Where the disease is most prevalent in Ontario, resources to treat and promote healthy lifestyles often most sparse, specialist says

It could be dubbed a diabetes catch-22.
In pockets of Ontario where the disease is so prevalent, resources to treat and promote healthy lifestyles to nip some forms of diabetes in the bud are often most sparse.
“So, if you're in downtown Toronto, you can probably get to a dietitian or diabetes educator who can advise you about your risk and help you get going on a lifestyle program … Those resources are so much less available in the North,” says Dr. Jan Hux, chief science officer for Diabetes Canada.
North East Local Health Integration Network (LHIN) figures have suggested that at least 12 percent of Northeastern Ontario’s population is affected by the often debilitating and sometimes fatal disease, compared to some 10 per cent of Ontarians. Statistics are even more “staggering” for those living along the Hudson Bay and James Bay coast, where some 24 per cent of the population lives with diabetes.
Many “high-risk” communities, where there are “large pockets” of low-income neighbourhoods, are often dogged with limited access to recreation opportunities.
“They can't afford the gym membership, they can't afford the running shoes, they can't afford the babysitter,” Hux told The Sault Star in an interview from Toronto. “So, (opportunities) may be there, but they're not accessible to them.”
About 90 per cent of diabetes cases are Type 2, which may be managed through physical activity and meal planning, or may also require medications and/or insulin to control blood sugar more effectively. Type 1 diabetes is always treated with insulin. Meal planning also helps to keep blood sugar at proper levels.
Meal planning, though, may be easier said than done, due to both economic and geographic barriers.
Food “security” is a “big challenge” in the North, Hux said. And the more north, the more profound the problem.
“Well, good luck on that if you live in an Indigenous community where it's just a fly-in community where Coca-Cola is 99 cents for a big bottle and it's $12 for a bag of milk and the apples are scabby and are $18 a pound,” Hux said. “(Remote residents) know they should be eating healthy, but they can't access the resources to do that.”
Hux applauded Ontario government expenditures toward diabetes prevention and education, but contended officials have yet to create solid standards of “what they want to see happen with that investment.”
The province, she contends, must set higher benchmarks for getting the population more up to speed on diabetes risk.
The Centers for Disease Control and Prevention in the U.S. suggests 90 per cent of people with prediabetes, the point where it's still preventable, don't know their status; there’s no such Canadian data, Hux said.
“So, should the government set standards for itself in terms of what are we going to achieve in terms of awareness, what are we going to achieve in terms of the number of people treated, what are we going to achieve in terms of the number of people having good outcomes …?” Hux said. “Sure, we want to see more investment, but we also want to see more accountability for that investment, so that investment is achieving what it's intended.”
All levels of government, including municipal, can help foster environments in which healthy living is made easier and available to more.
Water bottle refill stations at public arenas can be effective, said Hux, adding she scratches her head at the sight of schoolyards where outdoor play equipment is chained up following regular school hours, strictly for liability reasons.
“Well, do you want to be liable for 30 per cent of your children developing diabetes, or do you want to be liable for somebody skinning their knee?” she said.
These and many other issues have been on the front-burner during November, Diabetes Awareness Month.
A recent forum in Toronto, in which the emotional, physical and financial impact of nighttime hypoglycemia were discussed, heard from Dr. Roberta Bondar, a neurologist from Sault Ste. Marie and Canada's first woman in space.
Bondar shared personal anecdotes of time alone in the dark in space to drive awareness of nighttime hypoglycemia, the most common adverse effect associated with intensive insulin therapy. The condition’s severity varies from confusion and numbness to coma and seizures.
“When you get a renowned, brilliant person willing to align herself with diabetes and our cause, I think that says, 'No, this isn't something to hide in the closet about or be ashamed of,’” said Hux, who attended the event. “It's an important issue and important people are willing to speak to it.”
jougler@postmedia.com
On Twitter: @JeffreyOugler