Help and support for diabetics at Sharbot Lake Family Health Team

Jeff Green | Nov 12, 2009

Over three hundred patients from the Sharbot Lake Family Health Team, or 12% of the patient roster, receive counselling and other services from the diabetes team of Nurse Janice Morrow (RN, CDE) and dietitian Melissa Conrad (RD, CDE).

That makes the area served by the clinic 50% higher than the national norm, which is 8% of the population.

“It's not really surprising,” said Janice Morrow of the numbers, “considering that the average age of the population we serve is higher than the provincial average, and the incidence of Type 2 diabetes, which is the most common, increases with age.”

As a team, Morrow and Conrad help their patients self-manage their diabetes. This includes blood sugar monitoring, healthy eating, physical activity, using medications and insulin as recommended. The patients are seen regularly, for an average of 12 hours per year; this means that they are self-managing their diabetes for the other 8000 hours.

Of the approximately 900,000 people with diabetes in Ontario, roughly 30% have access to the kinds of services provided by the team. For patients in the southern parts of Frontenac County, such service is offered only at Hotel Dieu hospital in Kingston.

Although patients cannot control the aging process, the major factors behind Type 2 diabetes are lifestyle and genetics. “Genetics loads the gun, and lifestyle pulls the trigger,” said Melissa Conrad, using an apt metaphor for hunting season.

Lifestyle is something that Morrow and Conrad work on with their patients. They are the only Diabetes Education team working in central Frontenac County, which was one of the needs identified when the Sharbot Lake Family Health Team was established.

World Diabetes Day is coming up on Saturday November 14, the birthday of Frederick Banting, one of the discoverers of insulin, the hormone that helps the body control blood sugar. The theme for this year is “Understand Diabetes and Take Control”.

At this time, the team only serves the patient roster at the Family Health Team. They would like to educate the public about living with diabetes and pre-diabetes, and to help the public at large avoid the serious implications of diabetes.

“The effect of diabetes on general health is devastating,” Janice Morrow said, “It affects the eyes, the heart, teeth, the entire body from the tip of the head to the tips of the toes. People with diabetes are at a greater risk of heart disease, stroke, kidney failure, blindness, circulation problems and more. But the good news is the severity of the complications can be prevented by keeping blood sugars controlled”.

To decrease their risk of developing diabetes people are encouraged to follow a healthy lifestyle that includes healthy eating and physical activity. Other determining factors are body weight and shape. People who are overweight, and particularly those who carry their weight in their mid-section, are deemed to have one of the risk factors. A waist circumference for men over 40 inches (102 cm) and for women over 35 inches (88 cm) puts you at a higher risk of developing diabetes.

Other factors are identified through a fasting blood test, including high triglyceride levels, low HDL cholesterol (the good cholesterol), high blood pressure, and elevated blood sugar levels (over 5.6 on the sugar scale) are all indicators in addition to waist size.

Individuals with a fasting blood sugar over 6 are diagnosed as having pre-diabetes and individuals with blood sugar over 7 are diagnosed as having diabetes.

“For those diagnosed with prediabetes, there is research showing that losing 5-10% of their body weight, whatever that may be, can help prevent or delay developing Type 2 Diabetes,” said Conrad. “Prevention is a really big thing. If we can help people lead healthier lifestyles we may be able to delay or prevent the onset of Type 2 Diabetes.

Dietary improvements can be difficult for people to make. After a lifetime eating diets that are based on higher fat, particularly animal fat, low fibre, and sugar-enriched foods such as processed foods, it can be hard for people to change.

A healthy eating plan, which is higher in fibre, healthy fats and a higher percentage of fruits and vegetables, may be perceived as being more expensive and often involves more time spent on planning meals.

Processed, pre-packaged foods are cheaper and require little or no time to prepare, but most do not provide us with the fibre and nutrients that we need and may contribute to developing pre-diabetes and Type 2 diabetes.

“Achieving small goals is the target we aim for at each visit, as sustained lifestyle changes need to be done gradually,” said Janice Morrow.

One of the initiatives that the Diabetes Education team has undertaken is aimed at preventing the disease long before it has a chance to take hold, by bringing a lifestyle message to school-aged children.

A year ago, Janice Morrow went into the schools to talk about exercise and diet, and a Diabetes day is being planned by Morrow and Conrad for later this winter. 

For more information about prediabetes or diabetes check out the Canadian Diabetes Association at www.diabetes.ca. For more information about World Diabetes Day check out www.worlddiabetesday.org. To find out more about healthy eating check out EatRightOntario at www.eatrightontario.ca