In recognition of National Diabetes Awareness Month, Colleen Adams, Manager, Health & Digital Product Solutions at Medavie Blue Cross, hosted a conversation with Krisel Quiambao, Director of Clinical Services with Ellerca Health, and Dr. Michael Vallis, Ellerca’s psychologist advisor, on type 2 diabetes management. Krisel is a registered nurse, certified diabetes educator and health consultant, based in the Greater Toronto Area, and Michael is a health psychologist at Dalhousie University in Halifax. The follow are excerpts from that conversation, which took place as a Facebook Live event.
How prevalent is diabetes in Canada?
The International Diabetes Federation has identified the disease as one of the largest global health emergencies of the 21st century. In Canada, 1 in 3 Canadians live with diabetes or prediabetes. Of the Canadians with diabetes, 10% have Type 1 diabetes (an autoimmune condition) and 90% have Type 2 diabetes (a metabolic condition).
“We’re seeing more and more children and teenagers developing Type 2 diabetes and this is because of the increased prevalence of obesity.” Krisel Quiambao
What are the impacts of diabetes in Canada?
As of 2019, the national costs of treating diabetes grew to $30 billion. The average cost of an employee who has diabetes to an employer is $1,500 per year due to lost productivity, absenteeism and presenteeism.
Diabetes is linked to 1 in 10 deaths in Canada, is the leading cause of blindness and contributes to 30% of strokes, 40% of heart attacks and 50% of trauma amputations.
Why isn't our traditional medical system working for people with diabetes?
There’s a fundamental mismatch between the condition and human behaviour. Diabetes is a medical disease that must be self-managed and requires the patient to actively change unhealthy behaviours.
“What the doctor says is important only if you agree and are willing to follow their recommendations.” Dr. Michael Vallis
To live well with diabetes the individual often has to accomplish three steps:
First is disease acceptance. No one wants to have diabetes so individuals who come to view it as serious enough to address and yet manageable are on their way to success.
Next is treatment acceptance. This requires understanding your perceptions of the need for and any concerns about treatments, be they health behaviours, medication and/or insulin.
The final step is readiness for self-management. Change is hard and figuring out how to make changes and why these changes are important to you is central to long-term success.
As one lives with diabetes, these steps are often revisited as needed.
When someone is diagnosed with diabetes, what is that experience typically like?
People often feel overwhelmed, confused, even angry when they get a diagnosis. Shame is also common; people feel they are at fault for having diabetes. Yet, there are many risk factors that can increase someone’s chances of getting diabetes — which they have no control over — including a family history of the disease, age or race. People of colour are disproportionately affected by the disease.
At diagnosis, the first thing that people with diabetes should know is they are not alone. The second is to seek expert help to manage their condition.
“If managed well, they can lead long, fulfilling lives.”
A person diagnosed with diabetes should find a plan that motivates them, engages them and gives them hope. They should be fully involved in their own care, asking how they will be personally responsible for their health outcomes, with the support of a health care professional who specializes in diabetes management.
“Through the committed choices of the individual, you can actively live a healthier life than the one you had before you had diabetes.”
Dr. Michael Vallis
What are some key ways to manage diabetes?
The main tools in the Type 2 diabetes self-management toolkit are:
- Healthy eating
- Regular exercise
- Maintaining a healthy weight
- Managing stress and sleep
- Monitoring blood sugar levels to learn how to manage
- Taking medications when needed
What are some tips on eating well?
Eat balanced meals with plenty of vegetables and an appropriate amount of proteins. Carbohydrates have the biggest effect on blood sugar levels so managing portions are key. Remember that not all carbohydrates are the same and everyone responds to it differently. Find out what works best for you.
“If you can pick it off a tree or a bush; if you can dig it out of the ground or, if you can hunt it down and kill it, eat it. If it doesn’t come from any of those sources, be wary.” Dr. Michael Vallis
Match your intake to your expenditure of energy. If, during the day we consume 20% of our calories, when we expend 80% of our energy the supply and demand is out of balance. If we can reverse that so we eat more in the morning and less at night, we have a better chance of achieving our goals for healthy eating and maintaining a healthy weight.
Should everyone over 40 have their blood sugar tested?
Yes. It is recommended that once a person reaches 40 they should be screened for diabetes every 3 years. If they have high risk factors such as having a family history of diabetes, have overweight or obesity, are a person of colour or are a woman who has had a history of gestational diabetes or had a baby that weighed more than nine pounds, annual screening at an earlier age may be recommended.
Why is sticking to healthy habits and changing behaviours so hard?
Human brains are designed to:
- Approach pleasure (sugar has exactly the same pleasure effect on the brain as cocaine)
- Run away from pain — and choose the path of least resistance
- Focus on the immediate benefits, not the long-term benefits
However, there are good reasons for changing behaviours and a health coach can be there for support.
Aside from their family doctor, who should someone with diabetes get support from?
It’s best to get in touch with a health care provider who specializes in diabetes care. Certified diabetes educators can include nurses, dietitians, pharmacists, physicians and mental health practitioners. Find a provider who will not only listen to your concerns — without judgement — but wants to know about your concerns.
“Diabetes is a condition that you have that does not define you as a person.” Krisel Quiambao
Who is Ellerca Health?
improves patient care through leading technologies and innovation.
“Our aim is to make life with diabetes easier and to empower people through behavioural change coaching.” Krisel Quiambao
Ellerca has developed a supportive digital program, 360Care, that helps people with diabetes and other chronic health conditions in managing their health through a mobile app. This convenient solution features comprehensive virtual health counselling, mobile health tracking and self-management support from health care providers with expertise in diabetes and customer experience teams.
What is Medavie Blue Cross’s relationship to Ellerca?
Ellerca Health, together with Roche Canada, are partners in our Diabetes Care Program, which empowers plan members to take charge of their condition. The program provides all-in-one, exclusive access to real-time support from a team of health coaches and home delivery of testing supplies. The program is among the innovative health services offered through our Connected Care digital health platform and is accessible through our website or mobile app.