Sandy Lake prepares to stop "diabetic epidemic"

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The Ojibwa-Cree people of Sandy Lake are poised to halt the spread of diabetes, which is threatening to erupt into an epidemic on remote re-serves, including their own in northern Ontario.

"The community is visionary in some waysthey came to me be-cause they're a forward-thinking community which made (the problem) a political item on their agenda," says Dr. Stewart Harris, who was stationed at nearby Sioux Lookout until recently.

Four years ago type 2 diabetes, which can be controlled with proper diet and exercise, reached epidemic proportions at Sandy Lake from a few cases in the 80s. One in three of the 1,500 residents were either sick or car-rying signs of the disease in their blood, he says.

At least five of their prominent Elders had died of complications from diabetes-kidney failure, amputations and heart attacks which normally are so rare in Native populations. They became even more alarmed when the type 2 usually confined to geriatrics began showing up in their children. A few were hospitalized with serious infections and the dehydration which sometimes ends in diabetic coma.

The community went searching in Sioux Lookout, 180 kilomemetres by seaplane, for a physician who could give them some answers. Their meeting with Dr. Harris, who also happened to be a public health expert on diseases, would lead to one of the most exhaustive studies of diabetes among Indigenous people in North America.

"The whole point of the study was to find out why it's happening in Natives and also to try and get a handle on it, because it's a terrible disease," Harris says from London, Ont., where he now practices.

The study would show that some Native families are genetically sus-ceptible to diabetes, which then surfaces in those with a poor diet and sed-entary lifestyle.

"It's a silent killer because it takes from 10 to 20 years before the symptoms can show up.

"It's going to devastate some communities and will be the major health problem for Natives in future," he predicts.

An average of four per cent of the general population develops diabe-tes but Harris says up to 60 per cent of the people in some Native communi-ties can be afflicted.

"Certain families are affected more than others, maybe four out of six siblings and one of two parents could have diabetes."

In 1991 he recalls that "My public health side got the better of me be-cause I felt there was a health problem."

He approached the University of Toronto for funding and, using his personal contacts, began to gather a group of international experts in the field. Completed in April, the first phase of data from Sandy Lake cost close to $1-million to compile. Ontario's Ministry of Health provided the majority of funding while the National Institute of Health, in the U.S., topped it up.

A half-dozen locals were hired to interview people in both Oji-Cree and English on their attitudes to diabetes and suggestions to prevent it in fu-ture. A permanent project site was set up in a house where the 1,064 volun-teers would undergo hours of health tests.

Peer pressure to participate was high and subjects weren't hard to find, says Harris.

"People were genuinely interested in the project because we weren't some outsiders coming in, so they really bought into it."

To screen out those without diabetes, Harris's group conducted blood tests before and after giving a glucose drink. Then fitness and obesity tests were done.

The elderly provided family histories to compare diet and activities over a 40-year period and Harris found both had undergone profound changes on the modern-day reserve.

"So in the past 20 to 40 years they have gone from an extremely ac-tive life what with trapping or gathering wood for fires, to basically a sed-entary life-style. They don't walk, they drive everywhere. They don't hunt, they just go to the supermarket."

The diet has changed drastically too, he says, from the high-protein, low fat of wild meat to the high fat from such products as canne meat and bacon.

The two factors are a deadly mixture for those families at risk for de-veloping diabetes.

Guided by Harris in London, over the next three years Sandy Lake will attempt to reverse their collision course with a diabetic epidemic by eating healthier foods and becoming more active. He acknowledges it's not going to be easy but is hopeful because the suggestions for prevention have come straight from the community itself.

"We'll have a real idea of how much people are willing to prevent it for example, I may want you to lose weight and may suggest you use a Jane Fonda videotape. But you may not have a tape player and you may not even like Jane Fonda.

"We want to do what comes naturally and what is culturally accept-able," Harris concludes.