Dr. Calvin Ke: Closing the Gap in Diabetes Education Through Cultural Storytelling
Type 2 diabetes is one of the most pressing chronic health challenges in Canada, affecting millions of people across diverse communities.
Despite its prevalence, significant gaps remain in patients’ awareness of how to manage the disease effectively and reduce the risk of serious complications. When Type 2 diabetes is not well managed, it can lead to heart disease, stroke, kidney failure, and other life-altering conditions, many of which are preventable with timely education and risk management.
Dr. Calvin Ke, an endocrinologist at the Toronto General Hospital, University Health Network, in Toronto and an assistant professor in the Department of Medicine at the University of Toronto, is working to close this gap. He argues that traditional, one-size-fits-all approaches to diabetes education often fail to reflect the cultural, social, and linguistic realities of patients’ lives.
“Type 2 diabetes is highly heterogeneous and influenced by multiple factors, including environmental, genetic, and biological ones. There is a clear need for better health services and more effective approaches to managing this condition in order to prevent complications,” he explains.
To make education more accessible and actionable, Dr. Ke, who is also an adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES), is adopting a culturally appropriate approach to diabetes-related risk management, ensuring that information is relevant, easy to understand, and grounded in patients’ lived experiences.
Through his participation in the Health Data Research Network Canada (HDRN Canada) Pragmatic Trials Training Program, he is developing a pragmatic trial protocol designed to raise awareness among diverse cultural communities in Ontario using storytelling and culturally sensitive strategies. The goal of his protocol is not only to inform patients but to prevent avoidable complications at scale.
Why Diversity Matters in Diabetes Care
Dr. Ke emphasizes that type 2 diabetes is not determined solely by biological factors. Social and environmental conditions play a critical role in both risk and disease management.
“People from ethnically diverse populations who migrate to Canada often experience significant changes that affect diet and physical activity, as well as increased stress related to employment, income, and other social determinants of health. Factors such as food insecurity are also important contributors to the risk of developing type 2 diabetes and its complications.”
Yet conventional education models rarely account for this complexity. Traditional approaches often require patients to attend lengthy one-on-one sessions with a nurse or dietitian, a format that can be time-consuming and inaccessible for many. These programs also tend to rely on standardized materials that do not reflect patients’ cultural realities.
“There is a significant gap in education,” Dr. Ke explains. “First, many people lack access to diabetes education programs for various reasons. Second, the educational materials that are typically used are often not culturally appropriate. Third, a traditional didactic approach does not align with what many people want or find helpful; participants often feel they already know the information and therefore do not benefit from the support that is offered.”
From One-Size-Fits-All to Culturally Tailored Care
To address this gap, Dr. Ke developed a new approach that draws on advertising and marketing expertise to capture attention in ways traditional health communication often does not.
The intervention involves sending tailored letters directly to patients’ homes. Each message is adapted to the recipient’s cultural context, referencing holidays, shared histories, or culturally relevant events. The letters use storytelling, short narratives, and historical references to spark interest before introducing educational content. “Educational information comes after the reader is already engaged,” he says. “These stories are adapted for each cultural group.”
The model builds on a previously successful program in Alberta that used marketing-based messaging delivered through personalized letters and small gifts framed as communication from a friend. That intervention reduced cardiovascular-related hospitalizations by 36%. Recognizing that the original study population was predominantly white, Dr. Ke adapted the approach for ethnically diverse communities in Ontario, working closely with patients to ensure cultural relevance.
Outcomes will be evaluated using existing health data, including hospitalization records, allowing the intervention to be tested in real-world settings. While recruitment requires targeted strategies because of the program’s cultural specificity, Dr. Ke is developing methods to reach patients with relevant risk factors across communities.
Dr. Ke’s work demonstrates how culturally appropriate interventions can move beyond one-size-fits-all education models. By combining pragmatic trial methods with tailored communication strategies, he offers a scalable model to reduce disparities in diabetes care and prevent avoidable complications.
** The HDRN Canada pragmatic trials training program is coordinated and hosted by the Schulich School of Medicine & Dentistry and is an initiative by Health Data Research Network (HDRN) Canada. It has been funded with $3.48 million from the Canadian Institutes of Health Research (CIHR). Read more.
You can also watch this video for a brief overview of Dr. Ke's work
