Question

A 54-year-old Cree man living on-reserve presents to your rural clinic with obesity (BMI 36 kg/m²), type 2 diabetes (HbA1c 8.5%) and hypertension. He reports difficulty affording healthy food and has previously experienced dismissive care at an urban hospital. According to Canadian guidance on Indigenous health and diabetes, what is the most appropriate initial approach?

Accepted Answer

Work collaboratively to understand social determinants, provide culturally safe diabetes education and involve local Indigenous health workers

Answer

Increase his insulin dose without further discussion and arrange follow-up in 6 months

Answer

Advise strict calorie restriction and tell him that poor control is due to non-compliance

Answer

Transfer his care to an urban specialist clinic because rural services are inadequate

Answer

Avoid discussing colonisation or racism as these are political issues unrelated to his health

Practice question