The current status of diabetes care, diabetic retinopathy screening and eye-care in British Columbia's First Nations Communities.

Abstract

OBJECTIVES: 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. STUDY DESIGN: 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.