Diabetic foot complications among Indigenous peoples in Canada: a scoping review through the PROGRESS-PLUS equity lens

• Published in: Frontiers in Endocrinology
• Main Authors: Virginie Blanchette, Jérôme Patry, Magali Brousseau-Foley, Shweta Todkar, Solène Libier, Anne-Marie Leclerc, David G. Armstrong, Marie-Claude Tremblay
• Format: Article in Journal/Newspaper
• Language: English
• Published: Frontiers Media S.A. 2023
• Subjects: diabetes; foot ulcer; lower extremity amputation; indigenous peoples; diabetic neuropathy; peripheral arterial disease; Diseases of the endocrine glands. Clinical endocrinology; RC648-665; Briggs; Canada; First Nations; inuit
• Online Access: https://doi.org/10.3389/fendo.2023.1177020; https://doaj.org/article/255075376fcb4fb98453fc404af54535

IntroductionIndigenous peoples in Canada face a disproportionate burden of diabetes-related foot complications (DRFC), such as foot ulcers, lower extremity amputations (LEA), and peripheral arterial disease. This scoping review aimed to provide a comprehensive understanding of DRFC among First Nations, Métis, and Inuit peoples in Canada, incorporating an equity lens.MethodsA scoping review was conducted based on Arksey and O’Malley refined by the Joanna Briggs Institute. The PROGRESS-Plus framework was utilized to extract data and incorporate an equity lens. A critical appraisal was performed, and Indigenous stakeholders were consulted for feedback. We identified the incorporation of patient-oriented/centered research (POR).ResultsOf 5,323 records identified, 40 studies were included in the review. The majority of studies focused on First Nations (92%), while representation of the Inuit population was very limited populations (< 3% of studies). LEA was the most studied outcome (76%). Age, gender, ethnicity, and place of residence were the most commonly included variables. Patient-oriented/centered research was mainly included in recent studies (16%). The overall quality of the studies was average. Data synthesis showed a high burden of DRFC among Indigenous populations compared to non-Indigenous populations. Indigenous identity and rural/remote communities were associated with the worse outcomes, particularly major LEA.DiscussionThis study provides a comprehensive understanding of DRFC in Indigenous peoples in Canada of published studies in database. It not only incorporates an equity lens and patient-oriented/centered research but also demonstrates that we need to change our approach. More data is needed to fully understand the burden of DRFC among Indigenous peoples, particularly in the Northern region in Canada where no data are previously available. Western research methods are insufficient to understand the unique situation of Indigenous peoples and it is essential to promote culturally safe and quality ...