Pregnancy barriers (Richard Oster)
Self determination / cultural continuity (Richard Oster and Davida
Reingold)
Type 2 diabetes in kids (Davida
Reingold
and Kelli Ralph Campbell)
Diabetes and Pregnancy in Hobbema (Lawson Foundation)Maskwacis Diabetes Health Conference 2012, E. Toth
Dr Ellen Toth Other activities and anxieties
Medical Lead for Aboriginal Health –
Aboriginal Health Program –
Capital Health / AHS /North / Edmonton Zone,
Medical Director: Aboriginal Diabetes Wellness Program / Aboriginal Wellness Program
GRUMP!
We are NOT winning…
well…
maybe?????
Diabetes epidemic
Pregnancy complicating diabetes
Mental Health: effects of residential school.
Maskwacis Diabetes Health Conference 2012, E. Toth
ADSS 2009
Authors: Oster, Hemmelgarn, Toth, King, Crowshoe, Campbell
Rates of high risk pregnancies
Diabetes and high risk pregnancies
Plan for today
Introduction
What is diabetes
Standing Strong
Maskwacis Diabetes Health Conference 2012, E. Toth
What is Diabetes?• A condition where the sugar in the blood is too high
• A common problem all over the world (1% to 50%)
• A chronic condition with no cure
• A condition that can be managed
• Several types and several “complications”
Maskwacis Diabetes Health Conference 2012, E. Toth
Newoyaw: Life map for Living with Diabetes
Newo = 4Miyaw = BodyNewoyaw = 4 Bodies
MindBodySpiritEmotion
ACKNOWLEDGEMENT:Aboriginal Diabetes Wellness Program
How does it happen? What happens when we eat?
Food that we eat turns into sugar to be used as energy
Food Sugar Energy
= =
What happens when we eat?
Wood = Sugar Fire-Keeper = Insulin Teepee = Cell
The Fire-Keeper (Insulin) brings the wood (Sugar) into the Teepee (Cell) to make a fire that produces heat and energy
What happens when we eat?
Wood = Blood Sugar
•Blood sugar comes from the food we eat
Fire-Keeper = Insulin•Insulin brings the blood sugar into the cells•Insulin is made by the pancreas
What happens when we eat?
Teepee = Body CellFire = Energy
•The body’s cells use the sugar as energy
Why does it happen? What is Type 2 Diabetes?
Leaky Liver: Too much sugar:
Pooped out Pancreas: Not enough or Insulin too tired
Cell Resistance:Insulin unable to bring sugar into the cell
When we have diabetes several things are going on: - our bodies can release too much sugar- our insulin is not working properly - our cells resist insulin
What is Type 2 Diabetes?Leaky LiverThe liver leaks too much sugar. Blood sugars rise
Pooped out PancreasThe pancreas is not making enough insulin. Or the insulin is too tired and not able to work properly. Blood sugars rise.
Cell ResistanceThe cells don’t allow insulin to bring the sugars into the cell. Blood sugars rise.
Maskwacis Diabetes Health Conference 2012, E. Toth
What is Type 2 Diabetes? How can it be managed?Leaky LiverThe liver leaks too much sugar. Blood sugars rise
Pooped out PancreasThe pancreas is not making enough insulin. Or the insulin is too tired and not able to work properly. Blood sugars rise.
Cell ResistanceThe cells don’t allow insulin to bring the sugars into the cell. Blood sugars rise.
Lifestyle Lifestyle
Pills, mainly metformin
Lifestyle
Pills, diabeta, diamicron, gluconorm, januvia
Pills, mainly metformin
Insulin, the needle
Insulin, the needle
Insulin, the needle
Maskwacis Diabetes Health Conference 2012, E. Toth
Other types of diabetes
Type I Gestational Prediabetes
Also secondary diabetes, eg to pancreatitisMaskwacis Diabetes Health Conference 2012, E. Toth
Type 1 Diabetes
Formerly known as juvenile-onset or insulin-dependent diabetes
Causes: Immune system damaging cells that make insulin; viruses and /or environmental
You need insulin injections for the rest of your life
Gestational Diabetes
Diabetes during pregnancy.
Causes: Hormones that help the baby develop can affect your own insulin's ability to handle sugar. This is a type of insulin resistance.
Both mother and child are at a higher risk of developing type 2 diabetes later in life.
Pre-Diabetes
< or = 6.0No diabetes
6.1 – 6.9Pre-diabetes
> or = 7.0Type 2 diabetes
Good! Take action! Diagnosis
Maskwacis Diabetes Health Conference 2012, E. Toth
Pre-Diabetes
Prediabetes can be slowed down or prevented by proper nutrition, exercise & weight loss. It is a life time commitment.
Medication can also help (metformin)
Plan for today
Introduction
What is diabetes
Stand Strong
Maskwacis Diabetes Health Conference 2012, E. Toth
How might communities stand strong?
Prevent diabetes, and pre-diabetes
Treat diabetes, and pre-diabetes
Live well with diabetes
Assess and treat diabetes complicating pregnancy
Maskwacis Diabetes Health Conference 2012, E. Toth
Type 2 Diabetes Risk Factors
Overweight / Obese / Inactive
Aboriginal, Hispanic, African, Asian
Family history of type 2diabetes
Age
Previous gestational diabetes
STRESS Modified from CDA, Toth
How might communities stand strong?
Personally Prevent diabetes
Residential school
Diabetes
Indian Act
Mental Health
Community Prevent diabetes
Plan pregnancies, test and treat diabetes in pregnancy
E. Toth, 2012
Social determinants of health
Family and friends
Community leadership
Self: genetics, health beliefs, self esteem, resources
Access to quality health care
What is needed for health?
Toth 2010Maskwacis Diabetes Health Conference 2012, E. Toth
Questions and discussionDr Ellen Toth: 780 - 407- 3636
www.braiddm.ca