A team dedicated to helping complex diabetics in Trail has enhanced its interdisciplinary approach with an additional physician.
Dr. Trevor Aiken, who some may recognize from Riverside Family Medicine Clinic, has accepted the position as lead General Practitioner for the newly expanded Diabetes Interdisciplinary Team that operates out of the Trail Kiro Diabetes Education Centre in East Trail. He will continue to work in family practice all while he delivers this specialized support, which started up for him in January.
“It is difficult for family physicians to manage some of the diabetics in their population because of the complexities of their care,” he said. “Having a team dedicated to diabetes – a diabetologist, dietitian and diabetes nurse – who have a lot more time to invest than a family physician has in their office, is really valuable not only for that patient but in terms of reducing the burden on the acute care sector.”
The team has operated for about two years with Dr. Chi Zhang, who is also the lead for the renal program in Trail. Zhang’s capacity was limited, though, and there was a growing need to get another doctor on board to manage complex diabetes on a weekly basis. The team previously set appointments once a month, but now is scheduling patients four times a month.
Residents with Type 1 or Type 2 complex diabetes are referred by their doctor when more assistance is needed in areas like nutrition, lifestyle management, medication regime or self-management skills. The nurse and dietician first meet with the patient, before a physician is added to the conversation and a health plan is developed.
“These people are folks who despite their best effort … are looking for a little more assistance with their management regime,” explained Dawn Tomlin, who manages Interior Health’s diabetes facilities in the region. “We bring a level of care with the participation of the physician to bring the best evidence and best options to that person to better manage their diabetes.”
Diabetes is a chronic, often debilitating and sometimes fatal disease, in which the body either can’t produce insulin or properly use the insulin it produces. Insulin is a hormone that controls the amount of glucose (sugar) in the blood. Diabetes leads to high blood sugar levels, which can damage organs, blood vessels, and nerves.
“Diabetes, whether it is complex or not is a burden,” added Tomlin. “They say that people with diabetes probably need to make 200 additional food or lifestyle considerations every day over somebody who doesn’t have it.”
The disease is on the rise in Canada, according to the Canadian Diabetes Association. It released its Economic Tsunami, the Cost of Diabetes in Canada report in December 2009, which forecasted diabetes prevalence (number of people with the disease) to nearly double between 2000 and 2010, from 1.3 million to about 2.5 million. From 2010 to 2020, the number of people with diabetes is expected to rise by another 1.2 million, the report adds, bringing the total to about 3.7 million. These increases escalate the proportion of the total population with diabetes from 4.2 per cent in 2000 to 7.3 per cent in 2010 and to 9.9 per cent by 2020.
New data has required changes to this data since 2010 actually saw a total of 2.7 million diagnosed.
Locally the numbers are expected to follow suit.
Currently, there are 1,628 people diagnosed with diabetes in Trail, in the Kootenay Boundary region prevalence sits at 5,857 and Interior Health (IH) counts 57,504 individuals in its region. The number of new cases tracked in Trail is 86, while there are 368 in the Kootenay Boundary and 3,940 IH-wide.
“As much as we have an interest in exercise, we actually are more sedentary, we’re bigger people, and we have access to nutrition in ways than previous generations have not had, and so we’re definitely more obese,” explained Tomlin.
Diagnosing the disease is often done at an earlier age now, she adds, which may also attribute the the heightened numbers. But regardless of improvements in detecting the disease, the cluster of symptoms one may experience still are not generally visible to the eye.
“The symptoms can be subtle and non-specific, like fatigue, weight loss or visual problems, or very general and vague that you wouldn’t necessarily recognize because of their insidious onset,” added Aiken.
His interest in diabetes started in England, where he ran a diabetes clinic.
Nowadays, his work is not only at the patient level. Aiken is a member of the Kootenay Boundary Division of Family Practice board, which is trying to establish a formal diabetes service for pediatrics.
“I think coordination of pediatrics with diabetes is important, especially at that stage in their life when they transfer from youth to adults,” he said. “Sometimes young people leaving home and going away for further education or travel will tend to get lost in the system, unless there is a robust transition to the adult service pool.”
The Trail Kiro Diabetes Education Centre is open to the general public from 8:30 a.m. to 4:30 p.m. five days a week at 1500 Columbia Ave (250-364-6292). The centre offers classes geared toward living well with diabetes but those interested must be a registered client before attending a workshop.