In 1999 the Manitoba First Nation Diabetes Committee (MFNDC) in response to the diabetes epidemic declared by Assembly of Manitoba Chiefs in 1997 developed the Manitoba First Nations Diabetes Strategy “A Call to Action.”
The Diabetes Strategy – “A Call to Action” identified 5 priority areas to be covered to address the diabetes epidemic in First Nations:
- Care and Support
- Prevention and Promotion
- Gestational Diabetes
- Research, Surveillance and Evaluation
- Policy and Infrastructure
The Integrated Diabetes Health Care Service Delivery Model was developed by the MFNDC in collaboration with the Assembly of Manitoba Chiefs (AMC) Grand Chief?s Office and direct input/feedback from the grassroots level. This project is supported by resolution passed by the AMC, Chiefs-in-Assembly in August 2006,
- AMC Resolution AUG-06.01 Manitoba First Nations Integrated Diabetes Health Care Service Delivery Model which approved in-principle the Integrated Diabetes Health Care Service Delivery Model as a framework for action.
Diabetes Integration Project
The Diabetes Integration Project (DIP) is an Integrated Diabetes Health Care Service Delivery Model that was developed to begin to address the needs for First Nations people who have been diagnosed with diabetes. The project will overcome barriers to access to a comprehensive, coordinated and integrated diabetes care and treatment service for limb, eye, cardiovascular and kidney complications. The DIP will utilize Mobile Diabetes Health Care Service Delivery Teams to provide diabetes care and treatment services in First Nation communities throughout Manitoba.
A phased-in approach is being utilized to implement the project and it is estimated that the project will be in full implementation by the end of the 2010/11 fiscal year. When in full implementation the project will have 11 mobile teams providing services in communities. Each team is comprised of two (2) Registered Nurses who will serve a population of approximately 8,000 people.
The plan is to have the teams located in the 5 geographical regions listed below:
- 3 Teams in Thompson
- 1 Team in The Pas
- 1 Team in Dauphin
- Team in Brandon
- 5 Teams in Winnipeg ( 1 team would be assigned exclusively to the Island Lake region)
Support to the Mobile Teams
Support to the Mobile Diabetes Health Care Service Delivery Teams will include the following:
- 4 dietitians (2 community outreach, 2 clinical)
- Mental Health provider (contract as needed)
- Program Medical Advisor
- Physician specialists (contract as needed)
- Surveillance Coordinator/Database programmer
- Administration support (visit scheduling, financial tracking)
The goal of the Diabetes Integration Project is to improve the health status of First Nation individuals, families and communities through actions aimed at reducing prevalence and incidence of diabetes and its risk factors, and to prevent or delay the complications of diabetes.
The objectives of the project are:
- To increase awareness of diabetes, diabetes risk factors, complications and strategies to prevent diabetes and diabetes complications among First Nations people;
- To increase practice of healthy eating and active living behaviors among First Nations people;
- To increase the early detection of diabetes cases in First Nations communities;
- To improve the practice of diabetes self-management among First Nations, and
- To increase ownership of the diabetes program and capacity to combat diabetes in First Nation communities.
The following clinical and diabetes education services will be provided to help clients monitor their diabetes status, screen for and to prevent further complications from developing and will support and encourage self management practices.
Clinical and Diabetes Education Services
- Foot Exam & Foot Wear Inspection
- Point of Care Testing (POCT)
- Lipid Profile
- Nutrition Screening
- Cardiovascular Screening
- Emotional Wellness
- Retinal Screening (referral only)
- Coordinating specialist consultations
- Physical Activity Assessment
- Diabetes Education services
- Capacity building of local health care teams
The Canadian Diabetes Association Clinical Practice Guidelines for the Management of Diabetes will be utilized as the “gold standard” of care for every client living with diabetes.
Project Launches Phase I
On October 20, 2008 two (2) mobile diabetes teams will be launched. The Thompson Team will provide services to six First Nation communities selected as pilot sites in the north and the Winnipeg Team will provide services to the six First Nation communities in the south.
First Nation Communities Pilot Sites
Funding for this project is provided by First Nations and Inuit Health, Manitoba Region, Health Canada through the Aboriginal Diabetes Initiative (ADI).