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Canadian Journal of Public Health

, Volume 101, Issue 5, pp 410–414 | Cite as

Improvements in Indicators of Diabetes-related Health Status Among First Nations Individuals Enrolled in a Community-driven Diabetes Complications Mobile Screening Program in Alberta, Canada

  • Richard T. Oster
  • Sandra Shade
  • David Strong
  • Ellen L. TothEmail author
Quantitative Research
  • 1 Downloads

Abstract

Objective

The goal of Screening for Limb, I-Eye, Cardiovascular, and Kidney complications of diabetes (SLICK) is to reduce the burden of diabetes among Alberta First Nations individuals. By analyzing the longitudinal results of SLICK over a six-year time span, our purpose was to examine both baseline diabetes-related health status and whether subsequent improvements occurred.

Methods

Diabetes complications screening, diabetes education, and community-based care were provided by mobile clinics which traveled to 43 Alberta First Nations communities biannually. Body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), total cholesterol and blood pressure, as well as the presence of foot and kidney abnormalities were assessed among 2,102 unique subjects with diabetes. Mean values of diabetes health indicators at baseline and subsequent visits for returning subjects were compared. Secular trends were sought by examining trends in mean baseline health indicators per year.

Results

High baseline rates of obesity, poor HbA1c concentrations, hypercholesterolemia, hypertension, foot abnormalities and kidney damage were observed. Significant improvements in BMI, blood pressure, total cholesterol and HbA1c concentrations were identified (p<0.01) in returning subjects. Similarly, significant decreasing secular trends in total cholesterol and HbA1c concentrations were observed (p<0.01). At baseline, females had a higher prevalence of obesity and abnormal waist circumference (p<0.05); however, males had more inadequate HbA1c concentrations (>8.4%), hypercholesterolemia, hypertension, foot abnormalities and kidney damage (p<0.05).

Discussion

Despite worrisome baseline clinical characteristics, diabetes-related health appears to be improving modestly in Alberta First Nations individuals.

Key words

Aboriginal North American type 2 diabetes mellitus mobile screening rural communities 

Résumé

Objectifs

Le projet SLICK (dépistage des complications du diabète) vise à réduire le fardeau du diabète chez les Premières nations de l’Alberta. Nous avons examiné l’état de santé de référence des personnes diabétiques et ses améliorations ultérieures en analysant les résultats longitudinaux du projet sur six ans.

Méthode

Le dépistage des complications, la sensibilisation au diabète et les soins communautaires ont été assurés par des unités sanitaires mobiles qui ont visité deux fois l’an 43 communautés des Premières nations de l’Alberta. L’indice de masse corporelle (IMC), le périmètre ombilical, l’hémoglobine A1c (HbA1c), le cholestérol total, la pression artérielle et la présence d’anomalies du pied et des reins ont été évalués chez 2102 sujets diabétiques. Nous avons comparé les valeurs moyennes des indicateurs pendant la visite de référence et les visites ultérieures des sujets de retour, et déterminé les tendances à long terme d’après l’évolution moyenne annuelle des indicateurs de base.

Résultats

Des niveaux d’obésité élevés, des concentrations excédentaires en HbA1c, de l’hypercholestérolémie, de l’hypertension artérielle, des anomalies du pied et des insuffisances rénales ont été observés au départ. Chez les sujets de retour, des améliorations significatives (p<0,01) de l’IMC, de la pression artérielle, du cholestérol total et des concentrations en HbA1c ont été détectées. À long terme, il y a eu des baisses significatives (p<0,01) du cholestérol total et des concentrations en HbA1c. À la base, les femmes affichaient une prévalence accrue d’obésité et de périmètre ombilical anormal (p<0,05). Cependant, les concentrations excédentaires en HbA1c (>8,4 %), l’hypercholestérolémie, l’hypertension, les anomalies du pied et l’insuffisance rénale étaient plus présentes chez les hommes (p<0,05).

Discussion

Malgré un profil clinique de base inquiétant, l’état de santé lié au diabète semble s’améliorer modérément chez les Premières nations de l’Alberta.

Mots clés

Indiens d’Amérique nord diabète de type 2 dépistage mobile population rurale 

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Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Richard T. Oster
    • 1
  • Sandra Shade
    • 2
  • David Strong
    • 3
  • Ellen L. Toth
    • 1
    Email author
  1. 1.Division of Endocrinology & MetabolismDepartment of MedicineEdmontonCanada
  2. 2.Blood TribeCanada
  3. 3.Calgary Health RegionCalgaryCanada

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