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The Type Talk

by Dr. Jeff Johnson | November 19 2015 | 2 Comments

November is a busy month (aren’t they all?), but one of the reasons it stands out for me is that it is Diabetes Month, and November 14 was officially World Diabetes Day, as declared by the International Diabetes Federation. Being involved in diabetes research and policy, I think of November as a time to highlight all things diabetes and hence, the topic of my very first Sandblog post!

I am often asked what led me to focus on diabetes in my academic career, and as is often the case, it was as much by accident as by plan. When I graduated from pharmacy school (all those years ago!) I had indicated to my professors that I would be interested in doing some teaching. What they said they needed was someone to cover the lectures on diabetes therapies. The rest, as they say, is history! The fact that the number of people living with diabetes continues to grow reminds me that there still remains a lot of effort, in practice, research, and health and social policy development, to overcome the major burdens diabetes places on us and our health systems.


One of the difficulties in addressing the challenge of diabetes is that it isn’t really just one condition that we are dealing with. There are really 3 major forms of diabetes in the population.

TYPE 1: Type 1 diabetes typically comes on during childhood, and at present, we do not know what causes it; just an unlucky circumstance that has a lifelong impact on those affected. Because we don’t know its cause, we don’t know how to prevent it—yet. We only know how to treat it, which requires regular insulin injections for the rest of the person’s life.

TYPE 2: While we often think of children as the image of diabetes, the much more common form is type 2 diabetes, which typically has its onset in adulthood. In fact, the vast majority, probably around 95% of cases of diabetes in the population, are type 2 diabetes. Type 2 diabetes is really considered a disease of the older adult population, affecting up to 25% of those over the age of 70. Type 2 diabetes is very different from type 1, and despite having some risk factors that we can’t change (such as age, ethnicity and family history), it is very much a preventable condition. We know that healthy eating and active living to maintain a healthy body weight can prevent the onset of type 2 diabetes, and especially in those who are considered at high risk of developing the condition.

GDM: The third major form is gestational diabetes (GDM), which first appears during pregnancy, in about 4 – 5% of all pregnancies, and has a very strong link to type 2 diabetes (similar risk factors like obesity, ethnicity and family history). Women who develop GDM are at high risk of developing type 2 diabetes later in life, after their pregnancy, as are their children. And therefore, this risk of developing type 2 diabetes can also be reduced through healthy lifestyle choices during and after pregnancy.

TYPE 2: A Closer Look

Two of the most important things that I have learned in my years studying type 2 diabetes is that:

  1. It isn’t really a sugar disease. I find this conclusion often surprises people. What I mean by this is that while blood sugars are high in people with type 2 diabetes, most of the damage (not the greatest choice of words!) is done by other things going on in their body.
  2. What affects people the most are the other health conditions they are also living with. These other conditions common in people living with type 2 diabetes include obesity, high blood pressure, arthritis, COPD (chronic obstructive pulmonary disease) and even cancer. And many of these other chronic conditions share similar risk factors, including body weight, smoking, poor diet, and physical inactivity. While we have many effective (and even inexpensive!) drug therapies to help manage these chronic conditions, because they all share common lifestyle risk factors, changing behaviours to prevent diabetes will also work to reduce the risk of these other conditions.

Unfortunately, one of the other conditions also common among people living with diabetes is mental illness, which makes all of those self-care activities all the more challenging. Within our healthcare system we need to pay greater attention to mental health in people living with chronic medical conditions, as self-care is an integral part of health care.

What Now?

Now that you know a bit more about diabetes and its types, what to do next? How do you incorporate that into your wellness programs? Here are a few links to get you headed in the right direction:

  1. Alberta Health Services Resource Centre. Alberta Health Services has a resource centre which outlines training, workshops and guidelines on diabetes management.
  2. Alberta Diabetes Foundation. The Alberta Diabetes Foundation also has information on diabetes and includes several regional and local fundraising events.
  3. Canadian Diabetes Foundation. The Canadian Diabetes Association has information about types, signs and symptoms and treatment of diabetes. Their “In Your Community” section also helps users find a regional office for resources and information, programs and services and support groups.

Make November the month to focus on diabetes prevention, and take steps to bring this initiative to your school or jurisdiction—the effort is worth the potential reward!

Dr. Jeff Johnson

With a long list of credentials to his name (including pharmacist, PhD, professor and health services researcher), 'Dr. Jeff' is a leader in diabetes and public health policy and research. In his current role of professor in the School of Public Health at the University of Alberta, and supported by a senior health scholar award from Alberta Innovates Health Solutions, Dr. Jeff is making a big impact in the health and wellness arena in Alberta and beyond. Despite this impressive array of talents, his inability to whistle has served a crushing blow, preventing him from realizing his dream of competing at the World Whistling Championship. Join the club, Dr. Jeff. Join the club.

. | November 20 2015 12:49 PM

Thanks for this post, Dr. Jeff! You provide a very good reminder that diabetes is about a lot more than the disease itself.  It is so important to recognize how many other areas of health and wellness can impact both diabetes management and prevention.  I appreciate you highlighting how the risk factors for diabetes also apply to preventing many other chronic disease conditions. School jurisdictions can keep in mind that by having a focus on diabetes and diabetes prevention, they also create an opportunity for employees to take action on preventing many other health complications at the same time.

Matthew M. Alberta Health Services - | December 7 2015 3:27 PM

Thank you, Dr. Jeff! This is a great reminder that diabetes is a complex illness that continues to affect more and more people. It is surprising to hear about the increase in prevalence of Type II Diabetes among children and youth; a largely preventable condition. I am interested in how everyone has a role to play in addressing the the social, environmental, political, economic and other determinants of health that can help to prevent diabetes and contribute to a healthier lifestyle for everyone.