Link to article: http://bit.ly/IaoYVN
Written by: Megan Ogilvie
Brampton, parts of Mississauga, Etobicoke, Rexdale and Scarborough have some of the highest rates in the province — with the exception of First Nations communities, where as many as one in three people have diabetes.
The report released Tuesday by the Institute for Clinical Evaluative Sciences (ICES), for the first time maps diabetes rates cross Ontario. It also plots rates of diabetes complications, painting a picture of who in the province is more likely to receive help in managing their disease.
Previous reports have shown some communities in the GTA have higher than average rates of diabetes. But the new data reveals rates in several areas are even higher than some experts anticipated.
In Brampton, Malton and Rexdale, for example, between 12 and 22 of every 100 adults have diabetes. The provincial average is about 9 cases for every 100 adults.
“It’s definitely an increase from previous numbers,” Dr. Sanjeev Goel, the diabetes primary care lead for the Central West Local Health Integration Network, said of the rates in Brampton, Malton and Rexdale. “It is surprising they are that high. That means, in some parts of those communities, one in five people have diabetes.”
The goal of the ICES study is to provide a baseline look at patterns of diabetes in Ontario to help policy makers and healthcare practitioners better target diabetes prevention and management strategies to communities that need them most.
Although the data in the report did not differentiate between type 1 and type 2 diabetes, the majority of people with diabetes — about 90 to 95 per cent — are thought to have type 2, said the study’s lead author, Dr. Gillian Booth, an adjunct scientist at ICES and a scientist at the Centre for Research on Inner City Health at St. Michael’s Hospital.
Type 1 diabetes, which most often appears when the patient is a child or teenagers, should not be confused with type 2 diabetes, in which the body does not produce enough insulin or uses insulin efficiently. Type 2 diabetes, which is closely tied to obesity, is a chronic disease that comes with myriad health complications, including stroke, heart disease, blindness and kidney disease.
Experts say the soaring rate of type 2 diabetes in Ontario — and across much of the world — is due in part to an aging population and to rising rates of obesity, spurred on by unhealthy eating habits and sedentary lifestyles.
But socioeconomic status and ethnic background also play a part in who will get diabetes and who is at risk for developing the disease.
Booth said diabetes is more common in certain ethnic groups, including people of Aboriginal, South Asian, African and Hispanic descent. These groups are more likely to get type 2 diabetes — and at an earlier age — due to a variety of genetic factors, including a propensity to gain weight and the likelihood that extra body fat will induce insulin resistance.
Booth said the pattern revealed by the report fits with where these at-risk communities live in the province.
“There is more ethnic diversity in the GTA, so we do see higher rates of diabetes as well,” she said. “Amongst recent immigrants, South Asians have among the highest rates of diabetes. We do see communities around the GTA, such as Brampton and Mississauga, having high rates of diabetes where we know a lot of South Asian immigrants are settling.”
Zacky Ahsan, 58, has had type 2 diabetes for 13 years. The Brampton resident of South Asian descent admits he did not manage his diabetes as well as he could after his diagnosis. In April 2011, Ahsan suffered a diabetes-related stroke and spent two months recovering in hospital.
“I learned my lesson,” said Ahsan, who immediately quit smoking and is now vigilant in monitoring his blood-sugar levels, taking his medications and keeping to an appropriate diet. He also volunteers with the Canadian Diabetes Association to educate as many people as possible in his community about ways to manage the disease to prevent complications.
“The majority of people are not aware of what will happen,” he said. “This is the only disease that affects the whole body — the renal system, the pancreas, the eyes, the limbs.”
Mimi Lowi-Young, CEO for the Central West Local Health Integration Network (LHIN), said the LHIN has known about the high rates of diabetes within its boundaries since being alerted by the 2006 Canada Census.
“We know we’ve got a very fast-growing population, especially of the South Asian population; we also have an aging population and we have a population who has increased obesity,” she said. “You put that all together and those are some of the factors that cause us to have a higher rate of diabetes.”
To help the thousands of residents with diabetes, the LHIN has 11 diabetes education programs scattered across the region and has opened a Centre for Complex Diabetes Care at Brampton Civic Hospital, which Lowi-Young said provides individuals with diabetes “a single point of access to help slow the process of their disease.”
• More than two-thirds of Ontarians with diabetes live in major urban centres.
• In northern and rural First Nations communities, diabetes prevalence among adults is as high as 32 per cent.
• Rates of chronic complications of diabetes, which include end-stage kidney disease, amputation and cardiovascular problems, were highest in northern Ontario and in rural areas in southern parts of the province. Rates for those communities were about three times higher than in urban areas.
• Rates of acute complications, which include severe high or low blood sugar levels, varied four-fold across the province. Rates for these complications were highest in smaller, rural communities in southern and northern areas of Ontario.
• People in urban areas had greatest access to diabetes programs and services.
• More than half of Ontarians with diabetes had an additional chronic medical condition.
"Miongoni mwa maeneo ya ""mwenyeji wa kwanza"" wa jimbo la Mississippi, sehemu za Mississauga, Etobicoke, Rexdale na Scarborough zina viwango vya juu zaidi katika jimbo hilo, isipokuwa jamii za First Nations, ambapo mtu mmoja kati ya watu watatu ana ugonjwa wa kisukari." Ripoti hiyo iliyotolewa na Taasisi ya Sayansi ya Tathmini ya Kliniki (ICES) kwa mara ya kwanza inaonyesha viwango vya ugonjwa wa kisukari katika Ontario. Pia huonyesha viwango vya matatizo ya kisukari, na kuonyesha ni nani katika jimbo hilo anayepaswa kupokea msaada zaidi katika kudhibiti ugonjwa wao. Ripoti za awali zinaonyesha kuwa baadhi ya jamii katika GTA zina viwango vya juu zaidi ya wastani wa kisukari. Lakini takwimu mpya zinaonyesha viwango katika maeneo kadhaa ni hata juu kuliko baadhi ya wataalamu walivyotarajia. Kwa mfano, katika maeneo ya Brampton, Malton na Rexdale, kati ya watu 12 na 22 kati ya watu 100 wazima wana ugonjwa wa kisukari. Kiwango cha wastani cha mkoa ni karibu visa tisa kwa kila watu wazima 100. "Ni ongezeko la idadi ya watu walioambukizwa na ugonjwa wa kisukari,"" alisema Daktari Sanjeev Goel, kiongozi wa huduma ya msingi ya ugonjwa wa kisukari katika mtandao wa afya wa eneo la Central West, kuhusu viwango vya ugonjwa huo huko Brampton, Malton na Rexdale." <unk>Inashangaza kwamba ni za juu sana. "Hii inamaanisha kwamba katika sehemu fulani za jamii hizo, mtu mmoja kati ya watano ana ugonjwa wa kisukari. ""Lengo la utafiti wa ICES ni kutoa mtazamo wa msingi juu ya mifumo ya ugonjwa wa kisukari huko Ontario kusaidia watunga sera na watendaji wa huduma za afya kulenga vizuri mikakati ya kuzuia na kusimamia ugonjwa wa kisukari kwa jamii ambazo zinahitaji zaidi." "Hata hivyo, utafiti huo haujatofautisha kati ya aina ya 1 na aina ya 2 ya kisukari, lakini ""inadhaniwa kuwa asilimia 90 hadi 95 ya watu wenye kisukari wana ugonjwa wa aina ya 2,"" alisema mwandishi mkuu wa utafiti huo, Dk Gillian Booth, mwanasayansi msaidizi katika ICES na mwanasayansi katika Kituo cha Utafiti wa Afya ya Jiji la Ndani katika Hospitali ya St. Michael." Ugonjwa wa kisukari wa aina ya 1 ambao mara nyingi huonekana wakati mgonjwa ni mtoto au kijana haupaswi kuchanganyikiwa na ugonjwa wa kisukari wa aina ya 2, ambapo mwili hauwezi kutengeneza insulini ya kutosha au kutumia insulini kwa ufanisi. Ugonjwa wa kisukari wa aina ya 2 unaohusiana sana na unene wa mwili, ni ugonjwa wa kudumu ambao unakuja na matatizo mengi ya afya, ikiwa ni pamoja na kiharusi, ugonjwa wa moyo, upofu na ugonjwa wa figo. Wataalamu wanasema kuongezeka kwa kiwango cha kisukari cha aina ya 2 katika Ontario na sehemu kubwa ya ulimwengu kwa sehemu ni kwa sababu ya idadi ya watu wanaozeeka na kuongezeka kwa viwango vya unene wa kupita kiasi, vinachochochewa na tabia mbaya za kula na mtindo wa maisha wa kukaa. Hali ya kijamii na kiuchumi pia huamua ni nani atakayekuwa na ugonjwa wa kisukari. Booth alisema ugonjwa wa kisukari ni wa kawaida zaidi katika vikundi fulani vya kikabila, ikiwa ni pamoja na watu wa asili ya Australia, Asia Kusini, Afrika na Hispania. Watu wa aina hii wana uwezekano mkubwa wa kupata ugonjwa wa kisukari wa aina ya 2 na katika umri wa mapema kwa sababu ya sababu mbalimbali za maumbile, ikiwa ni pamoja na mwelekeo wa kupata uzito na uwezekano wa mafuta ya ziada ya mwili kusababisha upinzani wa insulini. Booth alisema muundo uliofunuliwa na ripoti hiyo unalingana na mahali ambapo jamii hizi zilizo hatarini huishi katika jimbo hilo. "Kuna utofauti zaidi wa kikabila katika GTA, kwa hivyo tunaona viwango vya juu vya kisukari pia", alisema. <unk>Miongoni mwa wahamiaji wa hivi karibuni, watu wa Asia Kusini wana viwango vya juu zaidi vya ugonjwa wa kisukari. "Watu wengi wa eneo la Brampton na Mississauga, ambao ni maeneo ya karibu na mji mkuu wa Australia, wana ugonjwa wa kisukari wa aina ya 2 ambao ni ""kiwango cha juu cha ugonjwa wa kisukari"" na ambao wanaishi katika maeneo ya karibu na mji mkuu wa Australia, na ambao ni watu wa aina ya 2." Mmoja wa wakazi wa Brampton wa asili ya Asia Kusini anakiri kwamba hakuweza kusimamia ugonjwa wake wa kisukari kama alivyoweza baada ya kugunduliwa. Mnamo Aprili 2011, Ahsan alipata kiharusi kilichohusiana na ugonjwa wa kisukari na alitumia miezi miwili katika hospitali kupona. "Nilijifunza somo langu", akasema Ahsan, ambaye aliacha kuvuta sigareti mara moja na sasa ni mwangalifu katika kudhibiti viwango vyake vya sukari ya damu, kuchukua dawa zake na kudumisha lishe inayofaa. Yeye pia ni msaidizi wa shirika la Canadian Diabetes Association, ambalo linatoa mafunzo kwa watu wengi wa Canada kuhusu jinsi ya kuzuia ugonjwa wa kisukari. "Watu wengi hawajui nini kitakuwa", alisema. "Mimi Lowy-Young, Mkurugenzi Mtendaji wa Mtandao wa Ujumuishaji wa Afya wa Mitaa wa Magharibi ya Kati (LHIN), alisema LHIN imekuwa ikijua juu ya viwango vya juu vya kisukari ndani ya mipaka yake tangu kuonyeshwa na Sensa ya Kanada ya 2006.""" "Tunajua tuna idadi ya watu inayokua haraka sana, haswa ya idadi ya watu wa Asia Kusini; pia tuna idadi ya watu wanazeeka na tuna idadi ya watu ambao wameongezeka uzani", alisema. "Lakini, kwa sababu ya idadi kubwa ya watu wenye ugonjwa wa kisukari, LHIN ina programu 11 za elimu ya kisukari katika eneo hilo na imefungua Kituo cha Huduma ya Kisukari katika Hospitali ya Brampton, ambayo Lowy-Young alisema hutoa watu wenye kisukari ""mahali pa moja ya ufikiaji kusaidia kupunguza mchakato wa ugonjwa wao.""" Katika maeneo ya kaskazini na vijijini ya nchi za asili, idadi ya watu wazima wenye ugonjwa wa kisukari ni 32%. Kiwango cha matatizo ya kisukari, ambayo ni pamoja na ugonjwa wa figo katika hatua ya mwisho, amputation na matatizo ya moyo na mishipa, ilikuwa ya juu zaidi kaskazini mwa Ontario na katika maeneo ya vijijini katika sehemu za kusini za mkoa. Kwa ujumla, viwango vya maambukizi katika maeneo hayo ni mara tatu zaidi ya maeneo ya mijini. • Viwango vya matatizo makali, ambayo ni pamoja na viwango vya juu au vya chini vya sukari ya damu, vilitofautiana mara nne katika jimbo hilo. Idadi ya watu walioathiriwa na ugonjwa huo ilikuwa kubwa zaidi katika maeneo ya mashambani ya Ontario. • Watu katika maeneo ya mijini walikuwa na upatikanaji mkubwa wa programu na huduma za kisukari. • Zaidi ya nusu ya watu wa Ontario walio na ugonjwa wa kisukari walikuwa na hali nyingine ya ugonjwa wa kudumu.