Treatment Options for Type 2 Diabetes: Traditional Indian Medicine or Western Medicine?

As new is approaching it's time to set new goals and reorganize ones life. But lets give food for thought some thought with regards to indigenous nutrition. This is some research i pulled together around diabetes but the overriding principle remains the same; eat excessively and suffer the consequences.

However, a major debate has been over what is healthy, mainly, low-carb high fat vs. low-fat high carb diets. Looking at a community research based approached i found the evidence to tipping towards the low-carb diet as being a more natural approach and in the larger picture more recognisant of a traditional indigenous diet. Taiaiake Alfred (2005) outlines an approach to traditional hunting and diet approach to decolonize from Canadian Imperial society.

Looking at Diabetes Type-2

Diabetes poses a serious threat to the health and well being of Canadians as well as the family members of diagnosed individuals. There needs to be proper implementation of strategic plans to address growing pandemic as failure to do will result in greater casualties as well as an exponential increase in associated costs. According the Canadian Diabetes Association (2010) approximately 2 million Canadians live with diabetes and one in three individuals is unaware that he or she has the disease. Diabetes affects all ages, from children who develop primarily type 1 diabetes to adults who develop type 2 diabetes (Canadian Diabetes Association, 2010). The proportion of the Canadian population who reported having diabetes increased by 27% between 1994 and 2000 (Canadian Diabetes Association, 2010). As the Canadian population ages and rates of obesity rise, this trend is expected to increase. However, averages for non-Aboriginals being diagnosed with type 2 diabetes dropped in recent years but the increase of minority and First Nations increased significantly.

Diabetes became a severe pandemic in Aboriginal communities in Canada, where its prevalence was estimated to be three to five times the national average (National Aboriginal Diabetes Association (NADA), 2010). Also, Aboriginal people living with diabetes had increased rates of heart disease, kidney disease, blindness, infectious disease and amputations (NADA, 2010). NADA (2010) also stated “most disturbing is that Aboriginal teens and children are now being diagnosed with type 2 diabetes – a situation virtually unheard of in the general Canadian population” (p. 1). Diabetes had a devastating impact on Aboriginal Peoples living with the disease, their families and communities. “Pandemic means that a disease is throughout the entire country” said Alex McComber, one of the conference chairs, who sits on the board of the National Aboriginal Diabetes Association who further stated, “if we talk about the phrase using Indian country, it's there, it's everywhere” (CBC News, 2006 February 13).

What new treatments are Western scientists exploring? In August 2007, U.S. researchers’ results from a mice study suggested bone cells released a hormone called osteocalcin that may help regulate the metabolism of blood sugar and fat deposits (CBC News, 2009). Dr. Gerard Karsenty of New York's Columbia University said, “Current research is focusing on using osteocalcin injections as a method to prevent or eliminate type 2 diabetes” (CBC News, 2009 December 7, p.1). Also, experts note that more research was needed before a connection can be made between osteocalcin and diabetes can be made which will take another 10 to 15 years before it would known if the treatment would be safe for and helpful to humans (CBC News, 2009 December 7, p. 1). Maloch’s (1989) view of Western medicine being analytical with emphasis on disease treatment was right on the money as well, speaking of money to treat and research an development comes a price to the scientific approach but was used as a method to avoid the harder and cheaper alternative of eliminating harmful foods. As well, the search for a cure was a long anticipated and does not address the immediate needs. Also, the injections continue to be an easy fix to the smaller issues which stem from a larger problem, a problem where diabetes occurs primarily in impoverished areas because of limited access of healthy nutritional foods either form isolation or from high costs of healthy foods. To further impound the logic behind a cure based approach are costs associated to giving the future cure to impoverished clients and a possible denial of service may occur as it currently happening to other Aboriginal services once provided by the Canadian Government.

What was most disconcerting was the formation of the term healthy foods? If food was not considered healthy for an individual should it then no longer be considered food, but more appropriately, poison? When reading labels on toxic products which are harmful to a person there are a set of legal restrictions of guidelines for controlling the product however, for food it seems the lack of control of food had been non-existent. With government seeking resolutions by science rational inducing humans to more chemicals, such as insulin treatments, would it not make sense to cut out the poisons? A First Nations scientist in Alert Bay, Alberta came to the same conclusion upon being diagnosed with type 2 diabetes.

Dr. Jay Wortman found out he was diabetic and instantly he knew he had to cut out all carbohydrates in his diet because it increased insulin levels (Wortman, 2008). Dr. Wortman was a Métis physician from northern Alberta who was leading practitioner for HIV/AIDs treatment (Wortman, 2008). In a statement Dr. Jay (2008) spoke of his reaction towards his diabetes “I knew about the diabetic diet, how life-style change was supposed to be the cornerstone of diabetes management and which drugs were to be prescribed to achieve normal blood sugar control and why. I also knew that, for the most part, newly diagnosed type 2 diabetics went on drug therapy immediately because of the ineffectiveness of life-style interventions and that, even then, most tended to struggle and fail in their attempts to maintain normal blood glucose values, the holy grail of diabetes management. Further complicating my situation was the fact that I abhorred the use of medication, often joking that drugs were just poisons with some desirable side-effects” (p. 1). Dr. Wortman solution was to immediately cut out all carbohydrates and little unknown to him was information on low-carbohydrate diets. Upon further research discover of the Atkins diet Dr. Wortman was convinced the current state of diabetes in Aboriginal health had correlation to high carbohydrate intake within the contemporary Aboriginals diet (Wortman, 2008).

In the documentary My Big, Fat Diet, Dr. Wortman created a trial in his First Nations community in Alert, Bay which chronicled how the Namgis First Nation removed sugar and junk food as well eating a traditional diet which included oolichan grease a very healthy fat and was a big part of the traditional diet in the past. The study was done for a year sponsored by Health Canada and the University of British Columbia (Wortman, 2008). In A Demonstration Project to Evaluate a Traditional-style Diet for Obesity the study's subjects lost 10.1% of body weight, shed 9.7% of their waist circumferences and improved their waist-to-hip ratios significantly (Wortman et al., 2008). More importantly, in the initial analysis, those with diabetes were found to have significant improvements in their “HbA1c levels - seeing a decline from a mean 7.1% to a mean 6.1% which means the diet alone improves HbA1c significantly while also reducing or eliminating medication” (Wortman et al., 2008).

My Big Fat, Diet documentary was a culmination of understanding the historical context of First Nations which Waldram (2004) highlighted as well the emphasis of a First Nations self-determined approach to solving the problem of type 2 diabetes. Understanding the traditional diet was paramount for a process of healing but, even more encouraging was the initiative of the individuals like Dr. Wortman and the residents in Alert Bay to change their current lifestyle to encompass a more holistic approach. Furthermore, the use of Maloch’s (1989) system of practitioner attitudes of both Traditional Indian Medicine and Western Medicine are highlighted in different tactics used to solve type 2 diabetes. However, Dr. Wortman was intrigued by the findings of the Atkins diet which utilized the scientific understanding of carbohydrate absorption and use of healthy fats to stabilize metabolism. So Dr. Wortman added oolichan grease, a traditional healthy fat, into a hybrid cure which was the low-carb diet/traditional diet. First Nations took on self-determining roles in finding solutions to the current dilemma and with the help of funding aids by the Canadian government for further research the situation can only continue to move forward in a holistic strategy to treat type 2 diabetes.

References

Alfred, T. (2005). Wasáse: indigenous pathways of action and freedom. Peterborough: Broadview Press.

Candian Diabetes Association. (2010). Diabetes Facts. Retrieved from http://www.diabetes.ca/

CBC News. (2006, Febuary 13). Conference aims to prevent native diabetes pandemic.
http://www.cbc.ca/health/story/2006/02/13/diabetes060213.html

CBC News. (2009 December 7). Diabetes: International epidemic, A growing global health problem. CBC News. Retrieved from http://www.cbc.ca/health/story/2009/10/16/f-diabetes-epidemic-global.html#ixzz0lbTrUl12

Maloch, L. (1989). Health, Indian Medicine, Indian Health: Study Between Red & White Medecine. Canadian Women Studies 10 (2 & 3): 105-112.

National Aboriginal Diabetes Asscociation. (2010). Press releases. Retrieved from http://www.nada.ca/whatshappening/press/

Public Health Agency of Canada. (2005). Building a national diabetes strategy:
a strategic framework. (Catalogue No. HP-5/2-2005). Ottawa, ON: Government of Canada. Retrieved from http://www.phac-aspc.gc.ca/publicat/bnds-bsnd/pdf/bnds-bsnd-vol_2-eng.pdf

Waldram, J. (2004). The Traumatized Aboriginal in James Waldrum, The Revenge of the Windigo: The Construction of Mental Health of North American Aboriginal Peoples. Toronto: University of Toronto Press.

Wortman, J. (2008). Dr. Jay’s Blog A forum to discuss the documentary film, My Big Fat Diet , and the science of low carbohydrate diets. Retrieved from http://www.drjaywortman.com/blog/wordpress/about/

Wortman, J., Ham, C., Vermunt, D., Mathias, R., Phinney, S., Vernon, M., Westman, E. (2008). A Demonstration Project to Evaluate a Traditional-style Diet for Obesity. University of British Columbia, Vancouver BC; Namgis Health Centre, Alert Bay BC; University of California/Davis, Davis CA; Duke University Medical Center, Durham NC. Retrieved from http://www.cbc.ca/thelens/bigfatdiet/Poster.pdf

Indigenous Stigma

Stigma is a powerfully negative label that greatly changes a person’s self-concept and social identity. Stigma operates as a master status, overpowers other aspects of a social identity, so that a person is discredited in other people’s minds and becomes socially isolated.

Retrospective labeling is interpreting someone’s past in light of present deviance. For example, if a person is presently abusing their child/children retrospective labeling implies that at some point the abuser has been abused during their childhood. Retrospective labeling has been relevant in the Section 718.2(e) of the Criminal Code, as well as the Supreme Court of Canada in R. v. Gladue, [1999] 1 S.C.R. 688, where Gladue (1999) asks judges to apply a method of analysis that recognizes the adverse background cultural impact factors that many Aboriginals face.

Projective labeling is a deviant identity used to predict future actions. For example, there are current stigmas with minority groups and more specifically Aboriginal groups with respect to use of alcohol. An amendment in The Indian Act (1927) states the prohibition of anyone (Aboriginal or otherwise) from soliciting funds for Aboriginal legal claims without special license from the Superintendent General. The amendment is put in place to stop the sale of alcohol by Aboriginals peoples to control deviant behavior. The amendment labels all Aboriginals will have deviant behavior with the continuance of alcohol consumption and thus a preventative measure inhibits any use of alcohol for the projective deviant group.

References

Department of Justice Canada. (2010). The Indian Act. Retrieved from
http://laws-lois.justice.gc.ca/eng/I-5/20101104/page-0.html?rp2=SEARCH&rp3=SI&rp1=indian%20act&rp4=all&rp9=cs&rp10=L&rp13=50#idhit1

Judgements of the Supreme Court of Canada. (2010). R. v. Gladue, [1999] 1 S.C.R. 688.
Retrieved from http://csc.lexum.umontreal.ca/en/1999/1999scr1-688/1999scr1-688.html