Article Title

So far and yet so close: Quality of management of diabetes in Australian and Canadian indigenous communities


Objectives: To compare quality of clinical management of Indigenous people with diabetes in remote areas of Australia and Canada.

Design: Clinical audit of diabetes management.

Setting: The Kimberley region of Western Australia and Northern Saskatchewan in Canada.

Subjects: One hundred and two Saskatchewan and 142 Kimberley patients from seven and 11 primary health services, respectively.

Main outcome measures: Indicators of quality of diabetes clinical management during the preceding two years.

Results: Overall quality of management was poor. Retinopathy screening was better in the Kimberley than Saskatchewan (58% screened in the preceding two years cf 30%). Glycemic control of Saskatchewan patients was better than that of Kimberley patients (16% with optimal control vs. 9%).

Conclusions: Continuing efforts at the level of health service organisation, patient and staff education, and creative ways to reduce barriers to access, as well as primary prevention initiatives, are required to counter the devastating effect of diabetes on Indigenous communities.


diabetes, indigenous peoples, patient education, treatment

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