Restoring Aboriginal culture through community-based type 2 diabetes screening

Abstract

Typically, type 2 diabetes (T2D) exists long before diagnosis, with complications and co-morbidities also beginning years before clinical presentation. So the question arises: Should individuals be screened for T2D? The answer is not clear, and it becomes even more complicated when applied to “vulnerable” populations such as Canadian Aboriginals, who are at an elevated risk of developing T2D (1). In this population, unique cultural and ethical issues arise in addition to the already debated economical, clinical and logistical factors. Does the community have access to affordable healthy foods and recreation infrastructure? Will the discovery of diabetes for some set in motion a negative stigma, such as “living contrary to traditional culture”? Can cultural barriers, for instance language, be an encumbrance to screening? Will screening interventions be viewed as potential threats to Indigenous autonomy? And so on.