By: Surjit Singh Flora
All over the world, November is Diabetes Awareness Month. This year marks the 100th anniversary of the life-saving and revolutionary discovery of insulin in Canada. Studies have shown that people with diabetes have a higher risk of contracting COVID-19.
Canada has never had a national strategy for diabetes. But Parliament has passed Bill C-237, an Act to Establish A National Diabetes Framework, and it became law on June 29, 2021, thanks to tireless advocates and diabetes organizations.
Canadians will now have a better legal framework to address the growing issue of diabetes. It was our Liberal government Member of Parliament from Brampton South, Sonia Sidhu, who introduced Bill C-237 as a Private Member’s Bill, An Act to Establish A National Framework for Diabetes. This bill received unanimous support from all political parties and was approved by both Houses of Parliament.
Indian-born Sonia Sidhu, a Member of Parliament (MP) for Brampton South in 2015, has been a tireless advocate for diabetes awareness and the leading voice in the #LetsDefeatDiabetes campaign here in Canada. Over the years, she has had dozens of consultations.
Sidhu’s Bill C-237 (also known as the National Framework for Diabetes Act) aims to increase awareness about diabetes and prediabetes. It also guides health care professionals and other professionals in treating and preventing diabetes.
This bill now requires the Minister of Health to work with representatives of the provincial health departments and other stakeholders to create a national framework to support diabetes prevention, treatment and rehabilitation. It will also help to identify the training, education, and guidance requirements of health care professionals involved in its prevention and treatment.
Canada has a high incidence of diabetes, and South Asian communities are particularly affected. Diabetes and prediabetes affects 11 million Canadians and can cause life-threatening complications if it is not treated. In Brampton, one in six are affected by diabetes. The rate is increasing, and Peel, which is home to a large South Asian population, is one of the most severely hit areas. Brampton is a city in Peel that has one of Canada’s largest South Asian populations.
Sidhu has been in politics for six years. She has 18 years of experience in healthcare and entered politics with an intimate understanding of the country’s health care needs.
“I have seen many newcomers with diabetes in the past. Over the years, diabetes has been increasing in South Asian Canadians.” She says South Asian Canadians need better support and care to manage diabetes.
All communities are affected by the disease. First Nations are also at greater risk of developing diabetes than the rest of the population, and they are three to four times as likely to be diagnosed with it than the general population. The Brampton MP says that she has seen the devastating effects of diabetes firsthand and knows it can be prevented.
Sidhu points out that Canada has seen double the number of diagnosed cases in the past 20 years. While diabetes is challenging enough in itself, it also causes further serious complications down the road. Patients with heart disease, kidney disease or amputation would often be suffering from diabetes.
Sidhu’s motion in 2019 to make November Diabetes Awareness Month was unanimously passed by the House of Commons.
Although South Asian immigrants arrive generally in good health, they quickly develop diabetes once they have settled in North America. It is not clear if cultural or psychosocial factors contribute to diabetes risk in this minority ethnic group.
Diabetes Canada leads the fight against diabetes and is committed to helping people with diabetes live healthy lives and preventing complications. Many factors, including ethnicity, can correlate with type 2 diabetes, and high-risk groups include people from African, Caribbean and Black communities and those who are Southeast Asian, South Asian, or Southeast Asian. Today, approximately 20% of Canada’s population is high-risk. The incidence of those diagnosed with the condition has jumped 100% in the last decade.
South Asian migrants are at high risk for developing diabetes. Most previous research on South Asians has focused on the whole group. A more recent study examined diabetes prevalence in five South Asian immigrants living in Ontario, Canada.
There were 431,765 South Asian immigrants who came from the first generation. Of these, 68,440 had diabetes (crude prevalence 15.9%). Standardization of income, age, sex, and gender revealed that South Asians from Sri Lanka had the highest diabetes prevalence (26.8%), followed by Bangladesh (22.2%) and Pakistan (19.6%), India (18.3%), Nepal (16.5%), and 11.6% for non-immigrants.
In each country in South Asia, there was an increase in the prevalence of diabetes among women and men. Increased diabetes prevalence in South Asian populations was associated with sociodemographic indicators such as income, education, English proficiency, refugee status, and other sociodemographic factors.
Experts claim that South Asians are at greater risk for myocardial injury and higher mortality rates from cardiovascular disease than other races/ethnicities in Canada. Experts admit that even though Indian Canadians are not considered at risk for heart attacks or other serious heart conditions, they are more likely to develop cardiovascular disease and die sooner than other ethnic groups.
Genetic disposition actually means that Indians, Africans, and Native Americans all have genes that store more fat. Therefore, even if an Indian had the exact same diet as a Caucasian, it is likely that the Indian would be more overweight than the Caucasian.
Indians eat a lot of carbs, and Indians would typically eat flatbread or white rice daily. White rice is less healthy than brown rice, but it’s also less expensive. The problem is that Indians are not aware of the fact or can’t afford brown rice, which is more expensive.
Traditionally, South Asians were blamed for their preference for oily foods with high refined carbs and sugar levels, such as sweets and samosas. However, experts believe that this is not enough to explain the high rate of heart disease in South Asians.
The jury is also still out on how such conditions variably affect the sexes.
Let’s begin with women. Many women are skinny, but being thin (undernourished) is not the same as being fit. They don’t have a routine for exercising, and they believe that household chores are enough for exercise and that being overweight is a sign of being healthy.
Inherently, our food has a high glycemic level (lots and lots of chapatis/ rice), and we add ghee, butter and oil to it. Older women in villages will often make their pregnant daughters and daughter in law’s drink cups of molten butter after giving birth to a baby. The diet that is “prescribed” by the elders is mostly ghee. Women gain weight after childbirth but never then lose it. They lose any muscle tone that they once had. A common warning is not to lift it; it will knot your stomach. “Don’t eat mangos; you’ll have a miscarriage,” goes another caution. These same thoughts were brought to Canada by the Indian women who work all day cleaning and mopping. Here, however, we can sit in front of the TV for hours watching the shows. Food is never digested in Canada.
Women also think that gyms are for bad guys, and they have fewer gyms in small towns.
Yoga is not a religion-specific practice, although this is what many believe. Many gurus give excessive warnings that can make women’s inhibitions worse. For example, you should only do this after you have bathed, eaten for at least three hours, and then drink water an hour before the session. But is yoga a surgical procedure? People already working full-time won’t be able to move. They’ve done the housework, so that should be enough for exercise.
When we are talking about them, men will only engage in sports until they graduate from university. Most people would choose cricket as their primary sport, although it is less intense than many other sports. Women are less likely to engage in sports than men due to a lack of facilities for change and encouragement.
Canadian Indians starting to work leave thoughts of sports behind. The work culture requires long hours, which leaves little time for exercise and sports. It also encourages weight gain by allowing people to eat late and then go to bed quickly. This is true for restaurant workers, factory workers, and domestic workers in cities.
As we are celebrating November as Diabetes Awareness Month around the world, it is important to note that this year posts a key landmark, because it marks the 100th anniversary of the life-saving and revolutionary discovery of insulin.
Let’s thank Brampton South Brampton MP Sonia Sidhu for her tireless work to improve the health of its Canadians.