Diagnosing the Legacy

The Discovery, Research, and Treatment of Type 2 Diabetes in Indigenous Youth


Diagnosing the Legacy

In the late 1980s, pediatric endocrinologists at the Children’s Hospital in Winnipeg began to notice a new cohort appearing in their clinics for young people with diabetes.

Indigenous youngsters from two First Nations in northern Manitoba and northwestern Ontario were showing up not with type 1 (or insulin-dependent diabetes), but with what looked like type 2 diabetes, until then a condition that was restricted to people much older. Investigation led the doctors to learn that something similar had become a medical issue among young people of the Pima Indian Nation in Arizona though, to their knowledge, nobody else.

But these youth were just the tip of the iceberg. Over the next few decades more children would confront what was turning into not only a medical but also a social and community challenge.

"Diagnosing the Legacy" is the story of communities, researchers, and doctors who faced—and continue to face—something never seen before: type 2 diabetes in younger and younger people. Through dozens of interviews, Krotz shows the impact of the disease on the lives of individuals and families as well as the challenges caregivers faced diagnosing and then responding to the complex and perplexing disease, especially in communities far removed from the medical personnel a facilities available in the city.

Table of Contents

Table of Contents
Cover 1
Contents 8
Foreword by Francis Desjarlais 10
Map 14
Introduction 18
Chapter 1: Early Alarm 26
Chapter 2: The First Patients of a New Disease 33
Chapter 3: Emerging Responses 40
Chapter 4: Island Lake 55
Chapter 5: Early Research, Innovations, and Strategies for Care 69
Chapter 6: Investigation and Hypotheses 82
Chapter 7: After the Deluge 90
Chapter 8: Revisiting Roots 101
Chapter 9: Food 109
Chapter 10: Poverty and Disease 119
Chapter 11: Partnerships and Participation 132
Chapter 12: Hopes and Dreams 145
Epilogue: Island Lake Encore 157
Afterword by By Heather Dean, Jonathan McGavock, Michael Moffatt, and Elizabeth Sellers 164
Acknowledgements 168
Notes 170
Bibliography 184
Index 188