Understanding lived experiences of Aboriginal people with type 2 diabetes living in remote Kimberley communities: diabetes, it don't come and go, it stays!

2019 ◽  
Vol 25 (5) ◽  
pp. 486 ◽  
Author(s):  
Sarah Straw ◽  
Erica Spry ◽  
Louie Yanawana ◽  
Vaughan Matsumoto ◽  
Denetta Cox ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Collaborative Research ◽  
Diabetes Management ◽  
Aboriginal People ◽  
Health Workers ◽  
Aboriginal Health ◽  
Community Members ◽  
Remote Communities ◽  
Aboriginal Community

This study aimed to explore the lived experiences of Kimberley Aboriginal people with type 2 diabetes managed by remote Aboriginal Community Controlled Health Services using phenomenological analysis. Semi-structured interviews formulated by Aboriginal Health Workers, researchers and other clinicians were used to obtain qualitative data from 13 adult Aboriginal patients with type 2 diabetes managed in two remote communities in the Kimberley. Together with expert opinion from local Aboriginal Health Workers and clinicians, the information was used to develop strategies to improve diabetes management. Of 915 regular adult patients in the two communities, 27% had type 2 diabetes; 83% with glycated haemoglobin A >10%. Key qualitative themes included: the need for culturally relevant education and pictorial resources; importance of continuous therapeutic relationships with healthcare staff; lifestyle management advice that takes into account local and cultural factors; and the involvement of Aboriginal community members and families in support roles. Recommendations to improve diabetes management in the remote communities have been made collaboratively with community input. This study provides a framework for culturally relevant recommendations to assist patients with diabetes, for collaborative research, and for communication among patients, Aboriginal Health Workers, community members, researchers and other clinicians. Interventions based on recommendations from this study will be the focus of further collaborative research.

scholarly journals Serious Complications for Patients, Care Providers and Policy Makers: Tackling the Structural Violence of First Nations People Living with Diabetes in Canada

2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Marion A Maar ◽  
Darrel Manitowabi ◽  
Danusia Gzik ◽  
Lorrilee McGregor ◽  
Cheri Corbiere
Keyword(s):  
Type 2 Diabetes ◽  
First Nations ◽  
Health Care Providers ◽  
Diabetes Management ◽  
Aboriginal People ◽  
Structural Violence ◽  
Treatment Strategies ◽  
Care Providers ◽  
First Nations People

Type 2 diabetes mellitus is a progressive metabolic disorder that affects Aboriginal people disproportionately around the world. Evidence shows that diabetes treatment strategies can effectively reduce complications related to the disease; in contrast many Aboriginal people develop these rapidly and at a young age. We conducted qualitative research on the barriers to evidence-based self-management behaviours and education from the perspectives of Aboriginal people living with type 2 diabetes and their health care providers on Manitoulin Island in Ontario, Canada. Applying the concept of structural violence, we analyzed the social and political arrangements that can put Aboriginal people with diabetes “in harm’s way” by interfering with diabetes management. Lastly, we provide recommendations for structural interventions.

scholarly journals Lifestyle interventions for type 2 diabetes management among migrants and ethnic minorities living in industrialized countries: a systematic review and meta-analyses

2021 ◽  
Vol 9 (1) ◽  
pp. e001924
Author(s):  
Lal Rawal ◽  
Berhe W Sahle ◽  
Ben J Smith ◽  
Kie Kanda ◽  
Ebenezer Owusu-Addo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Ethnic Minorities ◽  
Diabetes Management ◽  
Health Workers ◽  
Significant Heterogeneity ◽  
Lifestyle Interventions ◽  
Subgroup Analyses ◽  
Meta Analyses

The objective of this systematic review was to determine the effectiveness of lifestyle interventions to improve the management of type 2 diabetes mellitus (T2DM) among migrants and ethnic minorities. Major searched databases included MEDLINE (via PubMed), EMBASE (via Ovid) and CINAHL. The selection of studies and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In the meta-analysis, significant heterogeneity was detected among the studies (I2 >50%), and hence a random effects model was used. Subgroup analyses were performed to compare the effect of lifestyle interventions according to intervention approaches (peer-led vs community health workers (CHWs)-led). A total of 17 studies were included in this review which used interventions delivered by CHWs or peer supporters or combination of both. The majority of the studies assessed effectiveness of key primary (hemoglobin (HbA1c), lipids, fasting plasma glucose) and secondary outcomes (weight, body mass index, blood pressure, physical activity, alcohol consumption, tobacco smoking, food habits and healthcare utilization). Meta-analyses showed lifestyle interventions were associated with a small but statistically significant reduction in HbA1c level (−0.18%; 95% CI −0.32% to −0.04%, p=0.031). In subgroup analyses, the peer-led interventions showed relatively better HbA1c improvement than CHW-led interventions, but the difference was not statistically significant (p=0.379). Seven studies presented intervention costs, which ranged from US$131 to US$461 per participant per year. We conclude that lifestyle interventions using either CHWs or peer supporters or a combination of both have shown modest effectiveness for T2DM management among migrants of different background and origin and ethnic minorities. The evidence base is promising in terms of developing culturally appropriate, clinically sound and cost-effective intervention approaches to respond to the growing and diverse migrants and ethnic minorities affected by diabetes worldwide.

scholarly journals 2423

2017 ◽  
Vol 1 (S1) ◽  
pp. 77-78
Author(s):  
Scott Cohen ◽  
Jasmine Mack ◽  
Catherine Striley ◽  
Linda Cottler
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Health Workers ◽  
Healthcare Access ◽  
Economic Stability ◽  
Disease Etiology ◽  
Central Florida ◽  
Socio Demographic Factors ◽  
Comorbidity Status

OBJECTIVES/SPECIFIC AIMS: Research on social determinants of health (SDHs) in type 2 diabetes have largely examined disease etiology rather than severity. To find factors associated with complications, we investigated socio-demographics, healthcare access, and healthcare utilization in individuals with type 2 diabetes with respect to related comorbidity. METHODS/STUDY POPULATION: Community health workers assessed 8494 participants for type 2 diabetes (n=939; 11%) through HealthStreet, a community-engagement model implemented in North Central Florida. Comorbidities were defined as neuropathy, retinopathy, high cholesterol, hypertension, and kidney failure. We conducted multivariate analyses to test the association of socio-demographic factors and comorbidity status. RESULTS/ANTICIPATED RESULTS: Of 939 members with type 2 diabetes, 164 (17%), 272 (29%), 370 (39%), and 133 (14%) reported having 0, 1, 2, and 3+ comorbidities, respectively. There is a smaller proportion of African-Americans reporting 3+ comorbidities compared with other comorbidity groups (p=0.003). Those with more comorbidity are less employed (p<0.0001) and are more likely to have Medicare/Medicaid (p=0.03) than those without comorbidity. Those with no comorbidity are more likely to be uninsured compared to those with comorbidity (p=0.0297). Adjusting for age, race, gender, and BMI, those that have at least 1 comorbidity are 1.4 times more likely to be food insecure (p=0.004) and are 1.9 times more likely to have seen a doctor in the past 12 months (p=0.002) compared to those without comorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: Although there is complexity among the relationships between SDHs and diabetic comorbidity, results suggest significant sociodemographic and healthcare-related disparities among individuals living with type 2 diabetes. Members with more comorbidity utilize healthcare, but are more likely to be food insecure among other factors. Those with no comorbidity are least likely to see a physician, which could imply a gap in the care continuum. This analysis gives insight into the importance of efficient diabetes management, focused on disparities in economic stability and healthcare access and utilization.

scholarly journals Sharing Our Wisdom: A Holistic Aboriginal Health Initiative

2016 ◽  
Vol 11 (1) ◽  
pp. 111 ◽  
Author(s):  
Teresa Howell ◽  
Monique Auger ◽  
Tonya Gomes ◽  
Francis Lee Brown ◽  
Alannah Young Leon
Keyword(s):  
Role Models ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Health And Wellness ◽  
Participatory Action ◽  
Community Members ◽  
Aboriginal Community ◽  
Cultural Orientations ◽  
Health Circles ◽  
Cultural Belonging

<p>Colonization has had a profound effect on Aboriginal people’s health and the deterioration of traditional Aboriginal healthcare systems. Health problems among Aboriginal people are increasing at an alarming pace, while recovery from these problems tends to be poorer than among other Canadians. Aboriginal people residing in urban settings, while maintaining strong cultural orientations, also face challenges in finding mentors, role models, and cultural services, all of which are key determinants of health. Using a participatory action framework, this study focused on understanding and describing Aboriginal traditional healing methods as viable approaches to improve health outcomes in an urban Aboriginal community. This research investigated the following questions: (a) Do traditional Aboriginal health practices provide a more meaningful way of addressing health strategies for Aboriginal people? (b) How does participation in health circles, based on Aboriginal traditional knowledge, impact the health of urban Aboriginal people? Community members who participated in this project emphasized the value of a cultural approach to health and wellness. The project provided a land-based cultural introduction to being of <em>nə́c̓aʔmat tə šxʷqʷeləwən ct</em> (one heart, one mind) and learning ways of respectful listening <em>x<sup>w</sup>na:mstəm</em> (witness) <em>tə slaχen</em> (medicines) (listen to the medicine), through a series of seven health circles. The circles, developed by Aboriginal knowledge keepers, fostered a healthy sense of identity for participants and demonstrated the ways of cultural belonging and community. Participants acknowledged that attending the health circles improved not only their physical health, but also their mental, emotional, and spiritual health.<strong></strong></p>

Frequency of Diabetes-Related Complications in Type 1 and Type 2 Diabetes—Results from the International Diabetes Management Practices Study (IDMPS)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1584-P
Author(s):  
JUAN J. GAGLIARDINO ◽  
PABLO ASCHNER ◽  
HASAN M. ILKOVA ◽  
FERNANDO J. LAVALLE-GONZALEZ ◽  
AMBADY RAMACHANDRAN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Management Practices ◽  
Diabetes Management

1311-P: Machine Learning (ML) Application to Predict Patient Risk of Nonadherence in Type 2 Diabetes Management Using U.S. Claims Databases

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1311-P
Author(s):  
XIN CHEN ◽  
GAIL FERNANDES ◽  
JIE CHEN ◽  
ZHIWEN LIU ◽  
RICHARD BAUMGARTNER
Keyword(s):  
Machine Learning ◽  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Patient Risk

The Role of Disordered Eating in Type 2 Diabetes: A Pilot Study

2021 ◽  
pp. 155982762110024
Author(s):  
Alyssa M. Vela ◽  
Brooke Palmer ◽  
Virginia Gil-Rivas ◽  
Fary Cachelin
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Disordered Eating ◽  
Lifestyle Intervention ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Behavioral Therapy ◽  
Exercise Stress ◽  
Increased Risk

Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.

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