Diabetes becoming an epidemic

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Diabetes is reaching epidemic proportions in Native populations, said the head of the Assembly of First Nations national diabetes program.

At the current rate, more than 20 per cent of Aboriginals will have the disease by the year 2000, said Alethea Kewayosh.

A 10-year study released in Saskatchewan last year said Natives with diabetes in that province are seven times more likely to develop kidney failure requiring dialysis than non-Natives. Half of all diabetics who suffer kidney failure die within two years, she added.

The situation is the same in the United States. Native Americans who are over 35 and overweight have a 50-per-cent greater chance than the rest of the population of developing Type 2 diabetes.

Before the arrival of the white man and even before the turn of the century, diabetes was unknown to Aboriginals. The first epidemics in the states appeared in the southwest in the 1940s among the Pima Indians of Arizona. Now, about 50 per cent of all Pimas over 35 have the disease. Diabetes is also one of the top three causes of death among Aboriginals.

What exactly is diabetes and how does it develop? Normally your body changes sugars, starches and other foods you eat into fuel. This fuel is a form of sugar called glucose. Your bloodstream carries glucose to your body's cells. Insulin (a hormone made by the pancreas) helps the glucose to enter the cells.

In diabetes, something goes wrong with this process, either your body does not make enough insulin or your body cannot use the insulin correctly. If glucose can't enter the cells, it builds up in the bloodstream, causing high blood sugar. High blood sugar can cause serious damage to all organs of the body, including the eyes, kidneys and blood vessels. Symptoms include frequent urination, excessive thirst and hunger, wounds that heal slowly and frequent infections.

There are two major types of diabetes: Type 1 and Type 2. Type 1, or insulin-dependent diabetes, occurs most often in children and young adults. It usually appears suddenly and progresses quickly. People with Type 1 must take daily injections of insulin and follow a health diet in order to stay alive.

Type 2, or non-insulin dependent diabetes, usually occurs in adults over 30 who are overweight. About 90 per cent of all people with diabetes have Type 2. The onset is usually gradual and can often be controlled by diet and exercise, but some people also need oral medications or insulin injections to help control their blood-sugar levels.

Diabetes is a chronic, progressive disease that has no cure. Death is usually caused by the disease's complications such as kidney disease, heart disease and stroke, liver damage or amputations. Blindness, impotence and other devastating conditions may also occur.

The tendency to develop diabetes is believed to be hereditary, which contributes to its spread in small, isolated communities where many residents are related. But there are two other major factors that continue to the staggering statistics for Aboriginals.

The first is the change of lifestyle which has also changed the diets of most Natives. Ways of life have changed from nomadic hunting and farming to a more sedentary, indoor lifestyle that includes eating more processed foods.

Stress also contributes to the development and onslaught of disease. Native people have many stresses in their lives, beginning with the negative impacts of ignorance of their culture, extreme poverty and racism.

Many experts agree that early intervention and culturally relevant educational resources and interventions need to take place. The first step is education. And the first lesson is that fried bannock or frybread, a major food staple for most Natives, is perhaps the worst food that one can eat, because it has such a high fat content and no real nutritional value.

Many other foods need to be looked at and compared to the foods eaten hundred of years ago. The focus of a diet should be on lean meat, whole grans, including whole grain breads and cereals, fresh fruit and vegetables and low-fat milk and dairy products.

No more than 30 per cent of calories should be from fat, and less is even better. This means that for a person who eats 2,000 calories a day, only 600 calories should come from fat.

(With files from Ruth Denny, Editor of The Circle.)