For the health of it

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This article was published 02/10/2017 (3248 days ago), so information in it may no longer be current.

Samantha Olea has had more than her fair share of health challenges. At age 10, she was diagnosed with acute myelogenous leukemia. After radiation therapy, chemotherapy and a bone-marrow transplant that put the disease in remission, the blood cancer came back two years later.

Again, she persevered.

And as if life hadn’t already handed her enough — she was diagnosed with Type 1 diabetes. Having cancer as a child — twice — was a harrowing and difficult experience, but coping with diabetes and its symptoms as an adult has been just as difficult, in the sense it’s a condition she must grapple with for the rest of her life.

“I’ve had it for a good six years, and I feel like I don’t have a good grasp of the disease,” says the 28-year-old youth support worker at St. Amant.

Learning to manage her blood-glucose levels with insulin is a work in progress. And managing the cultural expectations she often faces as a member of the Winnipeg’s Filipino community is, too.

“With our culture, we’re all about food — having good food around makes for good company,” she says.

Like many cultures, food is deeply enmeshed in Filipinos’ sense of community and norms; saying ‘no’ can be tricky.

“You are expected to respect your elders and be polite, and so when being offered food, eating it is another way to show respect,” she says. “To not eat what’s offered is looked at as kind of insulting.”

Olea is likely not alone in this experience. Although Type 1 diabetes remains relatively rare, the Filipino community is among several ethnic groups at higher risk for developing Type 2, or insulin-resistant diabetes, the more common form of the disease.

For that reason, she is helping organize the upcoming Free Diabetes Expo: Healthy Eating/Healthy Living at the Philippine Canadian Centre of Manitoba.

“I feel like with the Filipino culture and having this expo, it can bring into perspective how the way we eat can really affect our health,” she says about the Oct. 14 event, the first of two this year organized by Diabetes Canada specifically for ethnic communities at higher risk of developing Type 2 diabetes.

The second will be held in November for the South Asian community.

“These are part of ongoing outreach where we try meet with communities and understand the needs and wants of people with diabetes or are at risk,” says Carly Kowalchuk, co-ordinator for community engagement at the Manitoba branch of Diabetes Canada.

Both cultural groups — along with Indigenous peoples, African-Canadians and people of Hispanic or Asian heritage — face a higher risk of disease regardless of other risk factors such as sedentary lifestyle and obesity, she says.

A recent U.S. study found, for example, that otherwise healthy Filipino Americans age 50 and older had a higher risk of disease than the rest of the American population.

Sherri Pockett, an endocrinology nurse clinician at St. Boniface General Hospital and a diabetes educator, says it’s not clear why these populations are more predisposed. But social factors, including food choices, can elevate the risk.

“The Filipino community tends to have a lot of rice in their dishes,” Pockett says. And, for the most part, white rice is the norm. Brown rice has more fibre, making it harder to break down in the gut, in turn allowing the carbohydrates it contains to be absorbed more slowly.

“With white rice, just a little raises blood-glucose levels quite a bit, fairly quickly,” she says.

The upside is diabetes is largely manageable. While Type 1 requires injections of insulin — the hormone normally produced by the pancreas — which signals to cells to absorb glucose for energy, Type 2 diabetes is different. People with Type 2 generally produce enough insulin, but the cells don’t respond to it well and consequently do not take in enough glucose. As a result, blood-glucose levels remain elevated for long periods. This condition is treatable with medication, Pockett says.

But it can also often be managed with lifestyle changes alone for those individuals willing to eat a better diet and exercise regularly. Moreover, a healthy lifestyle can largely prevent people from developing Type 2 diabetes.

But breaking old habits is easier said than done.

“If you’re in your 50s, sometimes trying to change 30 years of eating one way is difficult to do,” Pockett says.

Even people on diabetes medication should eat more fruits and vegetables and limit food portions, particularly for dishes high in carbohydrates such as white rice. As well, sweets are generally off-limits.

“It’s not that you can’t have treats once in a while,” Pockett says. But sugar-laden foods such as chocolate-chip cookies contain large quantities of simple carbohydrates — white sugar — that spike blood-sugar levels.

Excess glucose in the bloodstream can damage nerves, blood vessels and organs over time. This puts people with diabetes at risk of a multitude of negative health outcomes: blindness, heart attack and stroke, kidney failure and foot and leg amputations.

Pockett says amputations are the result of infections that occur from a wound, for example, on the foot. If blood sugar is not well controlled, harmful bacteria flourish.

“Sometimes it doesn’t take long before the infection spreads into the bone and then it’s very difficult to treat,” she says, adding this can lead to amputation to prevent infection from spreading, which could lead to toxic shock and death.

The potential long-term outcomes are indeed grim. But they are also largely preventable with proper treatment.

One problem for many people, however, is they have Type 2 diabetes and do not even know it — until serious health problems arise.

“The prime example is a guy in his 50s who hasn’t seen a family doctor for a while because he’s doing OK and then has a heart attack and needs a bypass,” Pockett says. “While they’re doing the bloodwork they find he’s had diabetes likely for years.”

Given what’s at stake, Olea hopes that awareness initiatives like the healthy living expo serve as powerful preventative medicine.

“It just shines light on the disease, and awareness is important if only because there are likely so many people who don’t even know they are diabetic,” she says.

 

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