Diabetes Care & Educating for equity (e4E)

Indigenous communities in Canada face higher rates of diabetes, particularly those living on reserves. This is influenced by factors such as healthcare access, food security, and the impacts of historical and social contexts.

However, Indigenous knowledge and perspectives on health—rooted in emotional, spiritual, and cultural dimensions—offer valuable strengths in addressing these challenges.

Indigenous communities possess a wealth of cultural knowledge and lived experience that can inform more effective diabetes care. By building on the resilience, traditions, and practical wisdom within communities, our approach develops tailored interventions that address the unique needs of Indigenous Peoples, including women and youth (Crowshoe et al., n.d.).

Interactions between Indigenous patients and healthcare providers remain crucial for transforming care. Physician accounts indicate that meaningful system changes—such as revising policies to reflect Indigenous historical and social contexts—are necessary to reform diabetes treatment (Crowshoe et al., 2018).

The project aims to:

  1. Adapt an existing knowledge tool into an interactive, learner-centered resource for both patient education and physician training;

  2. Assess the effectiveness of the E4E framework as an intervention within Indigenous-focused primary care clinics across rural and urban Alberta; and

  3. Identify current resource gaps to support the broader application of the framework across additional physician specialties, allied health fields, and other chronic disease contexts.

The Educating for Equity (E4E) Framework offers a promising model by addressing social barriers and integrating cultural perspectives into diabetes management. Its modular training program for family physicians has been associated with improvements in clinical knowledge, practical skills, and confidence in providing culturally responsive care (Crowshoe et al., 2018; 2019; Cheran et al., 2023).

Explore research on improving diabetes care for Indigenous patients through culturally safe, strengths-based approaches

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Terms to know

  • Diabetes is a broad diagnosis which encompasses a range of metabolic diseases characterized by dysregulation and issues with hyperglycemia resulting from in insulin secretion deficiencies and processes throughout the body. The impacts of getting diabetes causes a range of dysfunctionality in various organs of the body such weakening functionality, decreased utility of organs and failure of vital body structures.

  • Type 1 - An autoimmune disorder where the body’s insulin-producing cells are attacked and the body loses the ability to produce the essential hormone called insulin and cannot regulate blood sugar or convert food into energy.

    Type 2 - The body produces insulin but the Body can’t use or process that insulin which results in an “insulin resistance” and Hyperglycemia.

    Gestational Diabetes - During pregnancy the mother cannot process the insulin that she produces or does not produce a sufficient enough amount of insulin to support the pregnancy.

  • Diabetes is managed through health education, lifestyle, diet, exercise, orally administered medications and injected/pumped medications. ie. Synthetic Insulin

  • There is a greater occurrence of diabetes among people living on reserve is approximately 17.2% and those that live off the reserve is estimated to be 10.3%, this disparity puts the Indigenous population of Canada at a greater risk of both developing Diabetes, being underdiagnosed, and not give the tools or education to manage and prevent diabetes. (1)