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Winter 2005 |
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H
e a l t h P r o m o t i o n
Diabetes in
Newfoundland and Labrador: Together we can make a difference
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SVHS Photo |
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As we look forward in
health service delivery, we face many challenges not the least of which
is creating efficient health systems in support of those with chronic
diseases.
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By Dr. S. Ann Colbourne |
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As we look forward in health service
delivery, we face many challenges not the least of which is creating
efficient health systems in support of those with chronic diseases.
Newfoundland and Labrador has the highest
provincial burden of diabetes. At 6.4 per cent prevalence of diabetes,
increasing attention to screening and case finding will expand that
statistic. Our province is aging more rapidly than any other province.
As individuals accumulate more chronic disease and more complications of
chronic disease, we need to find strategies not only to optimize care,
but where possible, to influence healthy public policies and wellness
initiatives that will keep the population healthy.
Key diabetes prevention trials show that
aggressive “lifestyle modification” increasing activity levels, aiming
for healthy weights and decreasing fat consumption reduces incident
diabetes by 58 per cent. This is in excess of what can be achieved by
using medications to “prevent disease.”
We have a relatively sedentary,
overweight/obese (71 per cent adult, 36 per cent children) and aging
population. Social supports are eroding. We have significant
vulnerability in poverty, employment, literacy, food security, and sense
of control. Genetic predisposition for diabetes in combination with
vulnerability and unhealthy lifestyles will see this health burden
increase. The costs will be high. It is estimated that in 2016 the
direct provincial costs for caring for those with diabetes mellitus will
exceed $135 million. That does not account for indirect costs related to
disease complications or costs of human suffering.
Provincially, we have seen a coalescence
of efforts to address this concern. Government has mobilized and
invested primary health care resources to structure collaborative team
processes throughout this province. We see an evolving collective desire
amongst health professionals to seek efficiencies and improved practice
according to Canadian Diabetes Association guidelines. Through teamwork,
health professionals strive to promote evidence-based care in a timely,
efficient coordinated fashion that is not vulnerable to shifting human
resources, but rather is predicated upon promoting self management and
optimal therapies. Individuals and communities are significant partners
in these processes.
We must put aside our therapeutic nihilism
regarding efficacy of lifestyle interventions and embrace wellness
strategies in ways they have not previously been embraced. Physicians
working collaboratively with other health professionals will affect
optimal appropriate service delivery models. Together we are so much
more that the sum of our parts. Together we will seek a healthier
tomorrow for all.
Dr. S. Ann Colbourne is an internal
medicine specialist with Eastern Health and an associate professor of
medicine with Memorial University. She is also a member of the
Provincial Diabetes Strategy Advisory Committee.
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