Every day she's on call at her office in the Mohawk community
of Kahnawake south of Montreal, Dr. Ann Macaulay treats
patients suffering from diabetes. "People here die
of heart attacks at age of 50 because of diabetes. In this
day and age, that's unacceptable," says the doctor,
who has worked with members of the community for the past
three decades. When she goes to classes in elementary schools
and asks who has diabetic brothers, sisters or parents,
everybody's hands go up. "Diabetes affects 12% of the
native residents of Kahnawake," says Louise Potvin,
professor of healthcare and human equality (Chaire sur les
inégalités de santé) at the Université
de Montréal and a researcher on the interdisciplinary
healthcare research group. With Dr. Macaulay and two
other university researchers, as well as partners in the
native community, she runs the Kahnawake Schools Diabetes
Prevention Program (KSDPP).
"My own mother suffered from diabetes and we didn't
even know it," says Alex McComber, head of training
for the KSDPP and a member of the Mohawk community in Kahnawake.
"For a long time we've been seeing people die of diabetes,
but we weren't making the connection with our typical North
American lifestyles."
Fortunately, things are changing. Since 1994, workers trained
by the prevention program team have been touring the schools
to explain that the illness can be prevented through healthy
eating and physical activity. "When you sensitize the
kids, you indirectly reach the whole family, because they
transfer what they learn," Louise Potvin says.
Genetic predisposition may partly explain the high incidence
of diabetes in First Nations peoples and their descendants.
Natural selection may have led them to inherit a high capacity
for fat accumulation in their tissues. This special metabolic
feature would have helped them to survive in periods of
scarcity when nature was less than generous. But this "thrifty
gene" hypothesis - which has been challenged - is not
the whole story. A sedentary life and a diet too rich in
fat have created conditions likely to spread diabetes. The
illness attacks the pancreas and can lead to complications
including hypertension, neuropathy and kidney infection.
The most serious cases lead to blindness, blocked circulation
and subsequent amputation of limbs. This form of diabetes
should not be confused with infantile diabetes, which is
due to congenital defects of the pancreas, not to a poor
lifestyle.
Members of the grand family of the Iroquois, the ancestors
of the Mohawks of Kahnawake, were farmers who rounded out
their diet with food caught by hunting, fishing and gathering.
They ate beans, squash, corn and other vegetables long before
the days of Canada's Food Guide to Healthy Eating.
Researcher: Louise
Potvin
Phone: (514) 343-6142
Funding: Social Sciences and Humanities Research Council
of Canada, Health Canada, private donations
