MDSi Newsletter - Nov 2013

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Information about MDSi Newsletter - Nov 2013
Health & Medicine

Published on March 5, 2014

Author: BRAID-Research



Project newsletter for the Mobile Diabetes Screening Initiative (MDSi), university of Alberta

The Moccasin New Guidelines for Preventing, Diagnosing and Managing Diabetes and Pre-Diabetes MDSi Community Visit Schedule November 2013 - March 2014 Nov 18-29: Tri-Settlements Dec 9-12: Kikino Métis Settlement Dec 16-18: Bent Arrow (Edmonton) Jan 13-14: Edson Friendship Centre Jan 15: Marlboro Jan 20-23: Hinton Friendship Centre Feb 3-6: Grande Cache Feb 10-13: Wabasca/Bigstone Feb 24-27: Elizabeth Métis Settlement Mar 3-6: Lac La Biche MNA Mar 10-13: Trout Lake What are the Canadian Diabetes Association 2013 Clinical Practice Guidelines? They are the best advice for preventing and treating diabetes and its complications based on the latest scientific studies. What is new in the 2013 Clinical Practice Guidelines? Diagnosis of diabetes and prediabetes. A1C (2-3 month average blood sugar) can now be used to diagnose diabetes. The advantage is that an A1C test does not require fasting. Prediabetes. 25-50% of people with an A1C between 6.0-6.4 will end up with diabetes within 5 years. A1C target. Although an A1C of 7.0 or lower is the best way to avoid complications for most people with diabetes, there are some for whom a 7-8.5 range is more realistic (e.g. people who have had frequent, severe low blood sugars, who are at great risk of having a heart attack, or who have a very short life expectancy). Because of the “legacy effect” (keeping blood sugars in the normal range the first few years after diagnosis of diabetes resulting in decreased risk of heart disease even years later when blood sugars start to rise) the goal is to bring blood sugars in the normal range as soon as possible after diagnosis – using lifestyle, medication & insulin. Although diabetes medications continue to be chosen based on what will bring and keep the blood sugar in the normal range as soon as possible, there is greater emphasis on what works best for the individual with diabetes (e.g. cost, risk of low blood sugar reaction, preference and access to treatment) Please note this schedule may change. Please contact your Settlement office or Community office for final dates and information about booking an appointment. You can also check our web site: The BRAID / MDSi team In Montreal for the Canadian Diabetes Assoc. conference, to learn more about the new clinical practice guidelines. AH - MDSi funding to end in 2014 As people with diabetes are more likely to die from heart disease (due to its 2-4 fold increased risk), there is greater emphasis on its prevention using the ABCDEs: A: B: C: D: A1C <= 7 Blood Pressure <130/80 Cholesterol – LDL <= 2.0 mmol/L Drugs to protect the heart: - ASA (A - ACEi or ARB, S – Statin, A- ASA if indicated) E: Exercise: regular physical activity, healthy eating & body weight S: Smoking cessation Promoting self-management: The person with diabetes is the one in charge of taking care of their diabetes. The health professional can promote this self-management by encouraging the individual to set realistic, measurable & specific goals, discussing motivation & confidence and ways to increase the same, and providing the education/resources the person needs. MDSi’s funding from Alberta Health (AH) will end on March 31, 2014. We are seeking other sources of support and funding, but nothing has been confirmed yet. Please contact your community’s health representatives to help you arrange alternate health services for diabetes screening and diabetes care. You may be able to access services through your regular doctor or nearest PCN. We will be working with your community to help make these connections. Editor: Kelli Ralph-Campbell Moccasin Volume 6, Number 3 December 2013 Page 1 Published by MDSi / BRAID Research 8308 - 114 St., Suite 1055 University of Alberta Edmonton, Alberta, T6G 2V2 Phone: 780.407.8456 E-mail: Web:

The Moccasin What is it like to have diabetes when you are pregnant? We asked Aboriginal women about their experiences Introducing... Gustavo Castillo, Health Counsellor I am from Argentina. I grew up in one of the northern provinces of my country named Chaco where I went to elementary and high school. I studied medicine at the Universidad Nacional del Nordeste. My first area of specialization was internal medicine, which included serving Aboriginal clients. Than I moved to Buenos Aires (capital of Argentina) to specialize in nephrology -- working with patients with diabetes who were on dialysis or had had a kidney transplant. In September 2010 I came to Canada for a new adventure. I worked at the University of Alberta in their nephrology department. Although I practiced as a doctor for 12 years in Argentina, in order to be able to practice as a doctor in Canada I have to take qualifying exams and redo my medical residency. I’m now in the process of studying for these exams. In September of this year I started working for MDSi – traveling to Aboriginal communities in Northern Alberta. I like talking and sharing experiences with the people in these communities. Dr. Richard Oster (BRAID Research, University of Alberta) led a recent study that tried to better understand the real-life experiences of First Nations women with diabetes in pregnancy and to find ways to improve care. Dr. Oster interviewed 12 women from communities throughout Alberta. The study asked two questions: What is it like to have diabetes in pregnancy? What might help these women in having a healthy pregnancy? “Fear, disappointment, hassle, extra stress, no control, it sucked, I hated it, scary, it was hard, eye-opener, shocking, gross, tough, annoying, sickness, sugar, tired, I didn’t understand.” These were some words the women used to describe what diabetes in pregnancy meant to them. But the women said having a strong support system (family, health care, cultural/community) and resources (awareness/education) allowed them to take some control of their health. “It made me take care of myself better and eat healthier. So ever since then me and my kids’ diet has changed, like a lot.” “Now I know and I can show my kids. I can tell my kids the things that weren’t told to me by my grandparents. But I can help them control it before it happens.” Based on the information these woman shared, efforts to improve pregnancy care for Aboriginal women should take a patient-centered approach, help them enhance their support systems, increase their sense of control over their health, and provide them with awareness and education about diabetes in pregnancy. A full report of this study will be published soon in the journal Qualitative Health Research. Results of the study were recently presented as a poster at the annual Canadian Diabetes Association conference, and the poster can be viewed on our web site ( My hobbies are travelling, reading, playing soccer, walking, and photography. Although MDSi may be ending, we will still have lots of information resources up on our web site: (this new site is coming soon) Jane’s Moose (or Beef) Stew You can also follow us on Twitter: @BRAIDresearch @MDSIdiabetes You will need: 2 lbs 1-2 Tbsp 1 large 2-3 cloves 6 medium 1 cup 8 medium 28 oz can 1-2 cups moose (or beef), cut into 1" chunks oil onion, chopped garlic (optional) carrots, sliced celery, sliced (or 1 cup of peas) potatoes, cut in large chunks diced tomatoes, undrained broth And “friend” us on Facebook: BRAID Research How to make it: Trim fat from the meat. Fry onion (and garlic) over medium-high heat till soft. Add meat, carrots, celery (or peas), potatoes, tomatoes with their liquid and broth. Bring to boil, then cover and simmer for 1 hour and 15 minutes. Uncover and cook for another 15 minutes. ENJOY! (Optional - Bake in oven @ 350F for 2 hrs.) These drawings were gifts to the MDSi team, from students at a community school where MDSi gave a presentation. Funded in part by the Government of Canada. Page 2

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