Morrison N, Dooley J
University of Toronto Sioux Lookout Diabetes Program, Sioux Lookout, Ontario, Canada.
Int J Circumpolar Health. 1998;57 Suppl 1:364-9.
Clinically, non-insulin-dependent diabetes mellitus (NIDDM) in the First Nations population of the Sioux Lookout Zone (SLZ), Northwestern Ontario, represents a very different entity than that found in the general Canadian population. Here, its prevalence reaches upwards of 17% (over the age of 10) and children as young as five years of age have been diagnosed. Diabetic ketoacidosis is frequently found, and clients with blood glucose levels of 50 mmol/L or more have remained asymptomatic. Prevention and management of NIDDM in the SLZ must reflect this reality, as well as those of geographic remoteness; community-specific needs; and cultural, in addition to personal, relevance. Over the past five years, the Sioux Lookout Diabetes Program has been developing innovative services and resources to address these needs. Traveling foot-care and diabetes education programs, Community Health Representative training programs, a youth camp, school programs, grocery store labeling programs, and culturally relevant education manuals are a few such initiatives. Visions for the future include the development of a network of community-based diabetes workers to address more completely prevention and management needs on an ongoing basis and the development of stress management workshops for First Nations clients. With our current programming, these new initiatives, and an aggressive early screening program, we hope to stem the imminent onslaught of amputations, heart attacks, renal failure, and blindness.
临床上，安大略省西北部苏圣洛区（SLZ）原住民中的非胰岛素依赖型糖尿病（NIDDM）与加拿大普通人群中的情况截然不同。在这里，其患病率高达17%以上（10岁以上人群），甚至有年仅5岁的儿童被诊断出患有此病。糖尿病酮症酸中毒很常见，血糖水平达到50 mmol/L或更高的患者仍无症状。SLZ地区NIDDM的预防和管理必须反映这一现实，以及地理偏远、社区特定需求、文化因素以及个人相关性等情况。在过去五年中，苏圣洛糖尿病项目一直在开发创新服务和资源以满足这些需求。巡回足部护理和糖尿病教育项目、社区健康代表培训项目、青少年营、学校项目、杂货店标签项目以及具有文化相关性的教育手册等都是此类举措。未来的愿景包括建立一个以社区为基础的糖尿病工作者网络，以便持续更全面地满足预防和管理需求，以及为原住民客户开展压力管理工作坊。通过我们目前的项目、这些新举措以及积极的早期筛查项目，我们希望遏制即将到来的截肢、心脏病发作、肾衰竭和失明等情况。
