By Dr. CHRISTOPHER J. MORGAN
Everyone reading this article knows someone with diabetes. Diabetes has reached epidemic proportions around the world and here in Canada. Today, more than 9 million Canadians live with diabetes or pre-diabetes and, according to Health Canada, the number of people with diabetes is increasing by 7 per cent or more than 2 million each year.
The human cost of diabetes is devastating. Due to damage to the nerves and small blood vessels, diabetes is the leading cause of blindness for people over 20 and the number one cause of non-traumatic limb amputation. It is also among the leading causes of kidney failure, accounting for 10 to 20 per cent of diabetes deaths. Here is another alarming fact: the overall risk of dying among people with diabetes is at least double the risk of their peers without the disease. Diabetes is a chronic disease without a cure.
Both the American and the Canadian Diabetes Association (CDA) agree that education is the best approach to helping people prevent and manage diabetes. Over the last few years, CDA has presented a number of diabetes expos for different high-risk groups. The first Black Diabetes Expo took place at the Jamaican Canadian Association (JCA) in 2010. Due to its success and the need for ongoing diabetes awareness, this year will mark the 3rd Annual Black Diabetes Expo being presented by CDA and its Caribbean Diabetes Chapter. This year’s event returns to the JCA on Saturday, April 28 from 9:30 a.m. to 4:00 p.m. and is free for the community. Expo partners include TAIBU Community Health Centre, which has a culturally appropriate diabetes education program and the Jamaican Canadian Association.
Recently I had the opportunity to speak with the driving force behind the Expo, the founder and president of the Caribbean Diabetes Chapter of CDA, nurse and certified diabetes educator, Kathy Nelson.
Why do we need a Black Diabetes Expo?
First of all, we are a high-risk group for diabetes along with people of Aboriginal, Hispanic or Asian descent. A lot of our people are dying early because they have diabetes and don’t know it. Just being Black puts you at high risk.
Secondly, we need to increase diabetes awareness in our community. We need to educate those who are at risk, for example; those who have high blood pressure or high cholesterol or a history of heart disease; those who are overweight, especially around the tummy; if you have a family member with diabetes; if you’re over 45 and women who developed diabetes during pregnancy.
Third, we need to make people more comfortable talking about diabetes. Since I started the Caribbean Diabetes Chapter 12 years ago, I have found in too many cases people are in a state of denial, they are ashamed to know they have diabetes. It’s not well understood and diabetes is too serious to ignore.
Another important note is that we are seeing type 2 diabetes in young adults and children, in part because of the obesity epidemic. Parents of young children have to be aware of the connection between obesity in children and the risk of developing type 2 diabetes. We need school and community interventions, which lead to increased physical activity and improved access to healthy foods and less access to high fat and high sugar foods.
What is/are the goal(s) of the Expo?
We are trying to reach those who are at risk and those living with diabetes to provide meaningful information about prevention, lifestyle changes in terms of our eating habits and physical activity in order to improve diabetes self-management.
What will people be exposed to and what will they learn at this year’s Expo?
They will have an opportunity to have their blood sugar and blood pressure tested along with counselling on their results. Dr. Jacqueline James, endocrinologist, will discuss how to manage your blood sugar in particular in relation to various medications and insulin. Angela Forsythe, a registered dietitian from Toronto Public Health, will provide a cultural nutrition presentation with tips on portion size, and knowing what foods are likely to raise blood sugar levels. Kanika Russell from Toronto Rehab will show people what exercises they can do at home to help control blood sugar.
Dr. Paul Galiwango, cardiologist, will make the connection between diabetes and heart health. You will understand how diabetes significantly increases your risk of cardiovascular disease, leading to the fact that 50 per cent of people with diabetes will die of heart disease or stroke. In addition, people will get a chance to ask their questions. We will have very knowledgeable people present to take part in an open dialogue. There is so much for the whole family to learn.
As a community of people of African descent, what do we need to do to reduce the impact of diabetes?
Education is the key. People still do not know what diabetes is or how to prevent it? I have asked people with diabetes which organ is affected. Many don’t know. We need to know the risk factors and our likelihood of developing diabetes. People need to know, how do I live with diabetes? People need to know, how do I adjust my food and diet? What do my blood sugar readings before and after meals mean? What foods will raise my blood sugar? How will what I do physically affect my blood sugar? How do insulin and other diabetes medications work? These are just a few of the questions that people need answers to in order to improve their management of diabetes.
For example, not long ago at a Caribbean Chapter diabetes mall screening, I met a woman in a wheelchair with both of her lower legs amputated who had no idea that her diabetes was the cause of losing her legs. Her blood sugar that day was 23 (5 to7 is considered normal)!
Our community needs to have a sound understanding of diabetes and how to manage it because it is possible to lead a good quality of life while living with diabetes. But people will need support, often professional counselling; it is not possible for one person to handle it by themselves. Diabetes is a family affair; the entire family needs to be informed so the family can make the necessary adjustments to help the family member with diabetes. Remember, if dad or mom has it – the children are at risk too.
Family support is needed especially in terms of meals, medications, physical activity and keeping on top of medical appointments to check their eyes, feet, kidneys and so forth. Diabetes can also put a strain on relationships; let’s not forget the impact diabetes can have on impotence which can cause all sorts of frustration and problems without a proper understanding of the situation and what you can do to improve it.
Another very important education point is people need to know their three critical target numbers, blood pressure, blood cholesterol and blood sugar, because these are the key factors that affect the health and integrity of your cardiovascular system.
Some of the challenges we may encounter are the family physician who does not have the time to provide the appropriate education or they fail to make a referral to a diabetes educator or the community diabetes centre, or the information they do provide is not culturally appropriate especially in terms of diet and eating practices. So as we educate the community, we become more effective advocates for our own health and the health of our family members.
This is why I formed the Caribbean Diabetes Chapter to provide an ongoing, year-round group so people can continue being educated about diabetes self-management. This is why the Annual Black Diabetes Expo is so important so we can reach as many people as possible.
What activities are you and the chapter planning in the coming months following the Expo?
We are hoping to do more diabetes mall screening this summer in the Toronto area and our May and June chapter meetings will focus on the eye and kidney with presentations from various specialists.
Thank you Kathy, I will see you at the Expo.
For more information on the 3rd Annual Black Diabetes Expo or to register for the Expo bus, call 416-408-7190 or go to Diabetes.ca/black-expo. For more information about the Caribbean Chapter of CDA call Kathy at 416-987-0339.
Dr. Christopher J. Morgan is the director of Morgan Chiropractic & Wellness, an interdisciplinary health centre in Toronto, and the President of the Black Health Alliance, a network of community organizations, health professionals and community members working in partnership to advance the health and well-being of the Black community. He can be reached at 416-447-7600 or firstname.lastname@example.org.