AN iNdepeNdeNt SUppLeMeNt FrOM MediApLANet tO tHe NAtiONAL pOSt
Juvenile diabetes
Affecting your family’s
most vulnerable
Creature comforts
Manage your disease
with a trained pet
november 2010
DIaBetes
3
TiPS
TO MAnAGinG yOuR
DiABETES
BALANCING IS MORE
THAN JUST AN ACT
nick Jonas manages his diabetic needs while living every young musician’s
dream
PHOtO: MaRY ELLEN MattHEWS
BaCKGROUND ILLUStRatION: IStOCKPHOtO.COM/HELENa JaUNEGG
2 · NOveMber 2010
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt
CHallenGes
TiP/STEP
TiP
1
COnnECT TO A
STRuCTuRED
SuPPORT
CEnTRE
WE RECOMMEND
pAGe 7
Diabetes in pets
even the furry
members of your
family can be
affected by this
disease.
“in Canada, an
average of eight in 50
cats and four in 500
dogs are diagnosed
with diabetes.”
Pump it up
p. 4
nick Jonas’ experience
p. 5
Karen Kemp explains insulin pumps.
balancing diabetes management with his
worldwide tour.
COMinG TOGETHER
Participants at World
Diabetes Day
PHOTO: CANADIAN DIABETES
ASSOCIATION
Today, more than nine million Canadians are living with
diabetes and prediabetes. And the numbers are
growing rapidly.
research leads to
progress toward a cure
J
uvenile, or Type 1 diabetes, is an often misunderstood disease.
Unlike the more common Type 2 diabetes,
Type 1 diabetes is not
caused by lifestyle factors such as obesity. It is a non-preventable disease of the immune system that strikes with little warning,
primarily affecting the most vulnerable members of our families—our
children. Children diagnosed with
this disease can look forward to a
lifetime of careful, almost obsessive
management of their diet and exercise regimens, numerous daily finger pricks to measure blood glucose,
and multiple daily self-administered
shots of that life-giving Canadian
discovery, insulin. All in an attempt
to keep blood sugar levels within a
normal range. If they are successful—
which is by no means a given, even for
the most conscientious of patients—
they may avoid the potentially fatal
condition known as severe hypoglycemia and may ultimately escape
the devastating consequences of the
disease that occur later in life—loss of
kidney function, blindness and limb
amputations, to name a few.
The Juvenile Diabetes Research
Foundation (JDRF) is a non-profit
organization founded in Canada in
1974 by parents of children with Type
Jeff Matthews
Juvenile diabetes research Foundation
1 diabetes that is dedicated to finding
a cure through cutting-edge research
and discovery. JDRF is a formidable
balancing act, a worldwide alliance
that currently supports researchers
in over 22 countries, including more
than 40 human clinical trials. As the
world’s largest sponsor of Type 1 diabetes research, JDRF’s success stems
from its unique model for funding
research, one which capitalizes on
the combined passions of members of
the medical research community and
families stricken with the disease.
Canadian breakthrough
Canada, in particular, holds a unique
place in the world of diabetes. Since
1922, when Banting & Best first discovered insulin, Canadian scientists
have remained at the forefront of
research into Type 1 diabetes. This
country’s historically strong focus
on basic research in diabetes, coupled
with investments made by non-profits like JDRF have resulted in a robust
pipeline of diagnostic, preventative
and therapeutic opportunities whose
potential to forever change the face of
diabetes is limited only by our ability
to test them in human clinical trials.
For recognition of this fact, one needs
to look no further than the recent
announcement of a partnership
between JDRF and the Government
of Canada to create a wide-ranging
clinical trial network that will expand
Canada’s capacity to push forward to
a cure.
new technologies and
treatments
The JDRF Canadian Clinical Trial
Network (CCTN), initiated through
a $20 million-investment from the
Federal Economic Development
Agency for Southern Ontario and an
additional $13.9 million contributed
by JDRF will help bring new diabetes
technologies and treatments to the
marketplace and build new infrastructure to support wide-ranging
clinical trials in this country.
“The JDRF Canadian Clinical Trial
Network is an incredible opportunity for Canadian researchers and
families living with diabetes,” says
Andrew McKee, President and CEO of
new approach
needed to tackle diabetes
With an aging and growing
population, rising rates of obesity, increasingly sedentary
lifestyles (particularly among
young people) and 80 percent of new Canadians coming
from populations at high risk,
the rising prevalence of diabetes in Canada is dramatic and
alarming.
Today, more than nine million Canadians live with diabetes or prediabetes. Not only are the rates of diabetes
growing rapidly, the disease is associated with serious complications such
as heart attack and stroke, kidney disease, blindness, limb amputations and
premature death.
What we need is a significant shift:
in government approach, private sector involvement and most of all, widespread personal and societal change.
We understand that you can’t manage
what you don’t measure, which is why
we launched the Canadian Diabetes
Cost Model in 2009. This tool calculates
the prevalence and economic burden
of diabetes in Canada. The current
economic impact of diabetes is $12.2
billion annually in Canada—a figure on
track to reach $16.9 billion by 2020. This
year, we have rolled out provincial Diabetes Cost Models in New Brunswick,
Ontario, Alberta and British Columbia
with a further roll-out for all other
regions taking place in the weeks to
come.The provincial models help us to
further understand the economic and
human impacts of diabetes and support the development of focused and
comprehensive action plans.
The Canadian Diabetes Cost Models have revealed a need for targeted
investments in improving access to
diabetes healthcare services, education,medications,devices and supplies
and financial support: all key elements
in the prevention of diabetes and the
serious associated medical complications.
As powerful as this information
is, the Models do not account for the
six million Canadians living with
prediabetes—50 percent of whom will
develop type 2 diabetes and many of
whom will experience diabetes-related
complications even before a diagnosis.
The Canadian Diabetes Association
is committed to advancing and sharing
diabetes knowledge and empowering
all Canadians to protect their health.
MiCHAEL CLOuTiER
President and CEO
Canadian Diabetes Association
Jennifer McEvoy
Juvenile diabetes research Foundation
JDRF. “The network will give ordinary Canadians early access to cutting
edge technologies and therapies by
participating in clinical trials. It will
also bring welcome relief to Canadian
researchers, as it finally begins to
release the long-standing bottle neck
that exists between laboratory discovery and advances in patient care.”
Developments such as this serve to
remind us that World Diabetes Day
is not so much a day to consider the
terrible toll this disease has on our
children and our society as a whole,
but a day to reflect upon the enormous progress made towards a cure,
and to look toward the not-too-distant future, when the efforts of thousands upon thousands of doctors,
scientists and ordinary Canadians
alike are finally rewarded with
a cure.
diAbeteS
1St editiON, NOveMber 2010
Managing Director: Gustav aspegren
[email protected]
Editorial Manager: Jackie McDermott
[email protected]
Title Developer: David Shoemaker
[email protected]
Responsible for this issue:
Publisher: Christianne Cruz
[email protected]
Designer: Penelope Graham
[email protected]
Contributors: anna Belton, Lori Berard, Dr.
Chris Cobourn, Michael Cloutier,trisha Dunning, Judi Ferne, Nick Jonas, Karen Kemp,
Kim Lok, Damien Lynch, Jeff Matthews, Kristin McEvoy, Helen McGuire, Kelsey O’toole,
Barbara Pasternak, Dogs4Diabetics, International Diabetes Federation
Distributed within:
National Post, November 2010
this section was created by Mediaplanet and
did not involve the National Post or its
Editorial Departments.
Mediaplanet’s business is to create new customers for our advertisers by providing readers with high-quality editorial content
that motivates them to act.
?
DON’t MISS!
Looking for more info?
The Association continues to fund Canada’s best diabetes researchers in areas
such as insulin innovation, complications, special populations, prevention,
management and the search for new
treatments for all types of diabetes.
The Association also puts information into the hands of Canadians with
tools such as the online Healthy Living Series and by adapting essential
information for high-risk groups.
For example, we recently unveiled
new nutrition tools for Canadians of
South Asian descent, helping them
to enjoy their favourite foods while
achieving target blood glucose levels
and reducing the risk of developing
complications.
It is time to put people living with
diabetes and their families at the
centre of structured support systems and programs which empower
them to manage their health. Preventing diabetes and keeping Canadians with diabetes healthy will
cost the government, the private
sector and society far less in the
long-term.
Visit diabetes.ca to learn more
about diabetes and how you can
protect your health through tools
such as the Healthy Living Series.
Be sure to also go online to see the
stories of incredible supporters this
November during Diabetes Awareness Month—people who are living
healthy with diabetes, advocating
for the cause and breaking ground
towards a cure.
not online?
Call 1-800-BANTING (226-8464).
World Diabetes Day
To learn more about the 2010 World
Diabetes Day campaign,visit
worlddiabetes.ca or join the World
Diabetes Day Canada Facebook
page:
facebook.com/WDDCanada.
Disclaimer: The Canadian Diabetes Association
has neither reviewed nor endorsed the remaining contents of this Diabetes supplement.
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt
NOveMber 2010 · 3
neWs
Catching the early signs
Early diagnosis followed by individualized self-management
education is essential for
children with diabetes and
their families.
The symptoms can be mistaken for the
symptoms of other illnesses such as flu
or gastroenteritis. Children and adolescents are in a time of rapid growth,
varying sleep patterns and increasing
independence. These normal changes
may result in symptoms that are common to more than one disease making
it difficult for families to recognize
diabetes.
Educating parents, families, community workers and school personnel
about the early signs of diabetes is key
to early diagnosis. The early signs of
diabetes, like drinking more, urinating
more often and having less energy than
usual can be difficult to detect. Children are not usually in the presence of
their parents all hours of the day. How
would a parent know how often a child
drinks or goes to the bathroom when at
school? After diagnosis, parents often
say the signs were there but they just
didn’t associate them with diabetes.
Once a child is diagnosed, there is
a lot to learn. Parents, grandparents,
and close family should all be involved.
The child also should be involved in
his or her own care to the extent possible determined by age and maturity.
People who are with the child need to
be educated as well, such as teachers,
babysitters, extended family, coaches,
and parents of friends. They should all
understand the basics, particularly
recognizing and treating hypoglycaemia and knowing who to call in an
emergency.
Education may have to be taken
slowly and repeated once the first crisis
has passed.Children often come to terms
with diabetes before the family does.
anne BeLTOn
rN, bA, Mde, Cde
TRiSha DUnninG
rN, phd
[email protected]
4 · NOveMber 2010
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt
personal InsIGHt
Diabetes: a big part of who I am
W
hen I was
27, my life
changed forever while
traveling
back home
to Vancouver,following an emergency flight landing in California.
I was hospitalized and diagnosed
with Type 1 Diabetes. (My blood glucose
reading was 58 mmol - normal reading
is 4-7 mmol.) I nearly died.
When transferred to the Vancouver
Hospital, I met two women with Type
1diabetes who inspired me. One was an
82-year-old patient and the other was
my nurse, Heather. They both said that
anything was possible and now I know
that everything is possible!
At that time I was somewhat familiar with diabetes, since my older sister
had Type 1. However, I could never have
imagined what lay ahead. Living with
LEaRNING tO COPE
Karen Kemp
diabetes resource Manager
diabetes entails between four to eight
blood glucose tests daily, numerous
insulin injections,(my most challenging) constant carbohydrate counting, daily exercise and living with an
ongoing fear of the unknown. Along
with having a teenage daughter, I fear
for what the future holds.
To better manage my diabetes, I
started using an insulin pump in 1991.
It is like a computerized pancreas, preprogrammed to administer dosages of
insulin. I test my glucose levels before
eating and the reading is automatically
transmitted to the pump. My carbohydrates are entered into the pump which
then calculates the insulin required.But
stress,remaining sedentary for too long
or engaging in prolonged or unplanned
exercise can seriously affect my glucose levels and it needs to be monitored
closely.
Keeping a close eye
By maintaining good control, I have
managed to avoid many of the complications often associated with this disease. I now wear a Medtronic Continuous Glucose Monitoring system which
sounds an alarm when my glucose level
falls outside my target range.While not
totally infallible, it does reduce my fear
of going to sleep and not waking up.This
fear is very real to many of us who are
insulin-dependent and is of particular
worry to me as I lost my sister to this
when she was 29.
Making a difference
In addition to being an ambassador
for CDA, volunteering with JDRF,
coordinating Sweet Beat Walkers and
co-founding Diabetes Action Network, I get immense satisfaction from
working directly with individuals
living with diabetes. As the Diabetes
Resource Manager at White Cross
Dispensary & McNeil Pharmacy in
Ottawa, I emphasize that the key to
controlling diabetes is to “Test, not
guess!” Failure to do so allows diabetes
to control your life. Equally important is to educate your family, friends,
and co-workers about diabetes; show
them how to help you in the event of
low blood sugar. Also, when a family
member has diabetes the best support
one can give is for everyone to follow
the same diabetes healthy lifestyle.
Having Diabetes can be scary, but
I feel I have made the right decisions
to cope with this disease. And since
meeting those two women in Vancouver who inspired me, I love life and
appreciate every day as a gift.
November 14th is World Diabetes
Day. I challenge all readers to “Live a
Day with Diabetes.” Exercise for 20-30
minutes, alter your diet by reducing
high glycemic foods,count your carbohydrates, test your blood glucose, (if
possible) and log your food intake.
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt
InspIratIon
NOveMber 2010 · 5
2
TiP
Question: How does Nick Jonas, member of the band Jonas Brothers, manage his
diabetes and his busy touring schedule?
Answer: With support from his family and crew and his own constant
vigilance, he juggles his health and his life on the stage.
It can happen to anyone
ALWAyS KEEP
EXTRA TESTinG
SuPPLiES On
HAnD
t
- When were you first diagnosed
,with diabetes, what was the
w first thought to go through
your mind?
y
t I was diagnosed with Type 1 diabetes
w when I was 13 years old. When I first
found out I had Type 1 diabetes, I was
t afraid and thought ‘why me?’ Then I
thought, ‘why not me?’
e I quickly decided I was not going
to let diabetes slow me down. I stay
d positive, eat right and check my
blood glucose level several times
each day so I can make better decia sions that help me stay in range.
0 Learning how to give myself insug lin was also very important in my
everyday understanding of my diaf betes. My family has been very supportive and they made sure I never
felt like I was alone.
What symptoms did you have
and when did you decide it
was time to go to the doctor?
it, like food, exercise and emotions. I
monitor my blood sugar sometimes
up to 12 times a day with my Bayer
CONTOUR USB meter.
I make sure my family and crew
have extra testing supplies on hand
while I’m on tour so I’m always prepared if I’m in a rush to get on stage.
The meter I use plugs into my computer, wherever I am. The technology
makes monitoring my blood sugar,
logging the results and sharing information with my doctor an easier process for me, especially with my busy
schedule. I can quickly see my recent
blood sugar levels and trends and
share them with my doctor from the
road.
A month or two before I was diagnosed, I noticed I was always thirsty,
I was losing weight and I was irritable.
I lost about fifteen pounds in two to
three weeks.
I took some time off from touring
to see a doctor. The doctor sent me to
the hospital after she heard all of my
symptoms. My blood sugar was over
700,which is very, very high.
Has it been difficult managing
your hectic schedule on top of
the demands of diabetes?
Life can be complicated when you
have diabetes, especially when I’m
on the road for extended periods of
time. It’s important to know your
blood sugar level and what impacts
nick Jonas
Jonas Brothers
PHOtO: MaRY ELLEN MattHEWS
What advice can you offer
readers with Type 1 and Type 2
diabetes?
Stay active and stay positive. Build a
support team with your doctor, family
and friends and know that diabetes is
nothing to be embarrassed about. Go
online, read as much as you can. If you
go to my website, NicksSimpleWins.
com, there’s a lot of great information
about diabetes and ways you manage
it.
Why did you decide to go
public with your diabetes?
Having the support of my family was
definitely a big part of getting through
the first couple of months with diabetes. It’s important that other people
with diabetes don’t feel like they are
alone and my work with Bayer helps
me do that. Nearly every day I hear
from someone like me who says that I
make them feel it’s OK to have diabetes
and that’s really cool that I can do that.
Diabetes
for
life?
we beg to differ
“even some healthcare professionals are
amazed when we tell
them that diabetes can
be reversed through
weight loss.”
Dr. Chris Cobourn
Medical Director,
Surgical Weight Loss Centre
That the symbol for diabetes is
a blue circle is highly ironic: it
holds the same shape as a
device that can put it into
remission.
The device,an unassuming band with an
inflatable ring on one end and an access
port on the other, is called a Lap-Band or
laparoscopic gastric band and it has been
used throughout the world for more than
a decade as a well-established method
of weight loss. But what is perhaps less
known is that it has also been shown to
improve and even eliminate type 2 diabetes.
While the Lap-Band officially received
Health Canada approval as a treatment
option for type 2 in late 2008, the evidence had been mounting long before
that.Data published in The Journal of the
American Medical Association in early
2008 showed that 73 per cent of patients
with type 2 diabetes experienced remission of their symptoms within 2 years –
exciting news for patients who have long
struggled with its debilitating complications.
“Even some healthcare professionals are amazed when we tell them that
diabetes can be reversed through weight
loss,” says Dr.Chris Cobourn,Medical Director of the Surgical Weight Loss Centre
(SWLC) in Mississauga, a clinic that specializes in the Lap-Band procedure. “It’s
well accepted that the risk of diabetes
increases as weight increases, but there
still seems to be an element of surprise
when we tell them that the opposite is
also true: that diabetes can be reversed
with weight reduction.”
As the name suggests, the Lap-Band
procedure is laparoscopic in nature and
as such, is minimally invasive offering
a fast recovery time. In fact, surgery can
usually be completed at the clinic in
less than an hour with the patient going
home the same day. The procedure is
relatively simple.The surgeon places the
band around the upper portion of the
stomach which causes the patient to feel
satisfied earlier and longer with smaller
portions of food.This increased satiety in
turn,allows the patient to lose weight at a
safe rate and,more importantly,it allows
them to sustain that weight loss.
In order to maximize success, longterm follow up is crucial.Surgical Weight
Loss Centre, for example, ensures that
patients have ongoing access to professional support throughout their weight
loss program, not just on the day of surgery.
The Lap-Band may not be right for
everyone,however,and it is certainly not
a magic bullet.Patients must be committed to returning to the clinic or a local
affiliate for regular adjustments until
their weight loss goals are achieved.They
must also be committed to changing
the way they eat, making it a habit to
eat slowly and chew their food well. But
these are small concessions to make
when you consider the potential rewards
of diabetes remission, improved quality
of life, and restored self-confidence to
name a few.
To be sure, there are some risk factors that are beyond our control when
it comes to diabetes, but excess weight
doesn’t have to be one of them.A surgical
solution just might be the answer you
never knew you were looking for.
To find out if the Lap-Band might be
right for you, book a consultation with
one of SWLC’s surgeons today.
Call 1-888-285-7185 or visit www.lapband.ca.
paid for by Surgical Weight Loss Centre
6 · November 2010
AN independent SUPPLEMENT by mediaplanet TO THE NATIONAL POST
panel of experts
Helen McGuire, MHSc CDE
Senior Diabetes Education &
Health Systems
Specialist, IDF
Barbara Pasternak
Founder,
Diabetes Hope Foundation
Judi Fern
Cure Diabetes
Kim Lok
Living with diabetes
Question 1:
What is your best advice for
people with pre-diabetes?
The development of Type 2 diabetes
occurs over time and pre-diabetes is an early
stage of the disease; therefore everyone with
pre-diabetes is at high risk of developing
diabetes. The best advice that I can give is to
take the diagnosis seriously and take action.
This is an opportunity to examine your lifestyle and identify the changes you need and
want to make to improve your health such
as increasing your activity, managing your
weight,and eating a balanced diet with lots of
vegetables.These changes can help to prevent
or delay the diagnosis of diabetes. Take this
opportunity—you may end up feeling better
than you have in a long time.
Pre-diabetes is a serious ailment that
can be treated and often reversed simply by
making an adjustment to lifestyle and avoiding certain foods. Blood sugar levels may
return to normal ranges after the incorporation of exercise and diet modification.
People with pre-diabetes have blood sugar
levels that are higher than normal but not
high enough to be diabetes. If you are prediabetic, you’re at risk of developing Type 2
diabetes and the complications that come
with it. Losing weight, exercise and limiting
food portion sizes help with pre-diabetes, but
you need a diet plan that fits your needs and
lifestyle.
Know that you have tremendous influence
over your health. Learn early how to eat and
live in healthy ways that support steady blood
sugar levels. Learn as much as you can about
diabetes and its management to help prevent
its onset and to ensure a smoother transition
if it does. Reach out to community resources
for support—your local diabetes care centre,
others with diabetes and local charities can
make your journey much easier.Above all,
keep setting and reaching for your goals in all
aspects of your life.
Question 2:
Why is healthy eating and
physical activity key for people
with diabetes?
Managing diabetes has often been
described as a balancing act. With the help of
their health care team, people with diabetes
need to manage their blood glucose,blood lipids and blood pressure in order to prevent or
delay complications. Medications can help to
keep these factors in the target range but food
and activity play a very important role. The
food we select and the amount we eat affects
how high our blood glucose rises after a meal
and how long it remains above target. Activity helps to lower blood glucose. Balancing
the quantity that we eat with the amount
we exercise is also important to achieve and
maintain a healthy weight. Choosing the
right amount and selection of food along
with regular activity are key to the prevention of complications related to diabetes.
Research demonstrates that along with
healthy eating habits, regular physical activity
helps the body to use insulin better,which helps
to improve the symptoms—or even reduce the
risk—of Type 2 diabetes and reduce complications for Type 1. In many cases, you can control
and possibly reverse Type 2 diabetes through
better nutrition,weight loss,increased physical
activity,and regular checkups with your health
care team. Physical activity has an insulin-like
effect—it can help lower blood sugar levels.
Eating right is one of the challenges along with
checking your blood sugar regularly, taking
your medication correctly, and exercising as
your doctor recommends. Choosing the right
amounts of appropriate foods to eat doesn’t
have to be difficult; it just takes an understanding of food groups and some planning.
The continual management of blood
glucose levels is paramount for people
with diabetes to avoid, for as long as
possible, the complications that can arise as
the disease advances. Managing diabetes is a
constant juggling act that requires patients
to balance diet, nutrition and exercise to
achieve optimal blood sugar control. For
many patients,an insulin pump is an important tool in balancing it all,and we at Cure Diabetes strongly support their use.
Question 3:
What is the future of diabetes
care?
By 2030 it is estimated that half a billion
people will have diabetes worldwide and the
greatest increase in prevalence is currently
found in low income countries among the
most vulnerable populations. The future of
diabetes care will be determined by the decisions and actions that each one of us take
now. Will we use the knowledge, skills and
technology we currently have to improve outcomes for people with diabetes, prevent the
onset of diabetes and eliminate discrimination against those with diabetes? Time will
tell. We must act now.
With recent advancements in technology, drugs, and stem cell research, the future
of diabetes care is certainly looking more positive. Advances in stem cell therapy will eventually lead to a cure, but until a cure is found,
the focus is on new and improved technologie.
The implantable insulin pump with continuous glucose monitor for just-in-time readings
will allow better control of the blood glucose
levels, no more schedules to follow and will be
much easier to maintain. Faster-acting insulin
will help prevent long-term complications and
provide for a better life for all people living with
diabetes Until there is a cure…I am certainly
looking forward to a future without diabetes for
my children and for all children living with the
challenges of diabetes.
Diabetes is an epidemic and requires
renewed emphasis in research in the
areas of patient care, prevention AND a cure.
The costs of this disease to patients and their
families and to our health care system are
too high. At Cure Diabetes, we believe in supporting optimal care for patients living
with the disease, such as the use of insulin
pumps and frequent blood sugar testing. But
we also believe strongly in continuing to fund
research into treatments that will provide a
cure for this disease, for once and for all.
One in four Canadians either have diabetes or
pre-diabetes, the latter which, if left unchecked, leads to
Type 2 diabetes.
An under-recognized
but manageable disease
For many, Type 2 diabetes is
linked to genetic factors, a
sedentary lifestyle and being
overweight.
However, Cheng stresses that glucose control is just one component of
management. A person with diabetes
also has to monitor their blood pressure and cholesterol levels. “A complete diabetes management program
must monitor all three,” she adds.
According to the 2009 National Diabetes Surveillance System report from
the Public Health Agency of Canada,
Type 2 diabetes is one of the fastest
growing diseases in Canada with
more than 200,000 new cases yearly.
Nine out of ten people with diabetes
have Type 2 diabetes.
In Canada, the cost of diabetes this
year alone is about $12.2 billion,nearly
double its level in 2000. Diabetes is
expected to cost the Canadian economy $16.9 billion by 2020.
What is diabetes?
Diabetes (diabetes mellitus) is a metabolism disorder. Our bodies metabolize
digested food for energy and growth.
Most of what we eat is broken down
into glucose.
However,our cells cannot utilize glucose without the presence of insulin,
a hormone produced by the pancreas.
After we eat, the pancreas automatically releases an adequate quantity of
insulin to move the glucose present in
our blood into the cells.This lowers the
blood sugar level.
When a person has diabetes, the
quantity of glucose in the blood is too
high (hyperglycemia). The body either
does not produce enough insulin, produces no insulin, or has cells that do
not respond properly to the insulin.
This excess blood glucose eventually
passes out of the body in urine.So,even
though the blood has plenty of glucose,
the cells are not getting it for their
When goals are not achieved
Daily routine
Regular management of
diabetes is needed in
order to reduce the risk of
complications.
essential energy and growth requirements.
Consequently, a classic symptom
of patients with diabetes is fatigue.
Other common symptoms include
frequent urination, unusual thirst and
unexplained weight loss.
The other major concern is the long
term effect, explains Dr. Alice Cheng,
endocrinologist and Assistant Professor at the University of Toronto. “Long
standing high blood sugar levels can
result in problems with the eyes, kidneys, nerves, feet, and increase one’s
risk of heart attack and stroke,” she
says. Canadian Diabetes Association
(CDA) figures also show that four in five
patients die from heart attack or stroke.
The importance of early
management of diabetes
It is not all doom and gloom with
diabetes though. The good news is
that there is a lot a person can do to
help themselves. Type 2 diabetes can
be prevented or postponed by making lifestyle choices like following
a healthy diet emphasizing whole
grains, fresh vegetables and fruit and
being physically active every day.
“The importance of early management lies in our ability to reduce the
risk of diabetes complications. We
have very good data to show that the
earlier we achieve control, the better
people do,” Cheng says.
The glycemic goals (sugar goals) as
recommended by the CDA includes a
haemoglobin A1c level be maintained
at 7 percent or less. (The A1c blood
test indicates blood glucose levels in
the preceding three months). The
association also recommends that
patients with diabetes aim for blood
glucose readings within the range of
5-10 mmol/l two hours after eating.
Fasting glucose readings should span
4-7 mmol/l.
There are a number of potential
explanations when goals are not
achieved. These factors go beyond the
medical model and include the other
aspects of a patient’s life.
The patient’s support network
of family and friends are critical
in allowing them to make the lifestyle changes that are needed. Other
times, the reasons are underpinned
by locality—“Some patients may not
have ready access to fresh fruits and
vegetables, or they cannot access the
healthcare system. These are factors
that do play a big role in explaining
non-compliance,” says Cheng.
In some cases,patients may become
frustrated by the fact that the medications they are taking to help them
may have some bothersome side
effects. Hypoglycaemia, or low blood
sugar, and weight gain, are common
complaints. Fortunately, there are
new options for treatment which can
address some of these issues. However, public access remains a factor,
and a deterrent for patients without
options, Cheng acknowledges.
“Treatments aren’t cheap, but they
are becoming more effective.”
Do patients care?
Yes, says Cheng. “By virtue of them
coming to see me indicates to me that
they are motivated to manage their
diabetes.
“The sobering thing is that for every
patient I do see, there are several
others who should be under a doctor’s
care and aren’t, or who don’t know
they have the condition.
“Please see your healthcare team
and ask about your blood sugar,” she
says.
Damien Lynch
[email protected]
Facts
There is no single cause of
Type 2 diabetes but some factors can put you at greater risk.
■■ Being age 40 or over; being
overweight (especially with abdominal obesity); having a close
family member who has diabetes;
■■ having had gestational diabetes; and/or having given birth to
a baby that weighed more than 4
kg (9 lb) at birth;
■■ high blood pressure; high
cholesterol or other fats in the
blood; or member of a high-risk
ethnic group.
■■ Aboriginal people have three
to five times the risk of developing Type 2 diabetes than other
Canadians.
■■ People of Hispanic, Asian,
South Asian or African descent
are at higher risk of developing
Type 2 diabetes.
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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt
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3
DON’t MISS!
diabetes pet
companions
Philip and Edie
Philip Normington, who goes low
every day and has lost the ability to
recognize his own levels, was stuck
with regular stick testing before he
was teamed with Edie, a Labrador
Retriever, in November 2007. “Edie
has brought comfort and companionship into my life, and my family’s
concern,” says Normington of his
faithful canine friend. On January 30,
2008,Edie saved his life when she was
unable to revive him from a diabetic
coma. By locating his wife in another
part of the house and alerting her,
Edie ultimately saved the day.
Lawton and the
Schumacher family
PET PREVALEnCE
in Canada, an average of
four in 500 dogs are
diabetic.
PHOTO: SHANNON WHEATLEY
Diabetes in
pets is on the rise
Diabetes in pets, just as it is in
humans, is on the rise.
especially urinary tract infection
Diagnosis of diabetes mellitus
Signs of pet diabetes
,■■Excessive urination and/or inapt propriate urination in the house
■■Increased thirst and appetite with
y weight loss
■■Weakness and lethargy
■■Lowered resistance to infection—
r
TiP/STEP
TiP
yOuR DiABETiC
PET nEEDS A
HEALTH TEAM
AnD STRATEGy
In Canada, an average of eight in 50
cats, and four in 500 dogs are diagnosed with diabetes—however this
number may be higher due to nondiagnosed animals!
Pet diabetes is caused by a lack of
available insulin in your pet’s body
due to insufficient production by the
pancreas, or failure of the body cells
to respond to insulin, or both. In a
healthy dog or cat, glucose is absorbed
from the gastrointestinal tract into
the blood and needs to enter the
body cells to provide energy. Insulin transfers the glucose from the
bloodstream into the body cells. In
a dog or cat with diabetes, the pand creas produces insufficient amount
of insulin for this to occur, resulting
e in high blood glucose concentrations.
n
m
NOveMber 2010 · 7
If you suspect your pet may be
suffering from diabetes, take them to
your veterinarian for a general examination. Your veterinarian will check
your pet’s general health to rule out
the presence of other diseases and/or
infections. He or she may also conduct
the following tests:
■■Urine samples (To determine if
there is glucose in the urine and/or a
urinary tract infection.)
■■Blood samples (To confirm the diagnosis and determine the blood glucose
concentration in your dog’s blood. If
the blood glucose concentration is
consistently higher than normal, it
may indicate that your dog’s pancreas
is not secreting insulin.)
Treatment
You can successfully manage your diabetic pet’s health with insulin therapy, proper diet and exercise.
The majority of pets with diabetes
mellitus, just like humans, will need
insulin injections once or twice a day.
Your doctor will determine the dose
that’s right for your pet and teach you
everything you need to know about
administering the injection and monitoring your pet’s blood glucose level.
Based on the improvement of the
clinical signs and blood glucose levels,
your veterinarian will adjust the dose
until the correct dose is established.
This time period can vary from weeks
to months.
Living with your diabetic pet
Following a regular routine, as recommended by your veterinarian, is vital
for successful diabetes management.
Well-controlled diabetic pets enjoy a
good quality of life for many years.
Monitoring your pet’s blood
glucose level
You may be asked by your veterinarian
to monitor your pet’s clinical signs as
well as to regularly check the glucose
concentrations in urine and/or blood
samples using a handheld glucose
meter. Based on your findings, your
veterinarian will be able to make
the right decision about the insulin
dose your pet is receiving (increase,
decrease or maintain). It may help
to choose one insulin caregiver per
household and/or to mark on a cal-
endar when to give the injection and
whether it has been given or not.
nutrition and diet
In addition to insulin therapy, your
diabetic pet will also require a consistent feeding schedule. Your veterinarian will most likely recommend
a specialized diet that will help control diabetes symptoms. Always ask
your veterinarian before making any
change to your diabetic pet’s diet.
Exercise
Regular exercise is important for diabetic pets as it uses energy and helps
to maintain a good body condition. In
addition, exercise may improve insulin absorption.
The good news is that, although Pet
Diabetes is a serious disease, when
diagnosed early and correctly, it can
be managed successfully without too
much difficulty. With proper treatment and care there is a good chance
of a healthy life and normal lifespan
for your pet.
Courtesy of infovet.ca
Meri Schumacher’s three youngest sons have T1. One night their dog
Lawton alerted Meri as the boys were
biking. Dinner had been consumed
only minutes before, so she let it go
thinking Lawton wanted treats. The
dog refused to give up and jumped
in front of her son Ben’s moving bike,
then put his head in Ben’s lap and
kept pace beside the bike. Realizing
the sign,Meri yelled,“Ben check your
sugar!” He was at 72. “Lawton is on
FIRE!” says Meri of her dog, who is
consistently bang on with his alerts.
Marjo Mikkola and her feline
companion, Maru
Marjo and Maru
Marjo Mikkola’s cat, Muru, is 13 years
old, and was diagnosed with diabetes
last June. Muru lies on Marjo’s lap
for her glucose test and injection.
“Whenever it is time to give her the
insulin, I whistle and she comes to
me,” says Marjo, who never questioned the process. “Muru deserves
many more years of healthy life.”
Marjo suggests pet owners not hesitate in finding a diagnosis, and she
finds administering insulin is easier
than giving a pill. Muru’s activities
haven’t changed either—she is still
playful and loves to be cuddled.
Terry and norm
Terry O’Rourke has had T1 for 26 years,
has lived most of his life alone,and had
made peace with dealing with his disease on his own. However,Terry went
to a presentation about Dogs4Diabetes and realized “what they offered
was someone to share the ceaseless
burden that diabetes represents.”
Terry was paired with Norm,who has
enhanced his life in so many ways.
“Meeting his needs provides me with
an outlet to focus outside of myself,”
explains Terry who says Norm always
reminds him to observe the joy in the
here and now.
an important member
of your diabetic pet’s health team
SHOWCaSE
e
■■ Question: Your pet’s doctor has
diagnosed your four-legged comhpanion with diabetes. What’s next?
m■■ Answer: as a valued member of
your family’s health care team, your
veterinarian will give you all the information and guidance you will
need in order to effectively manage
your pet’s condition.
Managing your pet’s diabetes will
involve a customized treatment
strategy. Amongst other treatment recommendations, diet and
exercise will likely be included as
part of your pet’s treatment plan.
To ensure a healthy lifestyle, the
Canadian Veterinary Medical Association generally recommends that
dogs should have at least 15 to 20
minutes of exercise at least three
times a day.Cats should have the same
amount of activity twice a day.
Treating diabetes is possible and
requires commitment from a pet owner.
Following up with recommended
re-evaluations and ongoing therapy
adjustments is essential in order to
provide adequate care. If you have questions,your veterinarian and their veterinary health care team is always there
to help.
With good care, dogs and cats can
have a good quality of life, and though
the diabetes is not cured, therapy
allows the pet to lead a normal life.
FaCtS
The Canadian Veterinary
Medical Association (CVMA) is
the national professional
association for veterinarians in
Canada.
Carly took comfort in her new puppy,
Cuddles.
■■ Preventative care is important.
Your pet should see your veterinarian at least once each year.
Carly and Cuddles
Since its inception in 1948, the CVMa has been the national voice for
the veterinary profession, dedicated to serving and representing
Canada’s veterinarians. the association is committed to excellence
within the profession and to the
well-being of animals. It promotes
public awareness of the contribution of animals and veterinarians to
society. Here are their tips:
■■ Monitor your pet’s behaviour and
call your veterinary hospital if something isn’t
normal.
■■ Schedule your appointments and
be on time. If you have an emergency, call ahead to let the staff know
you’re coming and ensure
your veterinarian is available to help.
Carly was diagnosed at 10 year old.
“As a child, it is so difficult for them
to express themselves,” explains her
mother,Denise,“but having the power
of love changed so much for her.” Cuddles, Carly’s new puppy, became the
highlight of her summer instead of the
devastation of her diagnosis.Getting a
puppy was a purely positive experience and, “if you can handle diabetes,
you can handle the responsibility of a
pet,” says Denise.Cuddles brings Carly
purpose and unconditional love.
■■ Ensure that your cat is in a carrier
and your dog is on a leash.
■■ Visit www.canadianveterinarians.
net for more info.
[email protected]
KRiSTen mceVOy,
CvMA
[email protected]
KeLSey O’TOOLe