Diabetes in Culturally Diverse Populations

Question 1

What is CANRISK?

Answer 1

• Used for diabetes risk assessment in Canada’s multi-ethnic population
• Statistically valid tool for individuals !!>40 years!! of age

Question 2

Which ethnic groups are at an increased risk of diabetes? Which type of diabetes?

Answer 2

African, Arab, Asian, Hispanic, Indigenous and South Asian peoples)
- type 2 diabetes

Question 3

What are the reasons behind the increased risk of developing type two diabetes in ethnic groups

Answer 3

• genetic susceptibility
• altered fat distribution (more visceral fat with greater insulin resistance)
• higher prevalence of metabolic syndrome

Question 4

What are the difference between the age and progression of diabetes diagnoses in ethnic groups

Answer 4

Many of the people from high risk groups are diagnosed with diabetes at a younger age and often have diabetes-
related complications at the time of diagnosis due to long-standing unmanaged pre-existing diabetes.

Question 5

% risk of developing T2DM in in first nations vs non-first nations?

Answer 5

Indigenous people in their 20s have an 80% chance of developing type 2 diabetes compared to the risk to non-First Nations individuals at 50%

Question 6

How does rate of gestational diabetes compare in indigenous versus non-indigenous woman?

Answer 6

Indigenous women experience higher rates of gestational diabetes than non-Indigenous women

Question 7

How does occurence of diabetes complications compare in indigenous versus non-indigenous population?

Answer 7

Complications of diabetes are also more frequently seen among the Indigenous population than in the non-Indigenous population

Question 8

name common Cross-cultural Barriers

Answer 8

Lack of knowledge 
fear and distrust 
stereotyping 
assumed similarity 
nonverbal communication authority 
physical touch/contact 
verbal languages and styles

Question 9

T2 is a __ disease that results both from __ and __ factors

Answer 9

T2 is a heterogeneous disease that results both from genetics and environmental factors

Question 10

How can insulin and ethnic background be connected

Answer 10

Certain populations have lower insulin sensitivity thus have an increased chance for insulin resistance

Question 11

ethnic populations have an increased risk of __ and __ complications due to __ and __ factors

Answer 11

ethnic populations have an increased risk of metabolic and cardiorenal complications due to acquired and genetic factors

Question 12

What are the benefits of culturally appropriate health education for type two diabetes

Answer 12

It has short-to-medium term effects on glycemic management:

• mean reduction of HbA1C up to 24 months
• improved scores on knowledge of diabetes
• healthy behaviours for up to 6 months

Question 13

Are educational programs better in individual or group setting?

Answer 13

Larger reductions in HbA1C with individual and face-to-face delivered through educational programs and peer educators compared to with group-based diabetes education

Question 14

What is the risk of prolonged fasting with diabetes

Answer 14

Increases risk of hypoglycemia, hyperglycemia, diabetic ketoacidosis and dehydration

Question 15

What is important to consider when fasting during Ramadan while having diabetes

Answer 15

• Meal timing
• Meal quality
  • Meal before sunrise - Sahour
  • Meal after fast is broken - Iftar
• Hydration

Question 16

__ and belonging to __ already serves as a risk factor for developing T2 diabetes

Answer 16

Migration and belonging to an ethnic minority already serves as a risk factor for developing T2 diabetes