Looking at new Pathways to Health
Canada's Native peoples suffer adult-onset diabetes (type II diabetes mellitus) at more than four times the rate of the general population. It is thought this is the result of genes and the switch within a century from a physically rigorous existence to a sedentary western lifestyle with diets high in fat, sugar, and processed foods. The toll of unmanaged diabetes in Native populations is devastating. Unchecked diabetes can lead to blindness, heart disease, and amputation of limbs from blood vessel destruction. It is the major cause of death for Native women on reserves.
The very first step in diabetes management is patient education. The standard educational program that delivers vital information to diabetics is not as successful among Natives as it is with the general population. However, an innovative program based at Edmonton's Royal Alexandra Hospital, developed by Native elders and medical staff, may help Native diabetics live healthier lives.
The Aboriginal Diabetes Wellness Program combines Native philosophy, spirituality and traditional foods with Western medical practice. Dr. Don Voaklander, a U of A epidemiologist and Health Research Fund recipient, is comparing the success of the Royal Alex program to the standard diabetes education sessions offered in Alberta. He explains, "Native attendance in standard programs has been very low. This could be because diabetes information delivery conflicts with one of the principal values of Aboriginal peoples-non-interference. The general population is used to health information being directed at them by experts in a paternalistic manner. A feature of native culture is the individual's right to choose to partake of information. There is no explicit expectation of compliance."
Diabetic Natives from all over Northern Alberta are guided by elders through a four-day program which includes counselling, talk circles, healing ceremonies, and diet management that incorporates such traditional foods as bannock and wild game. Patients and their families stay at Anderson Hall on the Royal Alex grounds for the duration of the program. Dr. Voaklander comments, "Already this program has a high enrollment, which is a promising step toward long-term management of the disease."
Long-term diabetes management is crucial for reduced complications, improved health, and savings in health budgets. Dr. Voaklander's research checks patients at three months and six months after their participation in the Aboriginal Diabetes Wellness Program to measure blood sugar levels and the overall quality of life of the 150 participants. Comparative data gathered in southern Alberta will show how Native diabetics are faring in standard programs in the province. If Dr. Voaklander's study shows the Aboriginal Diabetes Wellness Program has good results, the information may help transform the way diabetes information is delivered to Native Canadians.
Dr. Voaklander is an epidemiologist with the Department of Public Health Sciences at the U of A. His research is supported by the Health Research Fund, administered by AHFMR on behalf of Alberta Health.
For information about the Aboriginal Diabetic Wellness Program, please call (403) 477-4512.
- The Canadian Diabetes Association :http://www.diabetes.ca/
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