title: The current status of diabetes care, diabetic retinopathy screening and eye-care in British Columbia's First Nations Communities.
abstract: OBJECTIVE
  The objective of this study was to evaluate the current status of primary diabetes care, diabetic retinopathy screening, and eye-care for First Nations individuals with diabetes living on-reserve in British Columbia.
  
  
  METHODS
  Prospective cross-sectional observational survey.
  
  
  METHODS
  A mail-out survey was sent to all BC First Nations Communities in the format of a 26-item questionnaire. A series of general questions were asked concerning community populations, regional transportation options and the availability of local health-care providers. Specific questions about the frequency and source of eye and diabetic retinopathy care in each community were also solicited.
  
  
  RESULTS
  A sixty-seven percent questionnaire response rate was achieved (136/202 communities). The community-reported rate of diabetes mellitus ranged from 4.8 to 11.8% with an average of 6.4%. The proportion of on-reserve individuals with diabetes receiving yearly retinal examinations for diabetic retinopathy was found to be only 33%. Many communities received eye-care from more than one professional group, but the majority of basic eye-care and retinopathy screening was provided by optometrists. Ophthalmologists were less likely to provide eye care for these communities; however, family physicians and nurses were frequently responsible for performing eye evaluations.
  
  
  CONCLUSIONS
  The vast majority of First Nations people with diabetes who live on-reserve in British Columbia do not have access to annual examinations by an eye-care professional. Eye evaluations and retinal screening were often the responsibility of individuals with little formal training in this area.
authors.affiliation: Department of Ophthalmology, University of British Columbia, Vancouver, Canada.
authors.forename: Harrup
authors.initials: H
authors.lastname: Kaur
authors.forename: David
authors.initials: D
authors.lastname: Maberley
authors.forename: Angela
authors.initials: A
authors.lastname: Chang
authors.forename: Dawn
authors.initials: D
authors.lastname: Hay
mesh_terms: D001955:British Columbia; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology / Q000628:therapy*; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D006282:Health Personnel / Q000458:organization & administration; D006801:Humans; D007198:Indians, North American; D009885:Ophthalmology; D009907:Optometry; D011320:Primary Health Care / Q000458:organization & administration*