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Room for improvement in diabetes care among First Nations in northern Quebec (Eeyou Istchee): reasonable management of glucose but poor management of complications.

Abstract：

OBJECTIVES:To evaluate the clinical management of type 2 diabetes in the Eeyou Istchee communities of northern Quebec. STUDY DESIGN:Retrospective quality assurance audit. METHODS:Patients with diabetes were identified using the Cree Diabetes Information System. Charts of eligible patients were audited for healthcare visits, glycemic control, blood pressure, lipid profile, pharmacological treatment and complications for the 2006 calendar year. Analyses were performed to assess the association of disease duration, age, target glycemic and blood pressure control with diabetes complications. RESULTS:Half of the patients (49.7%) achieved target HbA1c, 53.6% had a blood pressure of ≤130/80 and 58.7% had an LDL of ≤2.5 mmol/L. The proportion of patients meeting all 3 targets was low at 17.1%. The mean number of diabetes-related clinic visits was high, with an average of 3.9 visits to a physician and an average of 8.7 visits to a registered nurse. Of patients with a documented diabetic complication, 39.4% of patients were not being managed with an ACE/ARB and 48.2% of patients were not prescribed a statin. CONCLUSIONS:These findings suggest a possible treatment gap for risk factors and complications management. To circumvent further increases in diabetes-related complications, emphasis should be placed on improved healthcare worker training, greater use of clinical management and patient education tools and improved communication during the diabetes-related clinical visits. Development of a culturally appropriate multidisciplinary approach towards improved understanding of diabetes and multifactorial risk management for diabetic patients is essential for the prevention of diabetic complications.

journal_name

Int J Circumpolar Health

journal_title

International journal of circumpolar health

authors

Naqshbandi Hayward M,Kuzmina E,Dannenbaum D,Torrie J,Huynh J,Harris S

doi

10.3402/ijch.v71i0.18418

subject

Has Abstract

pub_date

2012-04-25 00:00:00

pages

1-8

eissn

1239-9736

issn

2242-3982

pii

18418

journal_volume

pub_type

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Room for improvement in diabetes care among First Nations in northern Quebec (Eeyou Istchee): reasonable management of glucose but poor management of complications.