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Diabetes in First NationsNo one knows why it is increasing . It seems to be because of all the changes that have happened in the native cuture, especially how they live. It�s like they are out of balance with themselves and nature. Today, it has been said (Hooper, 1995) that non-insulin dependent diabetes (NIDDM) is an epidemic in Native people; �in the old days, it was not known as a problem�. Diabetes was virtually non-existent in Native people in Canada before the 1940�s. Many believe that diabetes was introduced through contact with non-Natives. There are many environmental factors that affect and influence client care, some internal ones are; genetic background is a determining factor in the prevalence of type 2 diabetes. The more full blooded individuals were found to have the highest prevalance of type 2 diabetes as compared with those of more mixed heritage. Pima Indian families share the trait of low metabolic rate. This trait is considered predictive of weight gain and development of type 2 diabetes. A �thrifty gene� is also thought to cause a genetic predisposition to obesity, although this gene has not been identified. The thrifty gene theory suggests that people who experienced alternating periods of feast and famine gradually adapted by developing a way to store fat more efficiently during periods of plenty to better survive famines. (Canada, 2001). There are many external environmental factors contributing to diabetes in First Nations such as in Canada, there is geographic variation in prevalence rates. In general, there is a decrease in the rate from south to north, and from east to west. There is also a significant increase from remote to rural to urban areas. In B.C. statistics show increases of 22 to 190% in prevalence rated between 1987 and 1992 in different regions of the province. (Hooper, 1995). The NIDDM type of diabetes, which has historically been considered an adult condition, is now showing up in adolescents and children as young as two years old. Diabetes is emerging as one of the most threatening health conditions in Native people. Factors include rapid cultural change, acculturation stress, abandonment of traditional values changes in styles of living, conflict between traditional Native dietary patterns and modern Canadian food habits, decreased energy expenditure,obesity, stress-mediated hormones, and the inability to digest carbohydrates properly. Dr. Louis T. Montour (Hooper, 1995) a native physician has stated that �diabetes within Native communities is a symptom of other community problems and appropriate care requires involvement of the community. Cultural disruption, cultural transformation, socio �economic change and environmental damage have brought with them the growing tendency to replace wildmeat and other traditional foods with store bought products that are less nutritious, high in fats, starches and sugar. Dietary change and the declining use of traditional foods are linked to higher rates of obesity diabetes, high blood pressure, heart disease and dental decay. (Ship, 2002)
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