title: Call to action: A new path for improving diabetes care for Indigenous peoples, a global review.
abstract: Diabetes has reached epidemic proportions in Indigenous populations around the globe, and there is an urgent need to improve the health and health equity of Indigenous peoples with diabetes through timely and appropriate diabetes prevention and management strategies. This review describes the evolution of the diabetes epidemic in Indigenous populations and associated risk factors, highlighting gestational diabetes and intergenerational risk, lifestyle risk factors and social determinants as having particular importance and impact on Indigenous peoples. This review further describes the impact of chronic disease and diabetes on Indigenous peoples and communities, specifically diabetes-related comorbidities and complications. This review provides continued evidence that dramatic changes are necessary to reduce diabetes-related inequities in Indigenous populations, with a call to action to support programmatic primary healthcare transformation capable of empowering Indigenous peoples and communities and improving chronic disease prevention and management. Promising strategies for transforming health services and care for Indigenous peoples include quality improvement initiatives, facilitating diabetes and chronic disease registry and surveillance systems to identify care gaps, and prioritizing evaluation to build the evidence-base necessary to guide future health policy and planning locally and on a global scale.
authors.affiliation: Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. Electronic address: stewart.harris@schulich.uwo.ca.
authors.forename: Stewart B
authors.initials: SB
authors.lastname: Harris
authors.affiliation: Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. Electronic address: jordan.tompkins@schulich.uwo.ca.
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tompkins
authors.affiliation: School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada. Electronic address: btehiwi@lakeheadu.ca.
authors.forename: Braden
authors.initials: B
authors.lastname: TeHiwi
mesh_terms: D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D044382:Population Groups; D011320:Primary Health Care / Q000379:methods*; D012307:Risk Factors
keywords: Diabetes; Evaluation; Indigenous; Literature review; Policy; Primary healthcare