NOVEMBER IS DIABETES MONTH

November is Diabetes Month. The College of Pharmacy’s Drena Dunford is both an Instructor and a Canadian Diabetes Educator. The Canadian Diabetes Education Board certifies health care practitioners to promote the care and management of diabetes through teaching, patient care and continuing education. As a CDE, Dunford teaches both her patients and future pharmacists about holistic factors of diabetes care. Pharmacists play an important role in the management of diabetes as many medications, both prescription and over the counter, can factor in the overall health of a patient with this disease.

Dunford knew she wanted to work in the health-care field for her career and chose to study Pharmacy at the University of Toronto. “Pharmacy school was such a great experience. Some of my lifelong friends I met while studying.” Knowing she wanted to return home to Manitoba to work was one of the main reasons she became certified as a diabetes educator. “Diabetes is extremely prevalent in Manitoba and I wanted to be prepared to help patients I would encounter on almost a daily basis. The more I knew about this disease, the more I’d be able to empower them for their own health.” In the Manitoba Government’s Call to Action, it was projected that 8.5 per cent of the province’s population would have Diabetes in the near future.

After graduating in 2003 she moved back to Winnipeg as to work as a pharmacist for Shoppers Drug Mart.  After a few years, she became a civilian contractor to work as a pharmacist at the Canadian Forces Base in Winnipeg. Dunford worked in the primary care clinic at the base, working alongside doctors, nurses and other health care providers. Academia was a new challenge and she joined the then Faculty of Pharmacy in 2011. Now, between teaching Clinical Pharmacy and practicing as a pharmacist, she’s studying for her Doctor of Pharmacy through the University of Colorado and is the reigning champion of the Pharmacy Holiday Door Decorating contest.

Q & A with a Diabetes Educator

What is Diabetes?

Diabetes is a deficiency in insulin production and use. Blood sugar levels are regulated by insulin, so an issue with insulin causes issues in blood sugar.

When you eat, food is broken down to be used as energy. The blood cells carry this broken down food to the cells that need it. Insulin is responsible for directing the flow of blood sugar into the cells where it can be used as a source of energy. Think of it as your blood cells are a bus, food energy is a tourist and insulin is the tour guide. With proper insulin levels, all the tourists are directed properly by the insulin. But if there is an issue with insulin, the food energy tourists stay on the bus, causing your blood sugar to become uncontrolled.

Is there a difference between Type I and II?

The two main types, Type 1 and Type 2, are quite different. Type I is a total lack of insulin production. This is usually diagnosed in childhood and will require lifelong management of the disease. Type 2 is either a lack of insulin or an inability for the body to use insulin, called “Insulin Resistance”. This can happen at any time in life, but usually later on and there are varying severities.

90-95 per cent of cases are Type 2 Diabetes. Unfortunately in Manitoba, there is a concern with the number of cases of Type 2 Diabetes in children. Based on lifestyle, diet and other factors, what was an adult disease is quickly becoming more common in children. In 2010 the percentage of children with Type 2 diabetes was 10 times higher than the national average.

If someone is “pre-diabetic” what does that mean?

Pre-diabetic means a person’s blood sugar levels are higher than they should be, but not so high as to diagnose Diabetes. With lifestyle and dietary changes it can usually be managed safely. It isn’t an automatic pre-cursor to Diabetes. Think of it as a freeway with exits. Yes, if you continue on the freeway, it will escalate to Diabetes, but you have options to make a change.

How do the treatments vary for the different cases on Diabetes?

Like most disease management, there are spectrums for treatments. All cases do require diet and lifestyle management. Medicines that reduce blood sugar are often used to either increase sensitivity to insulin or cause the body to produce more. Patients may require insulin injections regularly to control their blood sugar levels as well.

It’s very important for health care providers to work collaboratively for their diabetes patients. With so many factors playing a major role in the daily life of a diabetes patient, keeping everyone on the same page is crucial.

Patient education is the key. There are several centres in Winnipeg, and throughout the province, designed to help patients and their families get equipped to deal with diabetes. Understanding how to manage your blood sugars and recognizing the symptoms of potentially dangerous situations is important for everyone living with this disease and patients should ask any of their health care providers, such as physicians, nurses and pharmacists, for clarification if needed.