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Last week I saw a young woman with a beautiful face outside the grocery store. It looked as if she was waiting for someone. Without a waistline, she stood over 6 feet tall weighing almost 300 lbs. She stood motionless eating a chocolate donut while her expression quietly stared into nothingness.

What I saw is an all too common scene and a troublesome reality of our society. What creeps up is the two-faced mask of obesity and diabetes which has become a symptom of the foreboding undercurrent of our culture's emotional climate. It may be hard enough for us to understand the weather, but I dare you to try and familiarize yourself with the climate of this health crisis now in epidemic proportions in the Niagara region.

I have invited Baher Khoury of PharmaViva Pharmacy in Thorold Ontario to share his expertise on diabetes. Mr. Khoury is a certified diabetes educator (2008, 2013) and a pharmacist.

Mr. Khoury since this is such a critical and complex health condition affecting many individuals we are pleased that you joined this discussion. Some of our readers would like to be more informed about diabetes. What is diabetes and who gets it?

Diabetes is a disorder of metabolism caused by malfunction of secretion or action of insulin. Carbohydrates such as starch, pasta, rice, bread, and potatoes are broken down into glucose after digestion. Glucose is the main source of energy and growth to the body's cells. Glucose flows in the bloodstream. Insulin helps to carry glucose from the blood to enter the cells for its use. If the pancreas is not able to secrete enough insulin, glucose will be highly concentrated in the blood. Or, if the body is resistant to the action of insulin, the insulin will not be able to carry glucose into the cells, and again the blood glucose level will be high. There are three types of diabetes: Type 1, Type 2, and gestational diabetes. In Type 1 diabetes, the pancreas is not able to produce enough insulin. This type of diabetes is usually diagnosed at an early age. 10% of patients with diabetes have Type 1 diabetes. Type 2 diabetes is the most common type of diabetes, affecting 90% of patients with diabetes. The body is not able to use the insulin effectively, which is known as insulin resistance. Gestational diabetes is a type of diabetes that some women develop late in pregnancy. Pregnant women should be checked for gestational diabetes at week 28 of gestation. Diabetes is not contagious, but there are several risk factors that may play a role in developing the disease. Three of the major risk factors are genetics (family history), a sedentary lifestyle (lack of physical activity), and obesity.

I hear reports that Type 2 diabetes has reached epidemic proportions in the Niagara Region. What is your reaction to that statement?

This is true. 10% of the population in the Niagara Region has type 2 diabetes, and 15% has prediabetes. Terry Young, the coordinator of the Canadian Diabetes Association in the Niagara Region, validates these trends. Prediabetes is the stage preceding the development of type 2 diabetes.

Aside from Niagara, what are the general demographics of this disease that we should know about?

According to Statistics Canada's 2012 data, there were a total of 1,924,066 men and women over 12 years old with diabetes. Of this number 894,226 people were over the age of 65. Diabetes is slightly more prevalent in males than in females.

What are the treatment options?

Insulin therapy is used to replace the insulin that is missing from the body. There are short-acting and long-acting types of insulin, and they are both given by an injection. When diagnosing someone with diabetes, the doctor will develop an insulin injection schedule that will work the best for them to control their blood sugar. Insulin can be used to treat all types of diabetes.There are also pills that can be taken orally for people with type 2 diabetes. These medications stimulate the pancreas to make more insulin. They may also make the body's cells less resistant to the effects of insulin. In addition to medical treatments, maintaining a healthy lifestyle is also very important in managing both type 1 and type 2 diabetes. Regular exercise and choosing to eat a healthy balanced diet including whole grains, vegetables, fruit, and lean protein goes a long way. It is also important to check blood sugar regularly, according to the doctor's recommendation.

Is diabetes preventable?

Type 1 diabetes is not preventable. Type 2 diabetes can potentially be prevented by lifestyle modification. Exercising regularly, eating a healthy balanced diet, and maintaining a healthy weight are all very important for prevention of type 2 diabetes.

Life style modification is a crucial part of a treatment plan, and this includes not only diet restriction but also habits modification and emotional motivation. I do not trust every advertisement because I am a pharmacist and believe in evidence-based medicine. But if a program will coach you through the change of unhealthy habits, motivate you to follow a healthy lifestyle and educate you to do better choices, I'll say go ahead and try it. The one thing I strongly advise is never to stop Diabetes management medications on your own, always involve your Doctor or Certified Diabetes Educator in your decisions. One more thing to add: It seems like many American products are advertised when it comes to Diabetes. However, units of measurement are different, and some guidelines are not identical. So it is a good idea to work with a local Certified Diabetes Educator to avoid confusions and follow better local practical solutions.©

If you have any questions about your diabetes, please call Baher Khoury at PharmaViva Pharmacy at 905-680-7077.


Mr Khoury thank you for sharing this important information for the benefit of our readers.

Diabetes: The Basics


May 15, 2014


James Kershaw


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Jim Kershaw says

December 23, 2016

Diabetes originates from one's diet and is said to be managable if taken serioulsy.

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