Question

A 48-year-old Cree man living in a remote First Nations community has type 2 diabetes with an HbA1c of 9.5%. He has missed several appointments in the past, describing previous experiences of feeling "judged" and "not listened to" by health professionals. Today he admits difficulty affording healthy food and limited access to transport. What is the most appropriate next step to improve his diabetes care?

Accepted Answer

Arrange a culturally safe visit involving an Indigenous health worker or navigator to explore barriers and co-create a management plan

Answer

Emphasise his "non-compliance" and warn that he will go blind or require dialysis if he does not attend appointments

Answer

Discharge him from the practice for repeated missed visits

Answer

Start insulin by telephone order and courier written instructions without further discussion

Answer

Increase his metformin dose and schedule standard follow-up without exploring his concerns

Practice question