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  • Health attitudes & Diabetes

    I hope I get some responses to this topic.

    My primary area of interest is in Type 2 Diabetes in Indian populations, specifically adherence to medical regimens (how well to people with diabetes stick to their eating plan, exercise, regularly monitor their blood sugar, etc.).

    I work in a diabetic clinic and, probably as many of you do, have relatives and friends who have diabetes, who are suffering from complications of diabetes, have died of complications, or are at-risk.

    I am constantly wondering why some people stick to their regimen and why some don't. Why do some people do everything they are supposed to do, and why are many people in denial about their health?

    I feel a combination of several things are to blame. Poor nutrition education, or education that is not presented in a way that it's understood by patients, fatalistic attitudes once diagnosed, denial of diagnosis, or eating and behavior patterns that are deeply imbedded (and where no behavioral counseling is offered or available).

    If you are interested, or if this topic strikes close to home, let me know your thoughts or experiences. I know alot of health initiatives are in place or are currently being developed and implemented, but more needs to be done for Indian people.

  • #2
    2cents:

    My personal opinion is that historic lifestyle changes are the main cause of so many cases of diabetes across Indian country.

    In days gone by, Indian people excersized more because of their need to subsist on a day-to-day basis. Hunting, gathering wood, making trips for water, child rearing and moving to a new location took a lot of energy and calories away.

    Basic food essentials were not processed then either. This cut down fats, salts and sugars.

    Today, our life styles do not resemble our ancestors. Government food subsidies (commodities), contain many harmful ingredients. So many of our people accept these because of their economic situations.

    It seems the majority of Indian people are below the national poverty level. Add this with the large families most of us come from... and it is disasterous.

    Even fresh fruit and vegetables are not a staple food item in most modern Indian family units.

    It is no wonder diabetes is so previlent in Indian communities.

    I'm sure you probably know all this, but I was just wanting to help.
    Powwows will continue to evolve in many directions. It is inevitable.

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    • #3
      Two pennies

      Well, This topic hits very close to home. Virtually everyone of the older members of my family have diabetes and unfortunately so do I. But I am the odd ball because I have type 1, and have had it for 4 years now. I think that it is very hard to take care of yourself, in my situation especially, after you have been able to eat and drink anything that you wated for 20 years and then all of a sudden have to stop everything that is sweet or tastes good. I found this very hard and I am still struggling with that fact that I need to take care of myself or else I will not be around to grow old. Sure everyone in my family hollars around at me, but they are the ones that do not understand what I am going through because the do not have it. I have only one sister, who is my age, that has had type 1 diabetes since she was young. I feel that i can relate to her more that I can with my other brothers and sisters because we are going through that same thing. And, we both have a hard time taking care of ourselves. I always wonder why do I have to have it, why did GOD pick me to have this disease? I even talked to my sister about that. Sometimes I wish that we were normal, that we would'nt have to take shots in order to live. I have to face everyday that I have a disease and that it will never go away, no matter how hard I wish it would. But I still try to live life to the fullest and POWWOW, POWWOW, POWWOW as much as I can. I try not to focus very much on this in my life, but sometimes I don't feel good or I just don't want to do anything, and my relatives just don't understand, they think I am being stink and would just rather stay away, but its not that I just dont feel good. So I would say that having type 1 diabetes is an everyday struggle. But, one of these days I will realize that I have to start taking care of myself because noone is gonna help me but me. So , yeah I think it is hard to take care of onesself when you have so many tempting things around you.

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      • #4
        I hate it

        That's right. Nobody can understand unless they have it.

        I feel like Kiowathonga somedays. But.... like her, I love to powwow. That's when my sugar level is most normal. It's tough not being able to sample all those good foods at powwows though. Everybody chowing down on tacos and here I am eating a bowl of rice. Wild rice is tasty if done right but hey, there isn't much grease in it. :dontknow: Face it folks. Sugar, salt, fat. That's what puts some good flavor in most foods.

        But.....we're not supposed to eat it. :duhh: It's like putting a gun to our heads.

        Dancing is another blessing to us. Great exercise and even greater exercise when yer jammin to Bear Creek, Mystic or some other of our great singers. Healthier dancing when you dance hard. All the kids walking around the dance arena when there's a good song....have got a lot to learn. We need that exercise because of what we eat today.

        Dang, look at what is eaten at wakes & funerals of someone who has passed away as a result of diabetes. Cakes, pies, baloney sandwiches. :6: :2: Dam, I think I'll go have one. J/K

        Actually, I hate the disease, but I still like me. I want to stick around for awhile. To all you relatives, hang in there. Watch what you eat, dance hard and you'll someday be sitting on the sidelines in your comfy lawn chair smiling happily as you watch your grand-children pickin' up where you left off.

        I love Indian people. :supperhap

        I hate diabetes. :TD:

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        • #5
          Originally posted by Kiwehnzii
          That's right. Nobody can understand unless they have it.

          I feel like Kiowathonga somedays. But.... like her, I love to powwow. That's when my sugar level is most normal. It's tough not being able to sample all those good foods at powwows though. Everybody chowing down on tacos and here I am eating a bowl of rice. Wild rice is tasty if done right but hey, there isn't much grease in it. :dontknow: Face it folks. Sugar, salt, fat. That's what puts some good flavor in most foods.

          But.....we're not supposed to eat it. :duhh: It's like putting a gun to our heads.

          Dancing is another blessing to us. Great exercise and even greater exercise when yer jammin to Bear Creek, Mystic or some other of our great singers. Healthier dancing when you dance hard. All the kids walking around the dance arena when there's a good song....have got a lot to learn. We need that exercise because of what we eat today.

          Dang, look at what is eaten at wakes & funerals of someone who has passed away as a result of diabetes. Cakes, pies, baloney sandwiches. :6: :2: Dam, I think I'll go have one. J/K

          Actually, I hate the disease, but I still like me. I want to stick around for awhile. To all you relatives, hang in there. Watch what you eat, dance hard and you'll someday be sitting on the sidelines in your comfy lawn chair smiling happily as you watch your grand-children pickin' up where you left off.

          I love Indian people. :supperhap

          I hate diabetes. :TD:
          I think it's great that many like Ki are taking it seriously and are trying to follow a diet and get lots of exercise.


          I know from personal experience that sickness can be reversed and one can achieve a healthy body - I just would like more people to know that when you get sick - it doesn't mean you're gonna keep being sick - you just gotta find out what to do to heal your body and then do it!

          Comment


          • #6
            Thank you for your responses so far. I have another question. Has anyone ever talked to you, or have you heard about how stress can impact your diabetes? This is the new area that we are looking at, as a barrier to adherence.

            Also, are you receiving regular nutrition and exercise education as part of your medical care (current protocol says education every 6 months)? Is is presented in a way that you understand or are you unclear about things?

            I know my mom had to look long and hard to find a good nutrition class after she was diagnosed, that presented all the food exchanges and how carbohydrates affected her blood sugar in a way that she understood and it made sense to her. Just the doctors or nurses telling her how she should eat wasn't cutting it. What helped her the most was understanding WHY she had to eat like that. Have any of you experienced this?

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            • #7
              Great idea, but again there are barriers to many Indian people. We could go to all the classes offered (if it was free) but having the $$$$ to eat like that? I don't think so. All we can do is the best we can with what we can afford.

              One of my friends from a neighbour rez told me about a mens diabetes support group that they have there. Kinda far for me. I just sit around with some other old fogies with "the curse" and gripe about it. Takes some of the stress off tho'. Have a good laff. Tease each other about how high the sugar readings are. I guess that's the extent of a " support group" (laff)

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              • #8
                Well we can pick up a bow and go hunting and eat all the old foods and most of us can still do that if your willing to work. My mother switched to old foods and her whole body is regenerating. She is the only one without diabetes in my family in her generation.

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                • #9
                  ___

                  From what I have experienced with Indian elders, there seems to be negative stigmas associated with Indian hospitals/clinics.

                  Among them is the lack of quality care and the limited amount of assistance Indian health facilities provide. Couple that with the long waiting period to see a doctor.

                  Indian elders also share many horror stories that have happened to them and their peers while at Indian health facilities.

                  Some elders are plain stubborn. This stubborness results in "reactionary" medical visits rather than preventative health visits. It seems like many elderly only go to the hospital when they are really, really sick. (This mentality is not only limited to Indian elderly).
                  Powwows will continue to evolve in many directions. It is inevitable.

                  Comment


                  • #10
                    I developed Type2 diabetes around 40 years of age. I am the only one in my family to develop it and the only one with hypertension. The first question asked was if there was any stressful situations going on in my life and unfortunately there was! Could this have been a factor?....I believe it was a contributor. I've had to go on insulin within the last 7 years.
                    I believe the hardest thing about this illness is trying to do the nutritional exchanges. Since carbs convert to sugar you have to really watch those intakes! Having a family to care for and cook for makes it harder too for me to eat more balanced meals. I monitor 3 times a day, I walk a manual treadmill for a mile and I've started taking exercise classes (which was a big thing for me cause I'm shy). I have my diabetes under control but only through hard work and the thought that I want to see grandkids in the future!

                    Comment


                    • #11
                      Diabetes is alive and thriving here on my rez too, one of my uncles has it but my mom and other 2 uncles don't have it. My mom keeps busy working in her garden and has always stayed fit. I asked her about diabetes before and she told me that she doesn't use salt and doesn't eat too much sweets and always stays physically active. She's in her mid 70's and is a lot healthier than a lot of younger folks who are sedentary. I try to live a healthy life but my eating habits aren't as good as they should be, but I do have a diet of our traditional foods like I know at least 8 different types of roots that we can eat and I know how to find them and dig them and cook them or dry them to store for later. I eat a lot of salmon and deer meat as well as elk meat, I know how to smoke deer meat and love to eat lots of traditional Native foods. However I also love to eat chips which are my downfall. I tried to give up coffee before but couldn't do it, (I'm addicted).

                      Sorry to hear that you have diabetes Ki, next time I see you at the powwows, I won't be waving my frybread or taco around in front of you.

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                      • #12
                        See, this is what I'm talking about. Current medical protocol recommended by the ADA (American Diabetes Association) states that you should be receiving nutrition and exercise education as a standard part of your diabetic regimen. And this means wherever you are receiving treatment, be it at an IHS service unit or regular physician's office. This goes along with the medical protocol that screens you for retinopathy (regular eye exams), foot care, regular dental exams, etc. Obviously this is not happening for the majority of Indian people where they are getting their care. I know that the service unit I work at, they really focus on prevention, but the clinic needs alot of work in structure, coordinating their resources to provide assistance to the greatest number of patients, and acknowledging the role that behavior and stress play in whether a person is going to actively participate in their care.

                        There are so many barriers to adherence to a diabetic regimen for Indian people that it's mind boggling. But still there are people who successfully stick to their regimen. It's really sad that I only know of one person that really adheres to their regimen, and that's my mom. That's what I'm wondering........what makes her different and motivates her to do what is recommended, and why are other relatives that are very close to me in denial about their condition?

                        This is an area that I feel truly dedicated to and it's so huge that it can be very overwhelming at times, not only because of all the systems that must be dealt with in providing quality care, but also the emotional toll that it can take because it strikes close to home. I know that I'm at risk because Type 2 diabetes runs on both sides of my family, but I also have done enough research to know that I can prevent it with the proper knowledge and resources. I guess that's the frustrating part is that there are resources but they are so hard to get to, or are very limited.
                        Last edited by Two-cents1; 04-06-2004, 05:19 PM.

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