Saturday, 28 March 2009

Diabetes as a Social Illness

Diabetes as a Social Illness.


People who talk negatively about health care providers are those who are not sick.    Dr James Kerr


I am a Doctor, my father was a Doctor, my brother is a doctor, my sister in law is a doctor, so I don’t want you to misrepresent what I say as prejudice towards Doctors.


Reductionism and Construction

These are not the terms health care providers are familiar with, but any undergraduate student in Anthropology can explain it to you.


Bringing a large amount of fact, reducing them to suit your hypothesis.

Focusing mainly on one small part of the body or viewing physiological or organic data as somehow more real than the social, cultural, psychological or spiritual aspects of health and illness


An example of that would be: Indians do not seem to be happy, so give them a questionnaire and if they answer yes to three out of five questions, they are depressed.

Indians and Depression, I wish to come back to it later. Have you noticed all of a sudden , since the easy availability of Prozac, Zoloft and Paxil, more and more Indians are depressed? Which came first, the egg or the chicken. I will explain later.


Creating a Hypothesis, backed by scientific data but out of context and believing in it , preaching it.


In Atlanta, a recent study showed, 32% of the inhabitants had Hight BP

In San Antonio, GDM is seen 1/5 young women.

In Gila River Reservation, one in every two person has Type 2 Diabetes


So, if I am giving a lecture in Australia


It would be wrong for me to say



1/3 have HBP

1/5 pregnant women have GDM

1/2 adults are Diabetic


Of course, I have the epidemiological and scientific data to prove it, but I forgot to mention an important thing.

The Context in which the research was done..

Majority of the inhabitants of Atlanta are BLACK

San Antonio is predominantly MEXICAN

Gila River is 100% Indian


In the name of political correctedness, the scientists, whether they are biomedical or social scientists  ( endocrinologist would be a biomedical scientist, an anthropologist would be a social scientist ) began to say that there are no difference in people, some even going as far as to say: Race as such does not exist…


I maintain

American Indians including Dene in Alaska to Yamana in Tierra del Fuego

Are different from their European counterparts

Not only

In the way they think

But equally importantly

The way the body works..


I am not talking about acculturation. I am  JEW but that does not mean that I cannot learn to use powerpoint presentation!  My westernization ( growing up in Australia, educated in Australia, UK and USA ) does not affect

My cultural identity

My sense of a person and belonging


Cultural and Spiritual Identity Crisis is the deepest social crisis affecting Western countries and I believe that the indigenous people whom they conquered 500 years and less ago will offer them a way out. But that is another story..


Physical, by that we mean Metabolic differences

When it comes to Chronic Diseases, we must believe in the research done by ourselves on Indians, rather than trying to incorporate the research done elsewhere and adapting it for the Indian.


This applies to



High Blood Pressure

Kidney Disease

Coronary Disease


Al the above have one thing in common

Not only they are chronic

But they are all preventable.


And in each one of the above diseases, the measurements, and what they reflect in the metabolism of the Indian is debatable…


Following are some examples and I can explain them well from a physiological and cultural view points. So a cultural explanation may coexist..


Blood Sugar and bringing it down by exercise…

Cultural Explanation


High Blood Pressure

Alcohol and its effect

What is normal blood pressure?



If low HDL is predictive of Heart Disease, how can we explain that close to 80 % of the indigenous people have low HDL?


High Triglyceride



Thin Membrane Disease

Inability to increase glomerular filtration rate is one of the earliest manifestations of impending kidney disease.



Increased alkaline phosphatase

Low or nonexistent CPK


Ability to manouevre BS, BP with diet and activity


Family history of Diabetes?

Genetic Susceptibitlity?


Absence of Type I DM?


At one time I decided to write down the difference in the ways of thinking of American Indians and Americans… it was pages and pages long.. may put here one day..


By the way, most Indians (the native people of the Americas) refer themselves by their tribal identity, rather than the so called politically correct Native Americans..


Will continue this subject later on..