Type II Diabetes in Indigenous Populations

I think that what I found during my research and the topic I chose definitely relates to the topics we discussed in class. Indigenous people lived a certain way before Europeans came to this land. Their traditional diet was very different from what is considered normal today. Changes in their diet began as soon as trade started between Europeans and Indigenous peoples as they were introduced to sugar, flour and other new, possibly less nutritious food. This was emphasized during the switch to reservations and through residential schools. Their way of life and diet was forcibly altered by each of these as the traditional way of gathering food became limited. What I see in this was that Europeans believed Indigenous people did not know how to care for themselves well enough through traditional ways, which lead to enforcing a new way of life. This is looking at how Europeans claiming authority over Indigenous peoples lead to various alterations in their lifestyle. It also raises the question of how and if Indigenous peoples were viewed as citizens. I may not have addressed these questions directly in my research but they are there when looking at Canadian history.

Seeing as how it would be impractical to share the entire research paper here, I thought I would include the introduction and conclusion.

When considering the long history of Diabetes Mellitus it is a fairly recent disease for Indigenous people of Canada. By starting with the general history of diabetes, I hope to establish a comparison point for the disease as it occurs in First Nations people. From there I will discuss the link between obesity and diabetes, starting with a discussion of the occurrence Caucasian women and transitioning into discussing First Nations people.  Following this, I will discuss data available on Inuit populations of the Northwest Territories. Unfortunately, there is not a substantial amount of data available for Métis people and because of that this paper will mainly focus on First Nations and Inuit people. From there, I will look at diabetes statistics that are available on all Canadians diagnosed with diabetes. Most studies on diabetes and obesity in Indigenous populations are relatively recent, having been conducted within the last fifty to sixty years. Though the focus is on Canadian First Nations, I will be doing a comparison to non-First Nations/Indigenous peoples when necessary. The colonization of Indigenous people of Canada has been detrimental to their health; enforcing a reservation system and assimilation on them has resulted in alarming rates of diabetes and obesity.

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In conclusion, it seems indisputable that colonization changed Indigenous health in Canada. Lifestyles along with diet were greatly altered as Europeans forced their way onto Indigenous land and Indigenous peoples onto reservations and into Residential Schools. Type 2 Diabetes Mellitus, an old disease in the history of the world, is fairly new for Indigenous peoples. It seems most probable that the introduction of refined sugars, flour, and other processed foods, along with decreased physical activity due to an altered lifestyle, led to the high and rising rates of obesity and diabetes. Indigenous peoples were self-sufficient, active and relatively healthy compared to their lives post-colonization. Caucasians and other non-Indigenous populations have significantly lower prevalence rates of diabetes. Unfortunately, I have not found why it is First Nations women that have higher prevalence rates and not men. There is the possibility that it is tied to obesity and the type, android versus gynecoid, that First Nations women have.

I knew when starting this research project that I wanted to look at how gender and diabetes were linked together. I was disappointed when I could not answer the question of “why”. The government publications state that men are at higher risk of developing diabetes than women are, but this is not true for First Nations people. I wanted to know why First Nations women are at higher risk than First Nations men. While many studies point out the higher prevalence among First Nations women, no study that I read said why this was true. My only speculation comes from a study I read on body fat distribution. The study noted that the participants with android obesity when there is more fat at the neck and there is a higher fat-to-muscle ratio in the arm than in the thigh,[1]  This observation makes me wonder if First Nations women are more likely to carry fat in this manner. This is a reasonable explanation, in my opinion, because android obesity is considered to be more common in men, which would explain why non-Indigenous men are at higher risk.[2]

[1] David S. Freedman and Alfred A. Rimm, “The Relation of Body Fat Distribution, as Assessed by Six Girth Measurements, to Diabetes Mellitus in Women,” American Journal of Public Health, 1989, vol. 79, no. 6, 715.

[2] Janjic D, “[Android-type Obesity and Gynecoid-type Obesity,” 1997, web, accessed March 30, 2017. https://www.ncbi.nlm.nih.gov/pubmed/8992575

I learned a lot more about the history of both diabetes and traditional Indigenous diets than I expected to learn through my research. One of the most interesting sources I found was on the history of diabetes. I learned that polyuria was found by Egyptians in 1500 BC in what they called the sugar disease.[1] Diabetes was named by the Greek in 164 AD, and Mellitus was added to it later when they discovered sugar in the urine.[2] This source also gave many examples of how the diet of diabetics was altered over time in attempts to treat the disease. Diets varied from being heavy in fats and pastries to being quite sparse, consisting mainly of bread, milk and barley water.[3]

Another source I found particularly interesting was in Mary-Ellen Kelm’s Colonizing Bodies. Her essay is written about the traditional diet of BC First Nations. I found it interesting that the traditional diet for them, being high in fats and proteins, was similar to some of the later recommended diets for diabetics mentioned in “History of Diabetes.”[4]

[1] Kathryn M. King and Greg Rubin, “History of Diabetes: From Antiquity to Discovering Insulin,” British Journal of Nursing, 2003, vol. 12, no. 13, 1091.

[2] Ibid.

[3] Ibid., 1092.

[4] Mary Ellen Kelm, “’My People Are Sick, My Young Men are Angry’: The Impact of Colonization on Aboriginal Diet and Nutrition,” Colonizing Bodies, UBC Press, 1998, 21.

During the span of my research, I looked at government pamphlets, studies, articles, interviews, and books. In the end, the most useful sources ended up being studies. Taking a look at my Bibliography for the paper, most of my sources were, in fact, studies. I found the government pamphlets useful for providing statistics on the general population. I wanted to try and find books on the subject but it proved to be difficult. With so many of my sources having been published in the last seven years, I tried to make it more focused on the history aspect through looking at dietary changes and also studies conducted on non-Indigenous populations. I came across only a few books specifically on Diabetes in Indigenous people and therefore had to pull my information mostly from other sources.

The sources I used vary in time when looking at publication dates. Most of the sources on First Nations and diabetes were published in 2010 or later. The studies on Inuit populations were actually published in 1965 and 1968. While a few sources were published in the 1980’s and 1990’s, most of the sources were actually published after 2000. I found studies that looked at obesity and diabetes prevalence in Caucasian women, and multiple studies that looked at diabetes in Inuit or First Nations populations. I was surprised to find any studies on the disease in Inuit populations because I understood that data for Inuit and Métis is limited.