It’s not just about sugar anymore:


A lot has changed in our understanding of diabetes over the years. As Marg Dorcas, RN Diabetes Nurse Educator of the Halton Diabetes Program puts it, “It’s not just about sugar anymore.” Good diabetes care requires aggressive management of blood glucose, blood pressure and blood fat levels.

Why diabetes education?Diabetes education equips individuals to know the targets of good management, and gain the knowledge and skills to work with their health-care providers to achieve those goals.

The incidence of Type I and Type II is growing at a rate which is described by the Canadian Diabetes Association (CDA) as “epidemic.” In addition, the 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada lowered the at-risk age for Type II diabetes to age 40 and over – meaning 2.5 million more Canadians are now at risk for Type II diabetes. (see

Education can help decrease the risk of complications associated with diabetes such as cardiovascular disease. The CDA informs us that “a full 80 per cent of people with diabetes will die from cardiovascular disease (heart disease and stroke). Earlier prevention, earlier diagnosis and very aggressive treatment of diabetes by controlling blood glucose levels, blood pressure and lipid levels have proven to prevent or significantly delay damage to the body’s large blood vessels.”

Diabetes is now considered a “self-management disease.” The choices diabetic patients make in relation to diet, exercise and medication will have a significant impact on their disease.

Anyone at risk for diabetes, or living with this illness, needs information in order to make good decisions. The CDA encourages people with diabetes to take an active role in managing their condition and to build a strong relationship with their health-care team.

About the Halton Diabetes Program hosted at Joseph BrantThe Halton Diabetes Program is a regional program offering diabetes education to Halton residents through a number of host hospital sites.

Burlington and area residents are fortunate to have one of these sites, hosted by Joseph Brant Memorial Hospital, located in the new Joseph Brant Community Health Centre adjacent to the hospital. A dedicated team of diabetes educators (nurses and registered dietitians) guides clients through a comprehensive one-year “staged” approach to education. It is an adult program for individuals diagnosed with diabetes. Joseph Brant also has Paediatric and Gestational programs.

Within two weeks of receiving a referral, patients are given an appointment to attend a basic class in diabetes education called Just the Facts. This class equips patients with basic information and strategies for managing diabetes, and the tools to begin learning what works and what doesn’t in their individual care. All clients are encouraged to begin home blood glucose monitoring; timing and targets are discussed; and basics of healthy eating are taught. Family members are encouraged to attend with clients to have questions answered and old myths dispelled.

Before leaving, patients are offered an appointment for the Skills for Success class which is taught in two separate half-day sessions about one week apart. Classes begin six to eight weeks later. The Skills for Success class builds on the initial information provided. It gives patients the opportunity to discuss challenges they might be experiencing and answer questions particular to their experience with diabetes. Patients can also sign up for individual workshops on a variety of topics such as nutrition, exercise and label reading. The workshops are offered every six weeks and can be attended any time over the year or beyond.

The next stage is an individual assessment with a nurse and registered dietitian; usually another six to eight weeks after patients have completed the Skills for Success class. At this time, patients and their diabetes education team can discuss how patients are managing and address any outstanding questions or issues. After this meeting, patients will be offered a follow-up appointment scheduled 12 months from the date of their Skills for Success class.

Marg Dorcas’s passion for her work is evident. She emphasizes the need for education is not only for the newly diagnosed person. “If patients have been living with diabetes for 10, 20, 30 years, they need to come in and see what’s new and meet the team! We can teach them how any food can fit into their healthy eating plan to promote improved blood glucose. We have better tools, better testing methods.”

Comprehensive education – to prevent and manage diabetes – is of critical importance to patients’ quality of life. The Halton Diabetes Program is one more service that Joseph Brant offers in living its vision of “Best People. Best Care. Healthiest Community”.

For further information about the Halton Diabetes Program, contact Marg Dorcas at 905-633-7070 or by e-mail at