The Mobile Diabetes Screening Initiative (MDSi) provides diabetes screening and education services to remote and off-reserve Aboriginal communities in Northern Alberta. MDSi screens for diabetes, cardiovascular risk factors, and diabetes complications using portable equipment. They have screened over 1700 people total, finding high rates of pre-diabetes, diabetes, obesity, high cholesterol, and elevated blood pressure. The screening helps reduce barriers to healthcare access for these communities and provides diabetes education.

1. The Mobile Diabetes Screening Initiative (MDSi)
for Aboriginal off-reserve and remote communities in Alberta
Dr. Ellen L. Toth,
Medical Lead
Why screen Aboriginal people for
diabetes? Why do community-based
screening?
•Type 2 diabetes and obesity are more prevalent amongst Aboriginal
peoples, and generally amongst the disadvantaged. Cardiovascular
disease is also a concern.
•Access to screening and diagnostic services is difficult for people living
in remote communities, such as in Northern Alberta.
•Access to services is difficult for geographic, financial, cultural, and
practical reasons. For instance, fewer doctors work in these areas.
•MDSi brings screening and diagnostic services to the communities.
This way, MDSi reduces some of these accessibility barriers.
The Process
•Team : The multi-disciplinary MDSi
team travels to Métis, off-reserve and
remote communities in Northern
Alberta, transporting testing
equipment in two vans. MDSi visits
each community at least twice a year.
•Screening : MDSi measures
clients’ height, weight, waist
circumference, blood pressure,
cholesterol and blood glucose levels.
Diabetes and cardiovascular risk are
estimated.
•Portable technology :
MDSi uses equipment shown to be
effective in community-based
settings. MDSi uses a rigorous
Quality Assurance protocol.
•Complications : For people who
already have diabetes, MDSi tests for
kidney damage (urine analysis) and
eye damage (retinal photos). Foot
assessment is also provided to check
for wounds and nerve damage.
•Education and counseling:
MDSi nurses and dietitians counsel
clients based on their personal test
results. Clients learn how to lead a
healthier lifestyle, and how to reduce
their risk of getting diabetes or
diabetes complications.
Who has MDSi seen?
• As of April 2007, MDSI had seen a total of 1796 clients in all
communities visited. 1503 were screened for new diabetes. 293
already had diabetes and were tested for complications.
• 840 Métis clients living on-settlement have been screened for
diabetes: 693 adults ages 18-91, and 147 children ages 6-17.
• 149 Métis clients living on-settlement who already had diabetes
were screened for diabetes complications.
• 15% of Métis people living on-settlement have been screened for
diabetes or diabetes complications.
• MDSi has visited each Settlement 4-7 times.
ACADRE Network
How much diabetes has MDSi found?
(Metis clients living on-Settlement, N = 840)
Adults screened for diabetes, N = 693
Males Females
At risk / pre-diabetes∗ 61% 46%
Probable diabetes ∗ ∗ 6% 5%
BMI Overweight/Obese 84% 82%
Total Cholesterol Abnormal 83% 77%
Abnormal, on no treatment 58% 66%
Abnormal, on treatment 56% 23%
Blood Pressure
Fasting Blood
Glucose
20%46%ElevatedBlood Pressure
percentile
22%24%Borderline/HighTotal Cholesterol
60%60%Overweight/ObeseBMI percentile
00Probable diabetes
25%23%At risk / pre-diabetesFasting Blood
Glucose
FemalesMales
Children (ages 6-17) screened for diabetes, N = 147
Discussion:
Due to portable testing and issues with fasting vs non-fasting
samples, the cases of “probable diabetes” need confirmatory testing.
Diabetes and pre-diabetes may be UNDERESTIMATED due to the lack
of post-meal or glucose tolerance data.
The significance of elevated fasting blood glucose (5.6-6.9, pre-
diabetes) in the absence of postprandial glucose elevation is unclear.
∗Fasting blood glucose 5.6- 6.9, ∗ ∗ fasting blood glucose 7.0 or greater
MDSi communities:
Métis Settlements
Buffalo Lake
East Prairie
Elizabeth
Fishing Lake
Gift Lake
Kikino
Paddle Prairie
Peavine
Other Communities
Anzac
Conklin (Métis)
Evansburg
Grande Cache
Hinton
La Crete
Marlboro (Métis)
Peerless Lake (First Nations)
Trout Lake (First Nations)
Wabasca
Wildwood