The increasing number of people with type 2 diabetes and prediabetes poses a significant challenge to the health-care system of every country, says Dr. Gary Lewis, director of the Division of Endocrinology and Metabolism at the University Health Network (UHN) and director of the Banting and Best Diabetes Centre at the University of Toronto.
“The complications associated with diabetes include a high risk of cardiovascular disease, blindness, amputation and kidney failure, and the consequences of managing these complications in an aging population are formidable,” he says.
At the same time, researchers are having tremendous success in developing new therapies, treating elevated blood glucose and reducing complications, he adds. “Diabetes is a disease that requires a tremendous amount of self-management – the good news for people who have the disease is that we can work together to help keep them healthy.”
UHN’s Banting and Best Diabetes Clinic provides exemplary care to diabetes patients who have complex illnesses. In this regard, “knowledge translation, or education, is an area that holds tremendous promise,” says Dr. Lewis. “Right now there is a significant gap between what we know works and what is applied by health-care providers and patients in everyday life.”
The clinic is sharing innovative methods of patient education with family physicians, pharmacists and dietitians. “We are looking at ways to improve education and provide better self-management support for people living with diabetes, through the development of more user-friendly tools, including the use of technology and social media,” he explains.
As part of this initiative, for example, UHN’s Centre for Global e-Health Innovation developed an iPhone app, called “Bant.” It captures blood glucose data and encourages healthy behaviour by offering incentives for teens with type 1 diabetes to follow their regimens.
Dr. Gary Lewis is the director of the Division of Endocrinology and Metabolism at the University Health Network (UHN) and director of the Banting and Best Diabetes Centre at the University of Toronto
UHN has a great legacy of diabetes research, starting with the first clinical use of insulin at Toronto General Hospital in 1922. Today, the network focuses on highly innovative research programs that will facilitate the translation of discoveries from the lab to the clinic. For example, stem cell research at UHN’s McEwen Centre for Regenerative Medicine has made significant progress in creating human insulin-producing beta cells. The goal of the research is to translate this discovery into clinical application by transplanting insulin-producing cells into patients with type 1 diabetes, eliminating the need for insulin injections.
“This research also holds promise for type 2 diabetes, as we further understand the development of the disease,” says Dr. Lewis.
Through a partnership with UHN, Sun Life Financial has announced a major investment in diabetes research, care and education. Mary De Paoli, the executive vice president of public and corporate affairs and chief marketing officer of Sun Life Financial, says, “At Sun Life, we’re concerned that one-third of Canadians will be living with diabetes or prediabetes in less than a decade.”
The University Health Network has been at the forefront of diabetes research and care in Canada since the groundbreaking discovery of insulin by Drs. Banting and Best in 1921, she says. “Today, UHN has one of the largest concentrations of diabetes clinical care, research and educational activity in the world – and certainly the most significant in Canada. UHN is on the cutting edge in the latest advances in diabetes research, and in raising awareness about the prevention of this disease.”
As part of its commitment to wellness in Canada, Sun Life has chosen to make diabetes prevention and awareness a major focus of its philanthropic efforts. “We believe we can make a difference and improve the lives of Canadians by making this commitment to diabetes prevention,” says Ms. De Paoli. “It is through awareness that we will see a measurable difference in our effort to curb the spread of this disease.”
Sun Life will bring special insights to the cause through the expertise developed by providing benefits and wellness programs to millions of Canadians. “In our business, we have seen both the human costs and the financial costs related to diabetes growing by 50 per cent in just five years – and these costs do not include all related conditions,” says Ms. De Paoli. “Together with UHN and Dr. Lewis, we have an opportunity to look at innovative approaches to preventing diabetes and making a lasting impact on the lives of so many Canadians touched by this disease.”
Diabetes Champion: Alia Rainbird
To find out more about the Canadian Diabetes Association and local programs and services in your community, call 1-800-BANTING (226-8464) or e-mail firstname.lastname@example.org. To read about other people living with diabetes, visit
Cereal can be a great way to start the day; just be careful which one you choose
Your mother was right: A smart start to the day includes a nutritious breakfast. This is true for everyone, but it’s especially important for people with diabetes, says Bozica Popovic, pharmacy manager at Loblaw’s Princess Street store in Kingston, Ont. “A person with diabetes who misses breakfast can end up with higher blood glucose as the morning progresses. The levels can remain that way all day, and people who are using insulin may require a higher dose. On the other hand, those on oral medications who miss breakfast can experience dangerously low blood glucose levels,” explains Ms. Popovic, a certified diabetes educator.
Lingering over a leisurely breakfast sounds like a lovely treat, but it isn’t a weekday option for most of us. Rather, we’re often busy and time-crunched, and looking for breakfast ideas that are quick and easy. Few breakfast foods are speedier to fix than a bowl of cereal, but have you looked at your supermarket’s cereal aisle lately? Most offer a bewildering range of products.
When it comes to choosing a nutritious breakfast in a box, Ms. Popovic’s top pick is unsweetened cereal that contains complex carbohydrates such as whole grains, and at least five grams of fibre per serving. Why unsweetened? “You can always sweeten it to taste,” she explains, “but you can’t take away sweetener that has already been added.”
It’s always a good idea to check the labels on any packaged food you buy, but in the cereal aisle – with its wealth of choice – reading nutrition labels is a must-do. Look for the words “whole grain” (e.g., whole oats) on cereal labels, and opt for products where whole grains appear near the top of the ingredient list. Beware of products masquerading as whole grain – red flags include the words “cracked wheat” or “multi-grain” – as they’re less nutritious than whole-grain cereals.
Shannon Richter is a registered dietitian at Loblaw’s Midland Avenue and Princess Street stores in Kingston, Ont., who conducts store tours for people with conditions such as diabetes. During the tours, she shows her customers how to read labels, what to look for, and other tips on choosing healthful products. In the cereal aisle, Ms. Richter guides customers with diabetes toward products that are low on the glycemic index (GI), such as oatmeal and some bran-based cereals. By contrast, high-GI cereals include cornflakes and crisped rice cereal. Low-GI foods raise blood glucose levels less than high-GI foods, and they do so more slowly.
As well as watching for sweetened cereals, it’s best to avoid those with added dried fruit. “We advise limiting the amount of dried fruit you eat if you have diabetes,” says Richter, “as it’s very high in carbohydrate.” Better to add a little fresh fruit if you want some natural sweetness in your cereal, she suggests.
One of the packaged cereals that contains the most dried fruit is granola, a product that may seem a nutritious choice, but one that Ms. Richter advises people with diabetes to avoid. “Granola is very dense and concentrated,” she explains. “If you read the label, you’ll find the suggested serving size is small and likely won’t satisfy you like a larger bowl of less dense cereal.” But, Ms. Richter concedes, granola can be a good topping to sprinkle sparingly on a bowl of yogurt.
For hearty and healthy breakfast recipes, visit www.diabetes.ca
Reprinted with permission from Diabetes Dialogue, Autumn 2012.