Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Outsmarting diabetes…                Presentation to Metis Settlelments –                            March 2010Dr Ellen To...
KNOWNS and UNKNOWNS                            MDSi                                   80%                   30%KNOWNS:    ...
Total: 4793Total 2608
Total 1407
The epidemicPopulation growth                                        Case findingPregnancy:Diabetes                       ...
Key Determinants of Health•   Income and Social Status, •   Social Support Networks,•   Education and Literacy, •   Employ...
The epidemic: can it be stopped?  Depopulation and     repopulation           Loss of culture                             ...
Adults without diabetes                  0.13 BMI points                   per year, weight                   increasing b...
Mean blood pressure getting better, 0.7 mm Hg per yearMDSi results to March    2010, DRAFTBP generally goodMDSi results to...
Low number, diastolic, should be well under 90MDSi results to March    2010, DRAFT  Cholesterol   decreasing   non‐  signi...
BAD NEWS:                  HgbA1c > 6.4                  being proposed                  for diagnosis of                 ...
BAD NEWS: many way too high to start withMORE BAD NEWS: not decreasingGOOD NEWS: not increasing, and some going down   MDS...
Adults with diabetes                    Just                     significant                     BMI loss                 ...
Significant loss of 0.3 kg per year MDSi results to March     2010, DRAFTSignificant improvement in mean blood pressure of...
Significant        decrease in        overall A1c        by  0.06 per        year       BAD NEWS:        some are        v...
Questions and            discussion           Dr Ellen Toth: 780 ‐ 407‐3636              Ellen.toth@ualberta.ca           ...
Upcoming SlideShare
Loading in …5
×

Outsmarting Diabetes: Presentation to the Metis Settlements, March 2012

393 views

Published on

BRAID Research, University of Alberta
www.braiddm.ca

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Outsmarting Diabetes: Presentation to the Metis Settlements, March 2012

  1. 1. Outsmarting diabetes… Presentation to Metis Settlelments – March 2010Dr Ellen TothUniversity ofAlbertaDiabetesSpecialistMobile Diabetes Screening Initiative:“… provide resources for screening fordiabetes and its complications inAboriginal off-reserve and remoteAlberta communities”(part of the 10 year Alberta Diabetes Strategy, 2003)
  2. 2. KNOWNS and UNKNOWNS MDSi 80% 30%KNOWNS: UNKNOWNS: ‐ have diabetes screen for risk of diabetes and ‐ visits take longer  cardiovascular risk‐ need foot and eye exams
  3. 3. Total: 4793Total 2608
  4. 4. Total 1407
  5. 5. The epidemicPopulation growth Case findingPregnancy:Diabetes Diabetesbegetsdiabetes Behaviours Genetics Environment Modified from Engelgau What is needed for health? Access to  quality health  care Self: genetics, health  beliefs, self esteem,  resources  Family and friends Community leadership Social determinants of health Toth 2010
  6. 6. Key Determinants of Health• Income and Social Status, • Social Support Networks,• Education and Literacy, • Employment/Working Conditions, • Social Environments, • Physical Environments, • Personal Health Practices and Coping Skills, • Healthy Child Development, • Biology and Genetic Endowment, • Health Services, • Gender, culture. Source: Public Health Agency of Canada Determinants of Health For Aboriginal  Peoples: • Colonization  • Globalization  • Migration  • Cultural continuity  • Access  • Territory  • Poverty  • Self‐ determination  Source‐National Aboriginal Health Organization
  7. 7. The epidemic: can it be stopped? Depopulation and  repopulation Loss of culture Loss of Traditional foodLoss oflanguage Diabetes Loss of clean water Indian Act Residential school Toth 2005 MDSi results to March 2010,  DRAFT People without known diabetes:  Unknown adults, unknown kids, and  people with diabetes (knowns)
  8. 8. Adults without diabetes 0.13 BMI points  per year, weight  increasing by 90  grams a year,  both  increasing  highly  significantly MDSi results to March  2010, DRAFT
  9. 9. Mean blood pressure getting better, 0.7 mm Hg per yearMDSi results to March  2010, DRAFTBP generally goodMDSi results to March  2010, DRAFT
  10. 10. Low number, diastolic, should be well under 90MDSi results to March  2010, DRAFT Cholesterol  decreasing  non‐ significantlyMDSi results to March  2010, DRAFT
  11. 11. BAD NEWS:  HgbA1c > 6.4  being proposed  for diagnosis of  diabetes, 6.1‐6.4  = pre‐diabetes GOOD NEWS:  A1c getting  significantly  better MDSi results to March  2010, DRAFTKids without diabetes
  12. 12. BAD NEWS: many way too high to start withMORE BAD NEWS: not decreasingGOOD NEWS: not increasing, and some going down MDSi results to March  2010, DRAFT 1 pre‐ diabetes? MDSi results to March  2010, DRAFT
  13. 13. Adults with diabetes Just  significant  BMI loss  of minus .1 BMI  points per  year MDSi results to March  2010, DRAFT
  14. 14. Significant loss of 0.3 kg per year MDSi results to March  2010, DRAFTSignificant improvement in mean blood pressure of 1 mm Hg per year MDSi results to March  2010, DRAFT
  15. 15. Significant  decrease in  overall A1c  by  0.06 per  year BAD NEWS:  some are  very bad! MDSi results to March  2010, DRAFTSignificant decrease in cholesterol of 0.7 mmol / L per year MDSi results to March  2010, DRAFT
  16. 16. Questions and  discussion Dr Ellen Toth: 780 ‐ 407‐3636 Ellen.toth@ualberta.ca www.braiddm.caACADRE

×