Addressing the gaps in diabetes care and screening on First Nations reserves

Dean Eurich and Padma Kaul shared updates on two projects looking at gaps in care for women and Indigenous people.

Recently, the Alberta Diabetes Institute (ADI) series of webinars in celebration of the 100th anniversary of insulin discovery continued with ADI members and experts in diabetes and epidemiology, Dean Eurich and Padma Kaul. The two shared updates on two projects—one focuses on improving diabetes care on First Nations reserves; the other on better understanding differences in health outcomes for men and women in Alberta with diabetes.

The RADAR project addresses the First Nations communities and their challenges in diabetes care

Diabetes and diabetes-related mortality rates are two to three times higher in Indigenous communities than in other communities. These communities face many challenges related to diabetes care, including difficulties in diagnosing and registering patients with diabetes, scarce resources for medical care and fewer health-care professionals on reserves, concerns about data privacy and lack of patient engagement with health care. Reorganizing the Approach to Diabetes through the Application of Registries (RADAR) is an attempt to improve the delivery of health care to Alberta’s Indigenous communities living on reserves.

Improving health care within First Nations reserves

The RADAR project has two main parts. The first aims to identify and register patients on reserves, sharing real-time medical data with the Alberta health-care system. This allows for better communication and improved health-care measures on reserves. To address the lack of diabetes experts on reserves, the second part of RADAR uses telehealth technology to partner a health-care coordinator outside the reserve with expertise in specific disease management with frontline health workers on reserves. After the team reviews cases together, the community determines the most appropriate medical care for their members, improving patient engagement and disease outcomes.

The REDISCOVER project is improving the health system using administrative data

After any health-related appointment or hospital or pharmacy visit in Alberta, administrative information is added to the health-care system. This data includes a patient’s age and sex, as well as mortality data from hospitals, data from hospital outpatient clinics, surgery information, practitioners’ claims, migration patterns and insurance plans. This routinely collected information is particularly useful for surveillance, outcome measurements and health-care cost estimation in the province, and researchers are using this administrative data with the goal of improving the province’s health-care system.

Diabetes screening and sex differences

It is important to verify the role of sex differences in diabetes, both in possible cardiovascular complications and in the efficacy of anti-diabetic drugs. This type of information can be drawn from health administrative data, which is where Real-world Evidence on the association between DIabetes and Sex on CardiOVascular Events Rate (REDISCOVER) comes in. With REDISCOVER, researchers are working to generate local real-world data that will shed light on the role of sex differences in diabetes screening, management and outcomes.