What could locally designed, team-based, type 2 diabetes remission services — using food-first approaches — look like in rural BC communities?
With $50,000 in seed funding from Healthcare Excellence Canada (HEC), two BC communities — Tumbler Ridge and Port Alberni — are starting a process to find out.
The new project is the result of a partnership between the Institute for Personalized Therapeutic Nutrition (IPTN), the Rural Coordination Centre of BC (RCCbc), and the Institute for Health System Transformation and Sustainability (IHSTS).
The three, BC-based organizations, led by the IPTN, came together to submit a proposal under HEC’s federal initiative to strengthen primary care in northern, rural, and remote areas in Canada. The project aims to design therapeutic nutrition-based type 2 diabetes remission services and solutions, tailored to each rural community’s specific needs, leveraging relationships and resources that the community already has.
“Type 2 diabetes is a huge and growing issue, especially in rural and remote areas of Canada,” said Sean McKelvey, the CEO of the IPTN, which is coordinating the project. “It can account for up to one-third of all doctors’ visits. But a growing body of evidence shows that people diagnosed with type 2 diabetes may be able to put the condition into remission if they are coached and supported in their community to change how and what they eat.”
Type 2 diabetes remission has been defined as three months of normal blood sugars without the use of any diabetes medications. Research has shown this can be achieved by a number of dietary patterns.
In general, however, successful food-based approaches involve eliminating ultra-processed foods, added sugar, foods that rapidly digest to sugar, and sweet beverages. The patient then focuses on eating minimally processed whole foods, getting adequate protein at every meal, and consuming plenty of colourful vegetables and healthy sources of fat.
Would type 2 diabetes remission services and supports look the same in every community? No! That’s because the patient demographics and existing services are different in each location.
The communities of Tumbler Ridge and Port Alberni are good examples of two very different communities. What they have in common are physician leads, supported by RCCbc and eager community volunteers, who are keen to tackle the local issue of improving remission rates for type 2 diabetes.
“It is a great example of collaboration between physicians, communities, and various healthcare partners that can bring best practice to rural British Columbia,” explains Dr. Dan Horvat, the RCCbc lead. “It is fantastic that rural communities are being given the opportunity to lead the way on this.”
The project is based on broad community engagement, relationship-building, and learning from rural, remote, and Indigenous communities. The engagement process will use the Partnership Pentagram Plus framework, which stresses the importance of including diverse perspectives — community members, health professionals, policymakers, health administrators, academics, and linked sectors (non-profit organizations and industries)—and gives everyone an equal voice in the co-creation process.
If the model of community-based engagement is successful, the next step would be to examine its application to diabetes remission in other rural and remote communities. The engagement process, and design of community-led solutions, may also then be applied to improving services and outcomes for other chronic diseases.
HEC’s Strengthening Primary Care initiative is designed to improve access to safe, including culturally safe, team-based primary care closer to home. The BC type 2 diabetes remission project is one of 20 teams funded to participate in this program. Learn more about Strengthening Primary Care.
For more information about type 2 diabetes remission using therapeutic nutrition visit the “Remission Possible” website at www.diabetesremission.ca
More information about each of the partners can be found at their websites:
Rural Coordination Centre of BC: rccbc.ca
Institute for Personalized Therapeutic Nutrition: therapeuticnutrition.org
Institute for Health System Transformation and Sustainability: ihsts.ca
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