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

• Published in: Canadian Journal of Public Health
• Main Authors: Oster, Richard T., Shade, Sandra, Strong, David, Toth, Ellen L.
• Format: Text
• Language: English
• Published: Springer International Publishing 2010
• Subjects: Quantitative Research; Canada; First Nations
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973552/; http://www.ncbi.nlm.nih.gov/pubmed/21214058; https://doi.org/10.1007/BF03404863

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.