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The National Diabetes Management Strategy: Diabetes Facts and Figures By using these slides, you agree to the terms on the next slide. The development.

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Presentation on theme: "The National Diabetes Management Strategy: Diabetes Facts and Figures By using these slides, you agree to the terms on the next slide. The development."— Presentation transcript:

1 The National Diabetes Management Strategy: Diabetes Facts and Figures By using these slides, you agree to the terms on the next slide. The development of these slides was made possible through financial support by Merck.

2 Terms of Use By using this web site and/or these slides and/or requesting and receiving the information on this site, you are accepting these terms of use. These slides and the related information on the The National Diabetes Management Strategy website synthesize publicly available information in a convenient format. This information is intended for use by policymakers, managers, media, planners, clinicians and researchers. All information provided on this site and in these slides is publicly available from the original sources. All information is attributed to the original source. All information in these slides is copyrighted by other parties. As a visitor to this site, you are granted a limited license to use the information contained within for non-commercial use only, provided the information is not modified and all copyright and other proprietary notices are retained. The National Diabetes Management Strategy and The University of Western Ontario resides in Ontario, Canada and this site and any transactions which you enter into through this site are governed by the laws of Ontario, Canada and the federal laws of Canada applicable therein. The faculty and staff of The National Diabetes Management Strategy The University of Western Ontario shall not be liable for any damages, claims, liabilities, costs or obligations arising from the use or misuse of the material contained on this web site, whether such obligations arise in contract, negligence, equity or statute law. The National Diabetes Management Strategy and The University of Western Ontario do not guarantee or warrant the quality, accuracy, completeness, timeliness, appropriateness or suitability of the information provided. Links to other sites are provided as a reference to assist you in identifying and locating other Internet resources that may be of interest. The National Diabetes Management Strategy and The University of Western Ontario does not assume responsibility for the accuracy or appropriateness of the information contained on other sites, nor do we endorse the viewpoints expressed on other sites.

3 Diabetes is an Aboriginal Problem

4 Diabetes is an Epidemic in Aboriginal Populations The national age-adjusted prevalence is 2.5 to 5 times higher than that of the general population. Age-adjusted prevalence rates as high as 26% have been found in individual communities. Aboriginal peoples are diagnosed with type 2 diabetes at a much younger age, with high rates of diabetes in children and adolescents. Dyck R, et al. CMAJ. 2010; 182(3): Green C, et al. Diabetes Care. 2003;26:1993–1998. Harris SB, et al. Diabetes Care. 1997;20:185–187. Fagot-Campagna A, et al.. J Pediatr. 2000;136:664–672.

5 Aboriginals are Disproportionately Affected by Diabetes PopulationData sourceAge of surveyed population Prevalence (%) (95% confidence interval) CrudeAge- standardized Non- Aboriginal CCHS ( ) 5.0 ( ) First Nations (on-reserve) RHS ( ) 17.2 ( ) First Nations (off-reserve) CCHS ( ) 10.3 ( ) Inuit2006 APS15+ 4 ( ) NA Métis CCHS ( ) 7.3 ( ) Self-reported diabetes among Aboriginal and First Nations populations is higher than in the non-Aboriginal populations. APS = Aboriginal Peoples Survey; CCHS = Canadian Community Health Survey; RHS = First Nations Regional Longitudinal Health Survey

6 Younger Age of Diagnosis Among First Nations Peoples General population with type 2 diabetes in family practice setting ( ) (1) General population with type 2 diabetes in family practice setting ( ) (2) First Nations population with type 2 diabetes in 19 communities (2007)(3) 54.9 years 55 years43.7 years Compared with the general population of people with type 2 diabetes, First Nations peoples were diagnosed with diabetes on average a decade earlier. 1. Harris S, et al. Diabetes Res Clin Pract. 2005;70(1): Braga M, et al. Can J Cardiol. 2010;26(6): Harris SB, et al. Diabetes Res Clin Pract. 2011;92(2):

7 Higher Rates of Complications in First Nations Peoples With Diabetes ComplicationFirst Nations population with type 2 diabetes in 19 communities (2007) 1) General population with type 2 diabetes in family practice setting ( ) (2) Age at audit Chronic kidney disease Depression Neuropathy Retinopathy Diabetic foot disease Number of diabetes-related health visits Compared with the general population with type 2 diabetes, First Nations peoples with diabetes are younger, yet have higher rates of many of the serious complications of diabetes. This higher morbidity is reflected in double the number of diabetes-related health visits in First Nations than in the general population with type 2 diabetes. 1.Harris SB, et al. Diabetes Res Clin Pract. 2011;92(2): Harris S, et al. Diabetes Res Clin Pract. 2005;70(1):

8 High Rates of GDM in Aboriginal Women PopulationPrevalence (%) Non-Aboriginal0.5 First Nations4.8 Inuit4.0 Métis2.2 Gestational diabetes mellitus (GDM) is defined as diabetes with onset or first recognition during pregnancy. It is a risk factor for later development of type 2 diabetes in the mother, as well as in the offspring. Garnier R, et al. Statistics Canada Health Analysis Division; Ottawa, ON: PHAC. Diabetes in Canada: Facts and Figures from a Public Health Perspective. Ottawa, ON: 2011

9 Increased Prevalence of Diabetes in Pregnancy and Adverse Outcomes Liu S, et al. Diabetic Med. 2012: [Epub ahead of print] Compared to non-FN women, FN women on- reserve in Ontario had: –Higher prevalence of diabetes in pregnancy –Less preconception/antenatal care –Less postpartum care –Higher mean birth weight and rate of macrosomia –Higher rates of pre-term delivery, jaundice, neonatal hypoglycemia, shoulder dystocia –Less primary care after birth

10 Aboriginal Population Growth Type 2 diabetes has reached epidemic proportions among Canadian Aboriginal peoples. The national age-adjusted prevalence is 2.5 to 5 times higher than that of the general population, and age-adjusted prevalence rates as high as 26% have been found in individual communities. 1-3 Aboriginal peoples are diagnosed with type 2 diabetes at a much younger age, with high rates of diabetes in children and adolescents. 4 Due primarily to a high birth rate, from 1996 to 2003, the Aboriginal population grew by 45%, nearly 6 times the growth rate of non-Aboriginals Dyck R, et al. CMAJ. 2010; 182(3): Green C, et al. Diabetes Care. 2003;26:1993– Harris SB, et al. Diabetes Care. 1997;20:185– Fagot-Campagna A, et al. J Pediatr. 2000;136:664– Statistics Canada. Aboriginal population in 2017.

11 Diabetes Surveillance System for First Nations Communities The First Nations Diabetes Surveillance System is a web-based surveillance application that will track type 2 diabetes and complication rates over time in First Nations communities. This information will allow the monitoring of the diabetes burden in each partnering community and can be used to inform and evaluate new quality improvement initiatives in communities. The goal of the Surveillance System is to monitor and track diabetes rates so that informed decisions can be made to improve community care. First Nations Surveillance System Newsletter. November 2010.

12 Diabetes Surveillance System for First Nations Communities Similar programs in Aboriginal settings in the United States and Australia have been associated with sustained improvements in quality of care for people diagnosed with diabetes. Although this program is currently a 2-year pilot program, it is hoped that in the future the system will be expanded to include other communities, and that ongoing financial support will help sustain the program. The Surveillance System has been generously funded by the Aboriginal Diabetes Initiative, First Nations and Inuit Health Branch at Health Canada. First Nations Surveillance System Newsletter. November 2010.


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