When Iris John showed up for the first Black Diabetes Expo four years ago at the Jamaican Canadian Centre (JCA), she was in rough shape.
The diabetic blood sugar level was 2.9, which meant that she was approaching an emergency that could have led to a coma.
“It took me almost eight hours that day to get her level back up to four,” said Kathy Nelson, who established the Canadian Diabetes Association’s Caribbean chapter 13 years ago to raise the level of educational awareness about the disease and also founded the Expo. “I took her in the JCA boardroom and provided her with my lunch and apple juice because I was very concerned about her health.
“What I discovered while talking to Iris was that she was on the wrong medication that takes a long time to leave the system of an elderly person. That medication of 10 milligrams taken twice daily was the reason why she was fainting regularly and why her sugar level had dropped drastically. I gave her a note to take to her doctor advising him take her off that medication.”
John was among a large group of diabetics that attended last Saturday’s Expo.
“This lady is a darling,” said the 80-year-old, pointing to Nelson. “She looked after me and I am feeling much better now.”
Blacks between the ages of 64 and 74 have a one in four chance of developing diabetes and more than two million Canadians have the disease that, if not treated or effectively managed, could result in a number of complications.
“It’s important that you know your blood sugar targets and the haemoglobin A1C which is a measure of how well your blood sugars are controlled and correlates very much with your risk of complications,” Guyanese-born keynote speaker, Dr. Jacqueline James, an associate professor in the department of medicine at the University of Toronto, told the audience. “If you can keep your A1C as close to normal as possible under seven per cent, then your risk of the long-term complications of diabetes such as blindness, kidney failure, nerve damage, amputations, heart attacks and strokes, can be prevented.
“You should be an active participant in your care so that you know what your blood sugars are, you know what medications you are taking and you can control your diabetes and prevent horrible complications.”
Dr. James, who as chair of the Banting & Best Care and Education Committee was responsible for designing and implementing interdisciplinary diabetes educational conferences and management guides for health care professionals, said individuals that attain the age of 40 should seek blood sugar tests at least once every three years.
“This disease can be very silent and you might not know you have it until you get a complication,” she said.
Some of the signs and symptoms of diabetes include unusual thirst, frequent urination, fluctuating weight, extreme fatigue and listlessness, blurred vision, frequent or recurring infections, tingling and numbness in the hands or feet, cuts and bruises that take long to heal and – additionally for men – challenges in getting or maintaining an erection.
Nelson, who came to Canada in 1970 and has worked at the Princess Margaret Hospital and Toronto Rehab, has first-hand knowledge of the devastating effects of diabetes.
Her father died in a diabetic coma at age 80 in 1992, six years after his right leg was amputated and her mother developed Type 2 diabetes at age 86 and passed away nine years later. Nelson’s eldest daughter, who lives in Jamaica, was diagnosed just over two decades ago, while six of her nine siblings have the chronic disease.
“It’s all about education,” said Nelson. “You need to know what blood sugar numbers mean, what to do when it’s high and what you should eat. This is a disease that can be controlled by the type of food you eat, physical activity and medication.”
The Expo brought together experts on subjects ranging from healthy eating and physical activity to medication management.
Attending the Expo for the first time was Mount Sinai Hospital, which is recruiting individuals for a study on Type 2 diabetes and high blood pressure.
“One of the medications recently approved is Victoza, which appears to lower blood pressure and sugar,” said Annette Barnie, the manager/co-ordinator of Mount Sinai Hospital’s diabetes clinical research unit. “We want to understand the mechanisms for that and by doing so we can tailor that medication for who should be on it.”
The Expo was held two days after a Ryerson University-led study, that provides guidelines on how best to deliver diabetes self-management and education programs to women in Black/Caribbean and Latin American communities as well as gender and ethnic groups where diabetes is more prevalent, was released.
“Studies have shown that diabetes education programs are effective in teaching people with Type 2 diabetes to manage their condition,” said Ryerson’s nutrition professor, Enza Gucciardi. “What isn’t known are which approaches work best with certain ethnic groups that are at higher risk.”
Gucciardi and her co-authors identified five diabetes program features – hospital-based interventions where diabetes education programs were administered, group interventions, use of problem solving techniques, frequent sessions and incorporating dietitians in self-management programs – with the broadest positive effects.
“Based on our findings, healthcare providers who work with women with Type 2 diabetes in the African-Caribbean and Latin American community should incorporate these features when creating diabetes self-management programs,” said Gucciardi. “But at the same time, they need to tailor it to each individual’s goals and preferences on what they want to achieve and how it can be delivered to be effective.”
BY RON FANFAIR