A 24-year-old First Nations woman living in a remote fly-in community in northern Canada has poorly controlled type 2 diabetes (HbA1c 10.2%) and early...

Question

A 24-year-old First Nations woman living in a remote fly-in community in northern Canada has poorly controlled type 2 diabetes (HbA1c 10.2%) and early nephropathy. She describes difficulty attending appointments in the regional diabetes centre due to travel costs and previous experiences of discrimination in urban health-care settings. Which of the following actions best aligns with culturally safe, guideline-concordant diabetes care for Indigenous Peoples?

Accepted Answer

Arrange virtual diabetes specialist and dietitian consultations coordinated through the local nursing station, explicitly acknowledge past negative experiences and explore her priorities

Answer

Emphasise that poor control is due to her personal non-compliance and insist she travel to the city more often

Answer

Discharge her from the practice if she misses further appointments

Answer

Prescribe a complex insulin regimen immediately without further discussion

Answer

Focus only on biomedical targets and avoid discussion of colonisation or social determinants

ca-mccqe1 MCQ (SBA): Type 2 diabetes in Indigenous patient and cultural safety