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Standing Strong Against Diabetes: Maskwacis Health Services Diabetes Conference, November 2012

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BRAID Research, University of Alberta
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Standing Strong Against Diabetes: Maskwacis Health Services Diabetes Conference, November 2012

  1. 1. Standing Strong against DiabetesMaskwacis Health Services Diabetes Conference, November 2012Dr Ellen TothUniversity ofAlberta Maskwacis Diabetes Health Conference 2012, E. Toth
  2. 2. Plan for today Introduction What is diabetes Standing Strong Maskwacis Diabetes Health Conference 2012, E. Toth
  3. 3. Dr Ellen TothDepartment of MedicineUniversity of Alberta – Diabetes specialist Doing clinics in Hobbema monthly.. every 2 weeks…. for 10 years Because there is a lot of diabetes in Hobbema Because it is not easy for people from Hobbema to get access to good diabetes or other Health Care Maskwacis Diabetes Health Conference 2012, E. Toth
  4. 4. Dr Ellen Toth BRAID Research: www.braiddm.ca Since 1999: “diabetes epidemic in aboriginals” main focus of work  SLICK/CHIPP in 2001,  ACADRE in 2002  MDSi in 2003  BRAID since 2002, BRAID kids 2008  CIRCLE in 2009  ADSS Present grants:  Pregnancy barriers (Richard Oster)  Self determination / cultural continuity (Richard Oster and Davida Reingold)  Type 2 diabetes in kids (Davida Reingold and Kelli Ralph Campbell)  Diabetes and Pregnancy in Hobbema (Lawson Foundation) Maskwacis Diabetes Health Conference 2012, E. Toth
  5. 5. Dr Ellen Toth Other activities and anxieties Medical Lead for Aboriginal Health – Aboriginal Health Program – Capital Health / AHS /North / Edmonton Zone, Medical Director: Aboriginal Diabetes Wellness Program / Aboriginal Wellness Program GRUMP! We are NOT winning… well… maybe????? Diabetes epidemic Pregnancy complicating diabetes Mental Health: effects of residential school. Maskwacis Diabetes Health Conference 2012, E. Toth
  6. 6. Authors: Oster, Hemmelgarn, Toth, King, Crowshoe, Campbell ADSS 2009
  7. 7. Rates of high risk pregnancies
  8. 8. Diabetes and high risk pregnancies
  9. 9. Plan for today Introduction What is diabetes Standing Strong Maskwacis Diabetes Health Conference 2012, E. Toth
  10. 10. What is Diabetes?• A condition where the sugar in the blood is too high• A common problem all over the world (1% to 50%)• A chronic condition with no cure• A condition that can be managed• Several types and several “complications” Maskwacis Diabetes Health Conference 2012, E. Toth
  11. 11. Newoyaw: Life map for Living withDiabetesACKNOWLEDGEMENT:Aboriginal Diabetes Wellness Program Newo = 4 Miyaw = Body Newoyaw = 4 Bodies Mind Body Spirit Emotion
  12. 12. How does it happen?What happens when we eat? = = Food Sugar EnergyFood that we eat turns into sugar to be used as energy
  13. 13. What happens when we eat? The Fire-Keeper (Insulin) brings the wood (Sugar) into the Teepee (Cell) to make a fire that produces heat and energyWood = Sugar Fire-Keeper = Insulin Teepee = Cell
  14. 14. What happens when we eat?Wood = Blood Sugar Fire-Keeper = Insulin •Insulin brings the blood•Blood sugar comes from sugar into the cellsthe food we eat •Insulin is made by the pancreas
  15. 15. What happens when weeat? Teepee = Body Cell Fire = Energy •The body’s cells use the sugar as energy
  16. 16. Why does it happen?What is Type 2 Diabetes?When we have diabetes several things aregoing on:- our bodies can release too much sugar- our insulin is not working properly- our cells resist insulin Leaky Liver: Pooped out Cell Resistance: Too much Pancreas: Not Insulin unable to bring sugar: enough or Insulin too sugar into the cell tired
  17. 17. What is Type 2 Diabetes?Leaky Liver Pooped out Cell ResistanceThe liver leaks Pancreas The cells don’ttoo much The pancreas is not allow insulin tosugar. Blood making enough bring the sugarssugars rise insulin. Or the into the cell. insulin is too tired Blood sugars rise. and not able to work properly. Blood sugars rise. Maskwacis Diabetes Health Conference 2012, E. Toth
  18. 18. What is Type 2 Diabetes?How can it be managed?Leaky Liver Pooped out Cell ResistanceThe liver leaks Lifestyle Pancreas Lifestyle The cells don’t Lifestyletoo much The pancreas is not allow insulin tosugar.mainlyPills, Blood making enough Pills, diabeta, bring the sugars Pills, mainlysugars risemetformin diamicron, the insulin. Or into the cell. metformin insulin is too tired gluconorm, januvia Blood sugars rise. and not able toInsulin, the work properly. Insulin, the Insulin, theneedle needle sugars rise. Blood needle Maskwacis Diabetes Health Conference 2012, E. Toth
  19. 19. Other types of diabetesType I Gestational Prediabetes Also secondary diabetes, eg Conference 2012, E. Toth Maskwacis Diabetes Health to pancreatitis
  20. 20. Type 1 Diabetes  Formerly known as juvenile-onset or insulin-dependent diabetes  Causes: Immune system damaging cells that make insulin; viruses and /or environmental  You need insulin injections for the rest of your life
  21. 21. Gestational Diabetes Diabetes during pregnancy. Causes: Hormones that help the baby develop can affect your own insulins ability to handle sugar. This is a type of insulin resistance. Both mother and child are at a higher risk of developing type 2 diabetes later in life.
  22. 22. Pre-Diabetes Good! Take action! Diagnosis < or = 6.0 6.1 – 6.9 > or = 7.0 No diabetes Pre-diabetes Type 2 diabetes Maskwacis Diabetes Health Conference 2012, E. Toth
  23. 23. Pre-Diabetes Prediabetes can be slowed down or prevented by proper nutrition, exercise & weight loss. It is a life time commitment. Medication can also help (metformin)
  24. 24. Plan for today Introduction What is diabetes Stand Strong Maskwacis Diabetes Health Conference 2012, E. Toth
  25. 25. How might communitiesstand strong?  Prevent diabetes, and pre-diabetes  Treat diabetes, and pre-diabetes  Live well with diabetes  Assess and treat diabetes complicating pregnancy Maskwacis Diabetes Health Conference 2012, E. Toth
  26. 26. Type 2 DiabetesRisk Factors Overweight / Obese / Inactive Aboriginal, Hispanic, African, Asian Family history of type 2 diabetes Age Previous gestational diabetes STRESS Modified from CDA, Toth
  27. 27. How might communities stand strong? Personally Community Prevent diabetes Prevent diabetes PlanMentalHealth Diabetes pregnancies, test and treat diabetes in pregnancy Indian Act Residential school E. Toth, 2012
  28. 28. What is needed for health? Access to quality health care Self: genetics, health beliefs, self esteem, resources Family and friends Community leadership Social determinants of healthMaskwacis Diabetes Health Conference 2012, E. Toth Toth 2010
  29. 29. Questions and discussion Dr Ellen Toth: 780 - 407- 3636 Ellen.toth@ualberta.ca www.braiddm.ca

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