Major gaps in diabetes clinical care among Canada's First Nations: Results of the CIRCLE study

Diabetes Research and Clinical Practice

Volumn 92, Issue 2, 2011, Pages 272-279

  Harris, Stewart B ^a   Naqshbandi, Mariam ^a   Bhattacharyya, Onil ^b   Hanley, Anthony J G ^c   Esler, James G ^a   Zinman, Bernard ^d  

^a WESTERN UNIVERSITY   (Canada)

^b ST MICHAEL'S HOSPITAL   (Canada)

^c UNIVERSITY OF TORONTO   (Canada)

^d MOUNT SINAI HOSPITAL   (Canada)

Author keywords

Aboriginal; Cardiovascular disease; Diabetes mellitus; First Nations; Microvascular disease

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; ANTICOAGULANT AGENT; ANTIHYPERTENSIVE AGENT; ANTILIPEMIC AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; HEMOGLOBIN A1C; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; INSULIN; LOW DENSITY LIPOPROTEIN; LOW DENSITY LIPOPROTEIN CHOLESTEROL; ORAL ANTIDIABETIC AGENT;

ADULT; ARTICLE; CANADA; CHRONIC KIDNEY DISEASE; CORONARY ARTERY DISEASE; CROSS-SECTIONAL STUDY; DIASTOLIC BLOOD PRESSURE; DYSLIPIDEMIA; FEMALE; HEALTH CARE QUALITY; HEART PROTECTION; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MALE; NON INSULIN DEPENDENT DIABETES MELLITUS; OBESITY; SMOKING; SYSTOLIC BLOOD PRESSURE;

ANTIHYPERTENSIVE AGENTS; BLOOD PRESSURE; BODY MASS INDEX; CANADA; CROSS-SECTIONAL STUDIES; DIABETES MELLITUS, TYPE 2; FEMALE; HUMANS; HYPERTENSION; INDIANS, NORTH AMERICAN; KIDNEY DISEASES; MALE; MIDDLE AGED; RISK FACTORS; SMOKING;

EID: 79955846219     PISSN: 01688227     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.diabres.2011.02.006     Document Type: Article

References (34)

1. International Diabetes Federation. Global burden: prevalence, projections, 2010 and 2030. Available at (accessed October 28, 2010). http://www.diabetesatlas.org.content/diabetes-and-impaired-glucose-tolerance.
2. Canadian Diabetes Association. An economic tsunami, the cost of diabetes. 2009. Available at: (accessed October 28, 2010). http://www.diabetes.ca/get-involved/news/the-canadian-diabetes-associations-economic-report-makes-news-across-canada/.
3. Green C., Blanchard J., Young T.K., Griffith J. The epidemiology of diabetes in the Manitoba-registered First Nation population: current patterns and comparative trends. Diab Care 2003, 26:1893-1898.
4. Dyck R., Osgood N., Lin T.S., Gao A., Stang M.R. Epidemiology of diabetes mellitus among First Nations and non-First Nations adults. CMAJ 2010, 18(3):249-256.
5. Harris S.B., Gittelsohn J., Hanley A., Barnie A., Wolever T.M., Gao J., et al. The prevalence of NIDDM and associated risk factors in Native Canadians. Diab Care 1997, 20:185-187.
6. Delisle H.F., Rivard M., Ekoé J.M. Prevalence estimates of diabetes and of other cardiovascular risk factors in the two largest Algonquin communities of Quebec. Diab Care 1995, 18(9):1255-1259.
7. Anand S.S., Yusuf S., Jacobs R., Davis A.D., Yi Q., Gerstein H., et al. Risk factors, atherosclerosis, and cardiovascular disease among Aboriginal people in Canada: the Study of Health Assessment and Risk Evaluation in Aboriginal Peoples (SHARE-AP). Lancet 2001, 358(9288):1147-1153.
8. Shah B.R., Hux J.E., Zinman B. Increasing rates of ischemic heart disease in the Native population of Ontario, Canada. Arch Intern Med 2000, 160(12):1862-1866.
9. Shah B.R., Anand S., Zinman B., Duong-Hua M. Diabetes and First Nations people. Diabetes in Ontario: an ICES practice atlas 2003, 13.231-13.246. Institute for Clinical and Evaluative Sciences. J.E. Hux, G.L. Booth, P.M. Slaughter, A. Laupacis (Eds.).
10. Oster R.T., Virani S., Strong D., Shade S., Toth E.L. Diabetes care and health status of First Nations individuals with type 2 diabetes in Alberta. Can Fam Physician 2009, 55(4):386-393.
11. Canadian Institute for Health Information. Treatment of end-stage organ failure in Canada, 1999-2008 - CORR 2010 Annual Report. Ottawa; CIHI, 2010: 1-83.
12. Minore B., Boone M., Katt M., Kinch P., Birch S. Facilitating the continuity of care for First Nation clients within a regional context 2001, Canadian Health Services Research Foundation, Ottawa, ON.
13. Ferreira M.L., Lang G.C. Indigenous peoples and diabetes: community empowerment and wellness 2006, Carolina Academic Press, Durham, North Carolina.
14. Statistics Canada. Special interest profiles, aboriginal identity, age groups, area of residence, sex and selected demographic, cultural, labour force, educational and income characteristics, for the total population of Canada, Provinces and Territories, 2006 Census of Population. Available at: (accessed October 28, 2010). http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/tbt/Rp-eng.cfm%3FLANG=E%26APATH=3%26DETAIL=0%26DIM=0%26FL=A%26FREE=0%26GC=0%26GID=0%26GK=0%26GRP=1%26PID=97446%26PRID=0%26PTYPE=88971,97154%26S=0%26SHOWALL=0%26SUB=0%26Temporal=2006%26THEME=73%26VID=0%26VNAMEE=%26VNAMEF.
15. Gracey M., King M. Indigenous health part 1: determinants and disease patterns. Lancet 2009, 374(9683):65-75.
16. Health Canada. Ten years of health transfer to First Nations and Inuit control. 1999. (accessed October 28, 2010). http://www.hc-sc.gc.ca/fniah-spnia/pubs/finance/_agree-accord/10_years_ans_trans/5_agreement-entente-eng.php.
17. King M., Smith A., Gracey M. Indigenous health part 2: the underlying causes of the health gap. Lancet 2009, 374(9683):76-85.
18. Naqshbandi M., Harris S.B., Esler J.G., Antwi-Nsiah F. Global complication rates of type 2 diabetes in Indigenous peoples: a comprehensive review. Diab Res Clin Pract 2008, 82:1-17.
19. Canadian Diabetes Association Clinical Practice Guideline Expert Committee. Targets for glycemic control. In: Canadian Diabetes Association 2003 Clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diab 2003; 27(Suppl. 2):S18-S20.
20. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee Dyslipidemia in adults with diabetes. Can J Diab 2006, 30(3):230-240.
21. First Nations Centre. OCAP: Ownership, control, access and possession. Sanctioned by the First Nations Information Governance Committee, Assembly of First Nations. Ottawa, ON: National Aboriginal Health Organization. 2007. Available at (accessed October 28, 2010). http://www.naho.ca/firstnations/english/documents/FNC-OCAP_001.pdf.
22. Dannenbaum D., Kuzmina E., Lejeune P., Torrie J., Gangbe M. Prevalence of diabetes and diabetes related complications in First Nations communities in northern Quebec (Eeyou Istchee), Canada. Can J Diab 2008, 32(1):46-52.
23. Virani S., Strong D., Tennant M., Greve M., Young H., Shade S., Kanji M., et al. Rationale and implementation of the SLICK project: Screening for Limb, I-eye, Cardiovascular and Kidney (SLICK) complications in individuals with type 2 diabetes in Alberta's first nations communities. Can J Public Health 2006, 97(3):241-247.
24. Hanley A.J.G., Harris S.B., Mamakeesick M., Goodwin K., Fiddler E., Hegele R.A., et al. Complications of type 2 diabetes among Aboriginal Canadians: prevalence and associated risk factors. Diab Care 2005, 28(8):2054-2057.
25. Dyck R.F. Mechanisms of renal disease in Indigenous populations: influences at work in Canadian Indigenous peoples. Nephrology 2008, 6(1):3-7.
26. Tonelli M., Hemmelgarn B., Manns B., Pylypchuk G., Bohn C., Yeates K., et al. Death and renal transplantation among Aboriginal people undergoing dialysis. CMAJ 2004, 171(6):577-582.
27. Stidley C.A., Shah V.O., Narva A.S., Dalton D., MacCluer J.W., Bobelu A., et al. A population-based, cross-sectional survey of the Suni Pueblo: a collaborative approach to an epidemic of kidney disease. Am J Kidney Dis 2002, 39(2):358-368.
28. Gerstein H.D., Mann J.F., Yi Q., Zinman B., Dineen S.F., Hoogwerf B., et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and non-diabetic individuals. JAMA 2001, 286:421-426.
29. Gaede P., Vedel P., Parving H.H., Pederson O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet 1999, 353:617-622.
30. Hoy W., Light A., Megill D. Cardiovascular disease in Navajo Indians with type 2 diabetes. Public Health Rep 1995, 110(1):87-94.
31. Davis T.M., McAullay D., Davis W.A., Bruce D.G. Characteristics and outcome of type 2 diabetes in urban Aboriginal people: the Fremantle Diabetes Study. Intern Med J 2007, 37(1):59-63.
32. Braga M, Casanova A, Dawson K, Gerstein G, Harris S, Ur E, et al. Management of vascular risk factors in a cohort of patients with type 2 diabetes mellitus (DM) in Canada: significant gap between guidelines recommendations and current practice [abstract 1212-P]. American Diabetes Association 2009 Scientific Sessions. New Orleans, Louisiana, June 5-9, 2009.
33. Howard B.V., Best L.G., Galloway J.M., Howard W.J., Jones K., Lee E.T., et al. Coronary heart disease risk equivalence in diabetes depends on concomitant risk factors. Diab Care 2006, 29(2):457-460.
34. Harris S.B., Ekoé J.-M., Zdanowicz Y., Webster-Bogaert S. Glycemic control and morbidity in the Canadian primary care setting (results of the Diabetes in Canada Evaluation Study). Diab Res Clin Pract 2005, 70(1):90-97.