June 02, 2021 Creating safe spaces for youth with type 2 diabetes

It is hard enough to learn how to cope with a diagnosis of diabetes as an adult. For young people, learning to live with the disease is just one more thing they have to deal with on top of the other challenges they face as they grow to maturity. But some young people like those from the Sagkeeng First Nation in Manitoba also have a compelling source of support: each other. And with support from a program that plugs into that power source, they are better able to navigate the journey to healthy adulthood.

“Can you imagine being a teenager and always making a healthy choice? It’s hard to do when all the choices are really bad ones,” says one youth.

Another says, “[Even if] I eat carefully and watch my blood sugar carefully, I may still have high blood sugar readings and need more insulin. It doesn’t mean I don’t care or that I’m not taking care of myself.”

Dr. Jon McGavock, a physiologist and epidemiologist at the Children’s Hospital Research Institute in Winnipeg, heard that message from the teens he was working with, and responded to their concerns. Dr. McGavock, who works with Indigenous communities throughout Manitoba, was initially spreading the message of physical activity for good health. There was just one problem with that: “It wasn’t resonating with the youth,” he says. “They already had the knowledge—what they lacked was the will and the means to apply it.”

The importance of listening

When Dr. McGavock asked the teens what was going on in their lives, he says that they spoke of feeling stigmatized by society and being bullied at school. He also consulted community Elders, who helped him understand the Indigenous focus on holistic health. Reading the report by the Truth and Reconciliation Commission of Canada led him to connect the dots between its findings and diabetes in youth. “I finally realized that it makes no sense to say, ‘Okay, guys, let’s eat some fruits and do push-ups today.’ What we needed was more holistic, resilience-centred care.”

In 2008, Dr. McGavock co-created an Aboriginal Youth Mentorship program with colleagues, Indigenous youth and Elders to provide just this type of care. Rather than using health-care professionals to deliver “interventions,” the program engages high-school students to support their peers. The 20-week program, which is funded by Diabetes Canada, welcomes not just children with diabetes, but all interested children in grades 3 to 5 (to a maximum of 40 per session) in 30 communities across five provinces.

Based on the four principles of the Circle of Courage (belonging, mastery, independence, and generosity) developed by Lakota psychologist and author Martin Brokenleg, the program “creates safe spaces for the youth to play and open up with others, so they don’t feel isolated in their communities,” says Dr. McGavock. Along with improving participants’ self-esteem, the program has helped some participants—both mentors and mentees—lose weight, even though weight management is not the primary focus.

Next on Dr. McGavock’s agenda: adapting the principles of the program to Indigenous children in their first 1,000 days of life. “That’s when you’re most likely to make a lasting difference.”

In their own words

Here is what other youth in the Sagkeeng community had to say about living with diabetes.

“We know what we should be eating but it’s hard when healthy food costs so much. Where I live, healthy food costs a lot. I could buy a box of noodles for half the price of a bag of apples.”

“When your family lives on a fixed income, you need to make your food last. Sometimes a healthy choice is not an option.”

Genetics and biology play a big role in the onset of type 2 diabetes. Even if I eat healthy and exercise a lot, I may still develop [it] and it’s still not my fault. Everywhere I look I see someone I know living with complications from type 2 diabetes. It’s scary but it’s also manageable.… It’s not our fault.

“We need compassion, not judgment.”

“We need to stop blaming and start asking questions that matter.”

“I don’t have to die from this disease.”

“Look past the stigma.”

Did you know?

2021 marks the 100th anniversary of the discovery of insulin. Today, more Canadians have diabetes than ever before. Diabetes or prediabetes affects 1 in 3 Canadians. One in 2 young adults will develop diabetes in their remaining lifetime. We can’t wait another 100 years to End Diabetes.  #LetsEndDiabetes Visit 100 Years of Insulin to learn more, including how you can support those living with or at risk for the disease.

You can join free virtual Diabetes Canada Peer Connect events for networking and education with others living with diabetes (type 1 or 2), their families, friends and caregivers. Sessions are held on Zoom and include speakers on hot topics, a panel of experts and breakout discussions. Visit Local Programs and Events (scroll down to Community Events for your region) to learn more and sign up today!

This article appeared in Diabetes Dialogue, Spring 2018.