Diagnosing the Legacy

Diagnosing the Legacy vividly describes the impact of this ‘new disease’ on the lives of individuals and communities and outlines clinicians’ attempts to diagnose, treat, and control it. It illustrates the limits of biomedicine in dealing with the totality of the personal and communal costs of this public health crisis and highlights the need to recognize and to integrate traditional ways and knowledge in an effort to counter it.”

– J.T.H. Connor, Professor, History of Medicine, Memorial University

“The United Nations-sponsored World Health Organization (WHO) has declared type 2 diabetes a rapidly growing epidemic. Diagnosing the Legacy addresses this complex issue through interviews with members of the reserves of Island Lake (St. Theresa Point, Garden Hill, Red Sucker Lake) in Northern Manitoba and Sandy Lake in Northern Ontario. Krotz also interviews local health-care providers, including retired pediatric endocrinologist, Dr. Heather Dean; researcher, Jonathan McGavock; Dr. Ron Mundy; and professor and physician, Dr. Michael Moffatt. Their stories personalize the struggles of those living with the disease and the ways in which communities are working together to address this epidemic.”

– Peggy Archer, The Diabetes Communicator

“As a whole, academically trained researchers and practitioners are making very little difference to the lives of Indigenous children with type 2 diabetes. We need to advocate, not for longer-acting or more concentrated insulins, or a better pill, but for better relationships, such as those between the Manitoba team and these remote communities, as described in the compelling stories of Larry Krotz’ book.”

– Ellen L Toth, The Lancet Diabetes & Endocrinology

“Diagnosing the Legacy is at once detective story, indictment, and scientific investigation. It problematizes existing approaches to type 2 diabetes among the First Nations of Canada. Krotz, a writer and filmmaker, does an outstanding service in using the lens of type 2 diabetes mellitus—which is increasingly diagnosed in young people, a population not previously thought to be at risk for this condition—to critically examine the political, social, economic, and biological features of this chronic disease among the people of the First Nations. Importantly, the book emphasizes the biological aspects of genetic risk together with the origins of health and disease, arguing that genetic risk—in conjunction with a fetus’s intrauterine environment—both impact that individual’s metabolism. This biopsychosocial perspective moves beyond genetic determinism to consider inequities in diabetes prevalence and treatment from an individual and community standpoint. Krotz stresses the importance of strengthening resilience among First Nations, shifting the locus from individual risk and responsibility to structural factors and solutions. Moreover, the book was written in cooperation with, and supported by, First Nations communities, who are partnering with academics to develop their own solutions to the growing spread of type 2 diabetes among their youth.”

– K. Liu, Desert Oasis Healthcare, CHOICE

“An engaging narrative and insights into the limits of biomedicine and public health when dealing with the type 2 diabetes, as our understanding of the disease and the public health crisis evolved.”

– Raglan Maddox, St. Michael’s Hospital/University of Canberra, American Review of Canadian Studies