Legendary former Maple Leaf captain Darryl Sittler has been newly diagnosed with pre-diabetes. His blood sugar levels are higher than normal, but not yet in the range for diabetes. He also has hope for a healthy future. "I want to see the Leafs win the Stanley Cup one day," he said at a panel discussion on diabetes in Toronto.
1. The Hockey Hall of Famer was joined on the panel by former Saskatchewan Roughriders defensive end John Chick, who has type 1 diabetes, as well as by experts on types 1 and 2. The panel was sponsored by Sun Life Financial as part of the company's support for diabetes awareness, prevention, care and research, and was part of the Canadian Diabetes Association's CDA Expo.
To stay healthy and prevent the onset of type 2 diabetes, Sittler has become serious about his diet and exercise habits. He's also made it his mission to raise awareness of the risks of developing the disease and encourage people to make healthy lifestyle choices. "Don't be in denial," he said. "Talk about it. Listen to your doctor. Don't take it lightly. Reduce the risk."
Sittler, 65, doesn't fit the overweight, out-of-shape stereotype of a person with type 2 diabetes. He does, however, have a strong family history of the disease which is the case for 50% of the people who develop type 2 diabetes. Sittler lost both his father and a brother to diabetic complications, so when his blood sugar levels crept into the pre-diabetic range he quickly took action. Even for an ex-athlete, it's not always easy to be disciplined about diet and exercise, he admits, but it's worth the effort: "You may think, 'I'm never going to get there,' but if you don't start, you never will get there."
Chick, a two-time hoister of the Grey Cup, is another athlete with hope. He has had type 1 diabetes since the age of 14. "I'm hoping for a cure not only for myself, but also for all those other people I've met who have it," he said.
The difference between type 1 and type 2 diabetes
With type 1 diabetes, the body can no longer make the insulin it needs to convert the sugar from food into fuel, because the immune system has attacked and destroyed the insulin-making cells (called islets) in the pancreas. According to panelist Dr. Robert Goldstein, Chief Scientific Officer for JDRF Canada (formerly called the Juvenile Diabetes Foundation of Canada), type 1 is believed to be caused by genetic predisposition plus some sort of precipitating event or environmental trigger that scientists don't fully understand yet, rather than by excess weight or inactivity. It's usually diagnosed in childhood or adolescence, and is managed by insulin injections, a healthy diet and exercise. It's not preventable, and it's not curable – yet.
Chick wears an insulin pump at all times, even during football games, to deliver pre-programmed doses of insulin throughout the day. It isn't a barrier to activity at all. "It's just an extension of me," he explained. "I've gotten it bashed a number of times. It can take it."
He also wears a continuous glucose monitor on occasion, when he needs to review and adjust his dosages.
2. Type 2 diabetes, on the other hand, occurs when the pancreas doesn't produce enough insulin, or the body doesn't properly use the insulin it does make (a condition called insulin resistance). Although also incurable and influenced by heredity, it's often preventable, and can usually be managed by diet, exercise and medication.
3. "I hesitate to say it can be reversed," said Dr. Jan Hux, Chief Science Officer for the Canadian Diabetes Association, who was also on the panel. "Gastric bypass surgery seems to bring blood sugar levels back to normal. However, it won't change a person's genetic background, and lifestyle issues still need to be addressed."
4. While the pump and monitor were originally developed for people with type 1 diabetes, they are being increasingly used by those with type 2 who are on insulin instead of the traditional routine of manual finger-pricking and individual injections.
Latest developments in diabetes research
"Work is proceeding on islet transplants, with some promising results", said Goldstein. That's despite the need for the immunosuppressant and anti-rejection drugs that go along with transplants. Researchers are also working on stem cell transplants to manufacture new islets. "Oral insulin hasn't proved effective to date" he added, "but inhaled insulin is working for some people with type 2."
"As a Canadian leader in health benefits, we see firsthand the physical and financial impact this disease can have," says Paul Joliat, Assistant Vice-President of Philanthropy and Sponsorships at Sun Life. "By focusing on awareness, prevention, care and research, we can help enable Canadians to live healthier lives. Whether you've been diagnosed with diabetes or you're so far just at risk, it's never too late to make a positive change."
Sun Life Financial and the CDA are encouraging Canadians to take the simple CANRISK online test (operated by the Public Health Agency of Canada) to assess their risk of type 2 diabetes. Simply visit take2minutes.ca and click "Start" to begin.
Find out more about what Sun Life is doing in the fight against diabetes.