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The National Diabetes Surveillance System (NDSS) is a Public Health Agency of Canada / Health Canada initiative to document the burden of diabetes with ongoing surveillance for the purpose of aiding planning of rational health service delivery. NDSS has reported rising National and Provincial diabetes prevalence and increased mortality rates compared to persons without diabetes.
NDSS has very little information about Aboriginal peoples. In NDSS's 2nd report (2008), an Aboriginal chapter describes the technical challenges with identifying Aboriginal peoples in administrative health databases, as well as the political challenges of working with Aboriginal groups to compare to local data.
Considerable field work is underway in Alberta with regard to screening for diabetes, its risk factors and complications in Aboriginal adults and children:
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SLICK (Screening for Limbs, I-Eyes, Cardiovascular and Kidney Complications) in First Nations. (Ongoing since 2001) |
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MDSi (Mobile Diabetes Screening Initiative) in rural Aboriginal and remote Alberta communities, of which Métis settlements represent about 50% of the activity. (Ongoing since 2003) |
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BRAID (Believing we can Reduce Aboriginal Incidence of Diabetes) is screening all of the on-reserve population of a single (status) First Nation in Alberta for diabetes (70% has been screened to date). (Ongoing since 2003) |
Information on all individuals seen in these programs is recorded in clinical databases including the Unique Lifetime Identifier (ULI, personal health care number), demographics and clinical results. Accordingly, information from these well characterized subjects in the Aboriginal clinical databases may be used to complement the use of the standard NDSS algorithms in the Aboriginal populations, or to test their validity, or to determine the best algorithms for ongoing surveillance.
Objectives of our Validation Study:
1. Use the information in BRAID to test the standard NDSS algorithm for identifying incident and prevalent adults with type 2 diabetes. Explore alternative algorithms if NDSS algorithms are not accurate enough.
2. Use the preferred algorithm to then describe the age and sex standardized annual incidence and prevalence of diabetes amongst Alberta’s First Nations (status) Aboriginal populations.
3: Compare incidence and prevalence calculations using capture-recapture.[1]
[1] Total number of people with a diabetes case date in the current fiscal year ÷ total population count for the current fiscal year without diabetes, minus previously prevalent cases.
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