We need a different approach to tackling diabetes
As we mark World Diabetes Day on Nov. 14, the mounting toll of this disease is staggering. One out of three Canadians has Type 2 diabetes or pre-diabetes.
In all likelihood, someone you know or love is affected. If left untreated or improperly managed, it can have devastating consequences, ranging from heart attack to stroke or even blindness. It touches many and its eradication requires us all to be united.
However, traditional public policy and professional guidance on healthy living has suggested that management and avoidance of diabetes and pre-diabetes is as obvious as it is easy. The mantra of “eat right and exercise” has been repeated for decades, often with the weight of large public health campaigns behind it.
The strategy until now has the effect of pointing the finger at the individual and the choices they make as both the solution and the source of the problem.
But it’s not that simple. Nor is it working.
Yes, exercise — just 20 high-intensity minutes per day, three times a week — has a hugely beneficial impact. As does skipping the junk food. But our research also shows that adopting healthy behaviours is often an uphill battle, where societal, cultural and commercial pressures make it increasingly difficult to meet these “simple” goals.
Take for example our teens, who have been urged to exercise at least 60 minutes per day through individual guidelines and school-based programs. Yet, without the appropriate support, this recommendation has fallen flat. Only nine per cent of 16- to 17-year-olds achieve this goal. It’s a shocking trend that should have us all concerned.
So if the goals aren’t achievable, then maybe it’s time to reinvent the game.
Rather than treating Type 2 diabetes and pre-diabetes as an individual failing, we need to shift responsibility for this epidemic to our communities and governments and away from its sufferers. We need to design better community programs that leverage the power of social support structures and help generate better access for all Canadians, regardless of personal circumstances, to healthier foods and an active lifestyle.
Perhaps, most importantly, we need to acknowledge that the “simple” solution of eating properly and getting exercise is more of a struggle today than it ever has been. That the common sense we’ve been taught for decades is, in truth, uncommon and nonsensical in a plugged-in, always-on and consumer-driven modern society.
Our labs at the University of B.C.’s Okanagan campus are at the forefront of research into community-based and community-driven health interventions. Our own data and work in our community has shown that behaviour change is incremental. It takes patience and requires an enormous amount of support on multiple levels, from government programs to public policy to family, friends and the community at large.
Through our research, we are beginning to understand the challenges individuals face living with Type 2 diabetes. We know that we need a new approach to its treatment, where everyone in the community, from government to academia to employers and the health care system itself, move in unity to shift collective behaviours toward a healthier and fuller lifestyle. We need an approach where we accept responsibility together and avoid blaming sufferers.
In our experience, the most powerful first step in helping those with Type 2 diabetes begins with a simple phrase: It’s not your fault and we’re here to help. With this mindset, we stand a better chance of winning this long battle.
Heather Gainforth, Mary Jung, Jonathan Little and Ali McManus are health promotion and diabetes researchers in the Faculty of Health and Social Development at UBC’s Okanagan campus.