Diabetics in Leduc County now have somewhere to go to help manage their condition, and get important questions answered. Started in November 2008, Self Manage to Improve your Life Everyday (S.M.I.L.E.) is a multi-disciplinary health care program offered through the Leduc Beaumont Devon Primary Care Network (PCN). With this program, a patient can get a referral through their family physician, and there is communication between the PCN and the family physician.
“The patient will come and see a nurse, pharmacist, social worker and a dietitian. Based on what their concerns are with how they are managing their condition, we can help them with target areas and help them set and achieve goals. It’s patient specific,” said Christina Snow, Chronic Disease Management Coordinator at PCN.
“The PCN, which services all of Leduc County, estimates there are over 1,700 diabetics that have been seen by primary care physicians. “There may even be more than that if people in Leduc see a doctor in Edmonton. We’re not capturing those people in our statistics.”
Over two million Canadians suffer from diabetes, and 60,000 new cases are diagnosed across the country every year. By 2010, the number of people diagnosed is expected to jump to more than three million, with more than six million people living with pre-diabetes, which increases the risk of developing type 2 Diabetes.
Diabetes is a lifelong condition where the body cannot properly store sugar taken from the foods we eat. When someone has diabetes, the pancreas either does not produce, or produces very little insulin. Insulin is needed to help the body use sugar for energy. When insulin is not available, the sugar we ingest from the food stays in the bloodstream, which causes blood sugar to rise.
“In Type 1 diabetes, your symptoms usually come on quite quickly and suddenly, and your pancreas doesn’t make any insulin at all,” said PCN Dietitian Andrea Lewis. “With Type 2 diabetes, you may produce some insulin, but it’s not getting where it needs to go. So you can’t use your energy properly, or you are not producing enough. “In Type 1 diabetes, patients do need insulin, in Type 2 diabetes, patients may or may not need insulin.”
About 10 per cent of people have Type 1 diabetes, with 90 per cent having Type 2. Both types may require people to take insulin or other medications as prescribed by their physician, eat healthy meals and snacks, and exercise regularily.
Insulin can be needed for both types of diabetes, but with Type 2, depending on your lifestyle, you can control it with diet and exercise or with oral medications. With Type 2 diabetes, you have 50 per cent of the cells that produce insulin, so by the time you are diagnosed, you are already not producing as mush as you did before you were diagnosed. Half of the pancreas is already not working.
Not everyone with Type 2 diabetes will need insulin. “There is a chance as the disease progresses, no matter what your best intentions and actions are, you may need insulin,” explained Snow. “It should not be seen as a failure on the part of the patient. The insulin is a way to help manage the disease, and it is a chronic disease.”
In the long term, diabetes complications could include blindness, heart disease, kidney problems, nerve damage and erectile dysfunction.
Jeremy Brace of the Canadian Diabetes Association said diabetes is a serious problem that costs our entire planet.
“Most people don't realize that it is not only the world's fourth leading cause of death, diabetes is increasing daily and now affects an estimated 246 million people globally.” He said people with diabetes can expect to live active, independent and vital lives if they make a lifelong commitment to careful diabetes management.
The Canadian Diabetes Association states those over the age of 40 are at risk for Type 2 diabetes, and should be checked every three years. Through the PCN’s Health Promotion and Disease Prevention and Management Program, family physicians in Leduc County have taken steps to ensure that all of their patients over the age of 40 have been screened for Diabetes. Symptoms and signs to look for include unusual thirst, frequent urination, weight gain/loss, extreme fatigue/lack of energy, blurred vision, frequent/recurring infections, cuts/bruises that are slow healing, tingling/numbness in hands/feet and trouble getting/maintaining an erection.
Those who should be tested more often include members of a high-risk group (Aboriginal, Hispanic, Asian, South Asian or African decent) and overweight individuals, especially those who carry the weight around the middle. Others at high-risk include having a family member with diabetes, health complications associated with diabetes, women who gave birth to a baby that weighed more than nine pounds and those who suffered gestational diabetes (diabetes during pregnancy), high blood pressure, high cholesterol, or those diagnosed with polycystic ovary system
“With three of more risk factors, you should be seeing your physician,” said PCN Pharmacist Trish Kopan. “We know a lot of men don’t go for their yearly physical as much as women do. Usually a lot of men are undiagnosed. Being age 40 or over is a risk factor itself. “For women, if you have given birth to a baby that is over nine pounds, you can develop gestational diabetes and there are studies that show you can develop diabetes later in life.”
Maintaining a healthy lifestyle is vital to staying healthy. “Tell people to look at their dinner plates, and what you want them to do is divide the plate in half. Half the plate should be a variety of raw or cooked vegetables, one quarter should be your starch and carbohydrate, and the other quarter is your meat or meat alternative,” Lewis said. You want leaner meats, leaner cuts, as well as beans and lentils. It’s based on a nine inch plate. In getting the fruit and vegetables, the fibre is really important, especially for weight management and people with diabetes who need to keep their blood glucose in control. Ensure the grains are whole grains, generally eating healthy – low fat, low salt, and lots of fruits and vegetables and fibre.
“It’s really important for people who have Type 2 diabetes to realize that just because you have diabetes does not mean that you have to eat special diabetic food. It really just comes down to watching your portions,following the Canada Food Guide, maintaining a healthy weight, keeping blood pressure under control, keeping physically active and following up with your family physician,” Lewis said.
Kopan said according to the CDA (Canadian Diabetes Association), based on a U.S study, a North American child born in the year 2000 stands a one in three chance of being diagnosed with diabetes in their lifetime. Snow said if people could make changes, they can change the course they are heading on.
“People do need to have this conversation with their doctor. They do need to get screened for diabetes. It can start with some simple blood work, getting their cholesterol tested, getting that blood sugar tested and getting their blood pressure checked. That’s a great start. We all need to take responsibility for our health.”
Michelle Minnoch
Leduc Representative
Reproduced with permission