Chapter 38- Type 2 Diabetes and Indigenous Peoples

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Chapter 38- Type 2 Diabetes and Indigenous Peoples
Importance: Medium- Read at least twice
Approximate time recommended: 35 minutes

I have highlighted what I think will be important for the exam. However you should read the entire chapter. All areas in grey (key messages and recommendations) are also important for the exam.

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Under the heading of: Introduction

Understand that colonization has resulted in a number of negative health outcomes for Indigenous people. Know that Indigenous people have higher prevalence rates of diabetes and its related complications.

Under the heading of: Screening in Indigenous Peoples and/or Communities

Know the screening guidelines for Indigenous adults

Under the heading of: Educating for Equity (E4E) Care Framework

Be familiar with Table 1

Practice Questions (press show answer to reveal answer)

You have a 20 year old patient of indigenous descent who has a BMI of 39 and a strong family history of diabetes. When should they be screened and how often?

A) At age 40 and every 3 years afterwards
B) Now and every 3 years afterwards
C) At age 40 and every 6-12 months afterwards
D) Now and every 6-12 months afterwards

You have a new patient who is of indigenous descent, has had a previous MI and obese. Her A1c is 8.1% (0.081) and her target is 7.0% (0.07) During the interview she brings up traditional medications. Which of the following would responses follow the Educating for Equity (E4E) framework the best?

A) Discuss you are the expert in this relationship and she is not.
B) Explore her desire to use traditional medications and agree to learn from each other. She could discuss how these meds fit into her culture and you could discuss potential interactions.
C) Discuss that the Diabetes Canada guidelines has a chapter on natural medicines which show indigenous medications are all ineffective and should not be used.
D) Explore the idea of using a GLP-1 medication as they would help reduce her appetite therefore helping with her obesity, review the SUSTAIN trials which show that GLP-1 medications can help prevent a further CV event and discuss how GLP-1s would be effective in getting her A1c to target.