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Type 2 Diabetes in Indigenous Peoples living in Canada
- Jan 2, 2022
- 4 min read
Intergenerational diabetes in Indigenous Populations as a result of the Canadian residential school system
By: Dalainey Gervais
This summer, the discovery of mass grave sites on former residential school grounds gave Canadians the wake up call many Indigenous groups have been advocating for for years. Residential schools were a government-sponsored institution run by the Christian church in hopes of assimilating the Indigenous population in Canada. Between 1831 and 1996, an estimated 150,000 children were stolen from their homes and imprisoned in one of Canada’s 130 residential schools.
The graves were a reminder to Canadians that it is time to address the needs of Indigenous Peoples head-on, as the reality of the trauma inflicted by government and Church is no longer labeled a thing of the past. Along with discussing intergenerational mental health trauma, it is important to address other long term health problems directly related to the former residential school system.
What is type 2 diabetes?
Type 2 diabetes is an insulin resistance condition. The body of an individual suffering from type 2 diabetes will produce insulin, however their body will not know how to use it. This leads to a decrease of insulin production from the pancreas. Eventually, the resistance to insulin will result in the increase of blood sugar levels and the body will stop producing insulin. There are many risk factors for developing type 2 diabetes, which includes having a family history of diabetes, being over the age of 40, being overweight or having Indigenous, African or South Asian ancestry.
There are many symptoms of type 2 diabetes, which may develop simultaneously or slowly over a several year period. According to the Diabetes Care Community, symptoms of type 2 diabetes include:
Increased thirst or hunger
Tiredness and fatigue
Blurred vision
Numbness in hands or feet
Sores that take longer than usual to heal
Spontaneous weight loss
There are medications that can help with increasing levels of insulin and regular blood sugar levels. In some instances, individuals with type 2 diabetes may be prescribed with injectable insulin, however in most cases this technique is only used in advanced cases of the disorder.
Prevalence of Type 2 diabetes Indigenous communities
According to a 2011 census of the Canadian population, statistics show rising numbers of self-identified Indigenous Peoples being diagnosed and/or experiencing early onset symptoms of type 2 diabetes.
The following figures are pulled from the 2011 census:
First Nations, Inuit and Métis populations are of the highest-risk groups to be diagnosed with diabetes in their lifetime
17.2% of First Nations living on a reserve are diagnosed with diabetes
10.3% of First Nations not living on a reserve are diagnosed with diabetes
7.3% of the Métis population are diagnosed with diabetes
Indigenous women are more likely to experience gestational diabetes, a condition where a women without diabetes develops high blood sugar during pregnancy
With only about 5% of Canada’s population identifying as Indigenous as of 2020, the statistics above suggest that approximately 35% of the Indigenous population or 560,000 of the 1,600,000 will be diagnosed with diabetes in their lifetime. This is in comparison to the 5% or 1,360,000 of the rest of the Canadian population who are diagnosed with diabetes.
In addition, research conducted by Crowshoe and colleagues suggest that indigenous people begin to show more severe symptoms of diabetes at a younger age, leading Indigenous people more at risk of developing severe microvascular diseases as a result of the underlying type 2 diabetes. This leads to a higher prevalence of chronic kidney disease, end-stage renal disease and lower-limb amputations in Indigenous populations living in Canada.
How residential school diets lead to type 2 diabetes in Indigenous communities
The treatment of Indigenous children in Canadian residential schools are a direct cause of Indigenous Persons being among those with highest risk for diabetes and complications related to the disease.
In an article written to highlight the extent of intergenerational health trauma caused by residential school, researchers Ian Mosby and Tracey Galloway reviewed the Truth and Reconciliation Commission of Canada (TRC) and noticed a recurring mention of hunger in residential school survivors. Multiple survivors have recounted begging for food while in residential school only to be given rancid food. Many recall deep hunger being the more prominent memory of their time in residential school. Although there is no true documentation on the nutrition intake from Canadian residential schools, researchers have made the deduction from accounts taken from survivors that on average, children in the residential school system ate between 1000 and 1450 calories per day, which is below the recommended average for children.
Malnutrition in developing children has detrimental health complications, including the increased risk of developing type 2 diabetes. Mosby and Galloway explain that the feeling of hunger activates the pituitary-adrenal stress response of your brains, which over long periods of time can halt the insulin response of the pancreas.
Indigenous children in residential schools were mostly starved and the insulin production process was often activated through their feeling of hunger, which led to the early development of type 2 diabetes in early adulthood. Having relatives with type 2 diabetes is listed as a high-risk factor in the development of the illness so many of the relatives of survivors of residential schools have unfortunately developed type 2 diabetes in their adulthoods. Thus, the starving of children in residential school is a direct cause of the prevalence of diabetes in Indigenous communities.
Calls to action: preventative screening in Indigenous communities
Preventative medicine is a strong solution to addressing the high rates of type 2 diabetes. Crowshoe and colleagues (2018) call for the immediate institution of preventative diabetes screenings for indigenous communities to catch and address symptoms in their early development. For Indigenous children under the age of 18 who are at a higher-risk, for example those who have a long family history of diabetes, researchers suggest preventative screenings to be conducted every 6-12 months.
Primary source 1:
Title: Diabetes and Indigenous Peoples
Authors: Lynden Crowshoe, David Dannenbaum, Michael Green, Rita Henderson, Mariam Naqshbandi Hayward & Ellen Toth
Journal: Canadian Journal of Diabetes
Year: 2018
Primary source 2:
Title: “Hunger was never absent”: How residential school diets shaped current patterns of diabetes among Indigenous peoples in Canada
Authors: Ian Mosby & Tracey Galloway
Journal: Canadian Medical Association Journal
Year: 2017
Other sources:
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