Science & Research

Improving care

Screening for Type 2 diabetes

BY LIZ KATYNSKI
Winnipeg Health Region
Wave, November / December 2012

Sandy Bay First Nation has one of the highest rates of amputation due to diabetes in the province. But that is changing, thanks to research led by Dr. Sharon Bruce.

An associate professor in Community Health Sciences at the University of Manitoba's Faculty of Medicine, Bruce launched a study in 2002 to determine the burden of diabetes-related problems and if people were getting the care they needed to manage their condition.

Diabetes can often lead to a number of health complications, including circulatory problems and nerve damage in the lower limbs. This can lead to amputation unless the patient receives proper care.

That wasn't happening at Sandy Bay. Of the 101 people identified with diabetes, 14 had advanced foot complications requiring specialist physician care, and 26 required regular foot care nursing. All of them had neuropathy - nerve damage that decreases sensation in the foot, and an early indication of problems to come. At the time, there was one foot-care nurse visiting the community monthly who was able to see 10 clients per trip. The people identified by the study were on a waiting list for foot-care services.

The study helped bring about change in the delivery of diabetes foot-care services. The Sandy Bay Home and Community Care Program took over foot-care services and now all people with diabetes have access to foot care. "We provided the information to the community and they made changes to the way foot care is delivered," says Bruce. "Now (people with diabetes) get a basic foot exam every year and referrals to a physician as needed," she says.

Bruce did the study with four community research assistants as well as her graduate student, Dhiwya Attawar, and a Sandy Bay community diabetes advisory group. Their work continues. "We are now developing a community-based diabetes prevention program," she says. "When research information translates into action, it is very rewarding to see that information used and some good come out of it."

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