Deck 6: Diabetes, Diet and Nutrition

Question 1

Diabetes rates are rising in the Indigenous population due to

A) increased education about environmental contaminants in foods.
B) the movement of Status First Nations to the cities and towns from their remote reserves.
C) changes in diet from traditional foods to market foods.
D) all of the above.

Answer 1

C

Question 2

Which are common complications of diabetes?

A) Organ dysfunction and failure
B) Blindness
C) Sexual dysfunction
D) Heart disease
E) All of the above

Answer 2

E

Question 3

Traditionally, the Inuit diet was composed of

A) a mixture of wild greens and meat.
B) mostly meat and fish, supplemented by some seasonal plants.
C) produce from their farms.
D) salmon fishing.

Answer 3

B

Question 4

Village life in pre-Contact British Columbia was supported by

A) an abundant supply of salmon.
B) hunting mountain caribou.
C) whaling.
D) farming.

Question 5

Pre-Contact Indigenous peoples were

A) well nourished.
B) often faced with starvation.
C) much less well nourished than their European contemporaries.
D) faced with cycles of abundance and starvation.

Question 6

Type 2 diabetes is also known as

A) adult onset diabetes.
B) congenital diabetes.
C) child onset diabetes.
D) inherited diabetes.

Question 7

Currently, the most common type of diabetes among the Indigenous populace is

A) type I.
B) type II.
C) gestational.
D) b and c

Question 8

Insulin is produced by the pancreas and

A) is required by the body for the metabolism of glucose.
B) assists glucose molecules to stay in the blood stream and away from the cells.
C) is insufficient when the body is able to use what it makes.
D) causes diabetes when too much sugar is eaten.

Question 9

Complications due to the disease process of diabetes generally include all of the following except

A) kidney dysfunction.
B) heart dysfunction.
C) damage to the nerves.
D) osteoporosis.

Question 10

Symptoms of diabetes that may become apparent when cells are starved of the glucose needed to perform metabolic activities include everything except

A) excessive thirst.
B) frequent urination.
C) loss of appetite.
D) weight change (gain or loss).

Question 11

Diabetes is already the leading cause of all of the following in all Canadian adults except

A) chronic obstructive pulmonary disease.
B) end-stage renal failure.
C) blindness.
D) non-traumatic amputation.

Question 12

Diabetics are four times more likely than members of the general population to be admitted to hospital because

A) they have third party insurance coverage.
B) they have high rates of diagnosed depression.
C) the hospital regulations permit their ease of admittance.
D) they are sufferers of a chronic disease.

Question 13

Which of the following is not a common health condition associated with organ dysfunction and failure in diabetes?

A) Gradual thickening of the blood vessel walls
B) Suppression of the immune system
C) Metabolism of body fat and protein
D) Suppression of adrenal function

Question 14

High blood sugar levels lead many diabetics to develop

A) chronic kidney disease.
B) gangrene.
C) coronary artery disease.
D) all of the above.

Question 15

Which of the following is a modifiable risk factor for developing diabetes?

A) Weight
B) Genetics
C) Family history
D) Gestational diabetes

Question 16

Which of the following statements about diabetes and Indigenous people is false?

A) Rates are three to five times higher.
B) Rates are highest among Indigenous women.
C) The disease is often detected later.
D) There are fewer health complications.

Question 17

Which of the following is considered to be an epidemic among Indigenous people in Canada?

A) Diabetes
B) Hypertension (high blood pressure)
C) Cancer
D) Human immunodeficiency virus infection

Question 18

Indigenous people suffer greater rates of renal complications as a result of all of the following except

A) higher rates of diabetes.
B) higher rates of cardiovascular disease.
C) lower referral rates to specialists.
D) higher rates of misuse of medications.

Question 19

What percentage of the diabetic population suffers from type 2 diabetes?

A) 10%
B) 25%
C) 50%
D) 90%

Question 20

Which group is more affected by type 2 diabetes?

A) Non-Indigenous men
B) Non-Indigenous women
C) Indigenous men
D) Indigenous women

Question 21

Risk factors contributing towards the development of diabetes among Indigenous populace include all of the following except

A) high-risk sexual behaviour.
B) physical activity.
C) obesity.
D) b and c

Question 22

Between 2001 and 2015, the age-standardised prevalence of diagnosed diabetes in Canadians increased from 4.48% to

A) 5.69% - a 27.0% increase
B) 6.78% - a 51.3% increase
C) 7.91% - a 76% increase
D) 8.69% - a 93.9% increase

Question 23

The Public Health Agency of Canada (PHAC) recorded a slight decline in the incidence (new cases) of diabetes in the Indigenous population over time, but an increase in the prevalence of the disease in Canada (people living with diabetes) because

A) improved care has allowed patients to live longer.
B) this is a statistical estimate.
C) the diabetes rates had risen slightly.
D) these are measures of the prevalence of diabetes.
E) it is useful to generalize about statistics.

Question 24

Market, or store-bought, foods that are rapidly replacing traditional foods in the diet of Indigenous Canadians are

A) preferred because they are inexpensive.
B) abundant in fresh vegetables and fruits.
C) commonly frozen and pre-packaged.
D) processed foods high in nutrient content.

Question 25

The transition from a traditional diet to a market diet is called the

A) nutrition transition.
B) tradition transition.
C) market transition.
D) lifestyle transition.

Question 26

Barriers to developing a healthy market diet among the Indigenous population living in rural and remote areas include

A) limited all-weather road access.
B) seasonal water transport.
C) reliance on food with long shelf life.
D) all of the above.

Question 27

Individuals suffering diabetes experience financial costs and the significant burden of disability which includes

A) reduced quality of life.
B) reduced life span.
C) significant loss of income.
D) all of the above.

Question 28

Diabetes may impair the functioning of some Indigenous communities where a significant proportion of the population is diabetic because

A) the financial burden of diabetes weighs down the entire community.
B) traditional harvesting is affected since sufferers are unable to hunt or gather traditional food.
C) it leads to widespread dependence on costly imported market foods.
D) all of the above.

Question 29

The "Thrifty Gene" theory claims that

A) Canadian Indigenous populations are genetically predisposed towards diabetes.
B) Indigenous people possess a deoxyribonucleic acid structure inherently more weighted towards an active lifestyle.
C) Indigenous populations are genetically susceptible to starvation.
D) The gene for sickle cell anaemia is present in specific Canadian Indigenous populations

Question 30

Measures implemented to reduce diabetes in the Indigenous population would significantly

A) reduce the burden of diabetes to the Canadian healthcare system.
B) reduce the community's financial dependence on the Public Health Agency.
C) reduce their opportunities to hunt and gather traditional food.
D) have no correlation to their consumption of sugar-laden, highly processed market foods.

Question 31

Unlike the non-Indigenous population, household food insecurity is much higher in the Indigenous population because

A) a significant number live in urban communities.
B) sociopolitical factors mitigate against a healthy market diet.
C) they often live in rural and remote communities.
D) they diversify diet through hunting and fishing.

Question 32

A combination of socioeconomic, cultural and geographic factors contribute to the rise in diabetes rates in the Indigenous population in Canada including

A) traditional diet and sedentary lifestyle.
B) resisting diagnosis and mistrust of healthcare system.
C) barriers to physical inactivity and leisure-time.
D) cost to physical recreation and educational campaigns.

Question 33

Divided jurisdictions of provincial, territorial, or federal healthcare programs and services for the Indigenous population contribute to a lack of clear and consistent

A) policies on controlling and preventing diabetes.
B) national diabetes data rates.
C) delivery of health services and benefits.
D) all of the above.

Question 34

According to the "Thrifty Gene" theory, when there are no longer periods of starvation

A) this gene allows the body to store fat and is thus beneficial.
B) this gene allows the body to store fat during times when food is scarce.
C) this gene allows the body to store fat and is thus harmful.
D) this gene allows the body to store fat during times when food is abundant.

Question 35

Examples of approaches for the prevention and treatment of diabetes that work are ones that work with the community to

A) develop culturally appropriate diabetes awareness curriculum.
B) provide physical assessments and feedback on dietary changes.
C) promote direct subsidies to retailers for purchase of country foods.
D) a and b

Question 36

Risk factors contributing towards the development of diabetes among Indigenous groups include all of the following except

A) obesity.
B) smoking.
C) sedentary lifestyle.
D) diet.

Question 37

What kind of diabetes is seen only during pregnancy?

A) Type I
B) Type II
C) Gestational
D) Idiopathic

Question 38

Women who develop gestational diabetes suffer a higher risk of developing

A) type 2 diabetes.
B) gangrene.
C) renal disease.
D) all of the above.

Question 39

Currently there is a low prevalence of documented obesity among many Indigenous groups.

Question 40

Prevalence of chronic diseases - diabetes, heart problems, hypertension, arthritis and some cancers - is significantly higher among Indigenous communities and is increasing.

Question 41

Obesity makes a major contribution to diabetes rates among Canadian Inuit.

Question 42

There are significant regional variations for different Indigenous populations such as the Inuit and the Cree population in Northern Québec.

Question 43

On average, diabetes reduces the life span by 5 years and has little effect on the quality of life remaining.

Question 44

Diabetes carries with it a heavy moral burden that lies on the shoulders of the individual, the community and, ultimately, the nation as a whole.

Question 45

The effects of the transition to a market diet on the Indigenous population are directly linked to the dietary causes of diabetes.

Question 46

Low education is directly linked both to a lack of awareness of health risks that leads to diabetes and its complications and to high income.

Question 47

Diabetes in the Indigenous population in Canada is considered to be an epidemic disease.

Question 48

Diabetes is three to five times higher in the Indigenous population than the general Canadian population. Explain how three changes in the traditional Indigenous lifestyle have contributed to increasing rates of diabetes among the Indigenous populace over time.

Question 49

Choose one of the three following determinants of health and explain what factors have affected (or are affecting) the epidemic rates of diabetes in Indigenous communities: Income and social status, culture/identity, or education and literacy.