title: Global complication rates of type 2 diabetes in Indigenous peoples: A comprehensive review.
abstract: OBJECTIVE
  The world's Indigenous peoples are experiencing an unprecedented epidemic of type 2 diabetes [T2DM] but little has been published describing the complications burden. The objective of this paper was to conduct a systematic review of T2DM complications in Indigenous populations worldwide.
  
  
  METHODS
  A literature review was conducted using PubMed and EMBASE to examine available complications data. Country, Indigenous population, authors, publication year, total sample size, Indigenous sample size, age, methodology, and prevalence of nephropathy, end-stage renal disease, retinopathy, neuropathy, lower extremity amputations, cardiovascular disease, hospitalizations and mortality due to diabetes were recorded.
  
  
  RESULTS
  One-hundred and eleven studies were selected. Results revealed a disproportionate burden of disease complications among all Indigenous peoples regardless of their geographic location. Complication rates were seen to vary widely across Indigenous groups.
  
  
  CONCLUSIONS
  Gaps were found in the published literature on complications among Indigenous populations, especially those living in underdeveloped countries. These gaps may be in part due to the challenges caused by varying operational practices, research methodologies, and definitions of the term Indigenous, making documentation of rates among these peoples problematic. Comprehensive surveillance applying standardized definitions and methodologies is needed to design targeted prevention and disease management strategies for Indigenous peoples with T2DM.
authors.affiliation: Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, Suite 245-100 Collip Circle, London, Ontario, Canada N6G 4X8.
authors.forename: Mariam
authors.initials: M
authors.lastname: Naqshbandi
authors.forename: Stewart B
authors.initials: SB
authors.lastname: Harris
authors.forename: James G
authors.initials: JG
authors.lastname: Esler
authors.forename: Fred
authors.initials: F
authors.lastname: Antwi-Nsiah