World Diabetes Day

                         

There has been much discussion and information sharing today on World Diabetes Day.  In fact, diabetes has been referred to as the epidemic of the 21st century by the World Health Organization. At approximately  1:00 pm today #WorldDiabetesDay trended on twitter. As a nurse, this has been a wonderful opportunity for advocacy.

However, as a Street Nurse, my thoughts turn today not only to the challenges faced by those diagnosed with diabetes but the extra difficulties faced by our homeless friends and those struggling in poverty without the opportunity of healthy choices. For most of us, it is impossible to imagine the challenges involved with being homeless and living on the streets without the added burden of chronic medical conditions. In Toronto, we are fortunate to have several drop in centres serving meals and snacks. In many cases, with budget concerns and meals prepared in large quantities, many options are high in carbohydrates such as pastas, rice, and bread products. Many of the snacks generously donated are baked goods. Although our clients are very grateful for the quantity of food, they may not always have the option of a special diet choice. Many food banks routinely provide non-perishable goods as well. Obtaining the types of food required by those with chronic medical conditions can be a challenge.

Street Nurses keep glucometers in our backpacks to check blood glucose levels and supplies for treatment if needed.  Without regular access to health care, many of our homeless friends will remain undiagnosed and untreated. It is not uncommon for a person with irrational behaviour caused by an abnormal blood glucose to be dismissed as being under the influence of alcohol or substances. As many of our homeless community also suffer with mental illness, a diabetic emergency can be overlooked and dismissed by some as a psychiatric concern. An extremely high blood glucose can lead to a state called Diabetic Ketoacidosis. This is a medical emergency and can be fatal if not treated. An extremely low blood sugar can lead to unconsciousness and also requires immediate medical attention. As a reminder, it is always important to rule out a medical cause when first interacting with clients in the community.

So tonight as our CN Tower is turned blue to commemorate World Diabetes Day, please do not forget about those sleeping below that tower on our streets. Please continue to advocate for safety, housing, healthy food and adequate income. These factors are referred to as social determinants of health and without these in place, no chronic medical condition will be overcome.