November is National Diabetes Month, and we spoke with Ethel Macatangay, Director of Nephrology and Diabetes at SHN. SHN operates Ontario's largest regional Nephrology program in Ontario, and serves a "diabetes hotspot" in Scarborough, with some of the highest incidences of Chronic Kidney Disease (CKD) and Diabetes in the GTA. Ethel coordinates the Nephrology and Diabetes education programs in Scarborough, and talks about the importance of prevention.
1. November is Diabetes Month. What do you think are some common misconceptions about Diabetes and Chronic Kidney Disease (CKD), and what should people know about them?
Diabetes is one of the leading causes of kidney disease, and in Ontario, we have more than 4.3 million people living with diabetes or pre-diabetes. Across Scarborough, we have even higher numbers of people living with diabetes than the provincial average.
People often don’t realize that those with diabetes or pre-diabetes are far more likely to have complicating health issues like high blood pressure and high cholesterol that eventually lead to them developing chronic kidney disease (CKD). If you find out you have high blood sugar that could lead to diabetes, you should adopt early interventions like changing your diet and exercising regularly to prevent those extra concerns or risks.
2. Here in Scarborough, we have some of the highest incidences of CKD. What are some of the biggest contributing factors?
There are different determinants of health that can lead to higher incidences of CKD, and here in Scarborough, we have a lot of those factors at play in a single community.
The first is ethnicity. Scarborough is very ethnically and culturally diverse, and due to different diets, lifestyles, and cultures, we have specific populations who are more pre-disposed to diabetes. This includes the Black, South East Asian, Chinese, and Filipino communities who call Scarborough home.
The second determinant is low socioeconomic status. Due to financial constraints, many of our residents eat low-cost foods, which are often processed and high in sugar and cholesterol, leading to a higher risk of diabetes.
Finally, age is a factor in diabetes and CKD, and Scarborough has a high population of residents who are over 65 years of age.
Combine all three of these determinants, and you can see why Scarborough’s population who are at higher risk of diabetes and CKD.
3. What is your favourite part about working at SHN and in the Scarborough community? What makes it special?
The diversity of Scarborough makes it unique. As health care providers, we interact with many different cultures daily and learn a considerable amount about them and our community. This means we have to be able to provide care while considering a lot of variables, including different languages and cultural nuances. We’re not dealing with a population where one size fits all, and our frontline heroes are committed to caring for our community in the best, most inclusive way we can.
We’re also very fortunate to have a leadership team and staff that reflect these ethnic and cultural groups, so we can learn from both sides – from our community and our workforce.
4. How has COVID-19 impacted hemodialysis treatments for our Scarborough community, and what will we need to ensure safe and accessible dialysis for our patients?
When patients end up in the ICU with severe COVID-19 symptoms, a large percentage require dialysis. During the first wave, everyone was clamouring to find respirators and dialysis machines because the virus severely impacted the lungs and the kidneys.
To further complicate things, we currently don’t have enough isolation dialysis units to ensure we keep COVID-19 positive patients needing dialysis separate from our other dialysis patients. This is why we’re excited about our future, including expanding and renovating our General hospital to accommodate new spaces and serve even more patients suffering from CKD and kidney concerns.
5. SHN operates the largest nephrology program in Ontario, serving over 4,000 patients per year. With incidences of CKD rising, how important is it that we have donor and community support to grow our programs and offer more services?
We need donor and community support to address the issues we have now and prevent these diseases and change the health trajectory of our community for the future. This support can grant us additional space, technology, and resources to meet the urgent need and demand for diabetes and CKD treatment here in Scarborough. Our low-income population doesn’t have the advantages or opportunities to change their health trajectory on their own, but with donor support, our hospitals can help slow the progression of diseases by increasing care and access to dialysis right here in the Scarborough community.
For resources and more information on SHN's diabetes education, visit SHN.ca/diabetes-education/