Diabetes Conversations: A Dialogue Among Metis, First Nations Community Members, and Professionals to Understand Type 2 Diabetes

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Type 2 diabetes mellitus (also referred as adult-onset or non-insulin-dependent; hereafter, T2DM) is a serious population health concern among increasingly urbanized First Nations and Métis Canadians (Public Health Agency of Canada [PHAC], 2005), whereas the incidence of T2DM among Canadians in general is much lower than the Aboriginal peoples in Canada (PHAC, 2011). Furthermore, the onset of T2DM in this population occurs at a younger age than in most other populations. The combination of early disease onset, increased urbanization of this population, and rapid progression of this preventable disease process calls for improved communication and collaboration among peoples, providers, and policymakers to slow this disease occurrence and progression. Although there are several published investigations of Aboriginal peoples’ and providers’ perceptions of etiology and prevention of T2DM in reserve or remote settings (Bhattacharyya et al., 2011; Denny, Holtzman, Goins, & Croft, 2005; Minore, Boone, Katt, Kinch, & Birch, 2004; Thompson, Gifford, & Thorpe, 2000; Vukic, & Keddy, 2002; Williamson, Vinicor, & Bowman, 2004), there are few published studies incorporating policymakers’ understanding of T2DM as it relates to susceptibility and prevention of the disease in an urban context. The perceptions of susceptibility to T2DM from policymakers alongside the peoples and health service providers are important to understand, both to add a further layer of complexity and because of their responsibility to influence health service delivery. Those who provide services may have a different view from those who undertake a decision-making role surrounding T2DM in non-urban or reserve or remote settings.