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Social Inequities Contributing to Gestational Diabetes in Indigenous Populations in Canada: A Scoping Review

      Abstract

      The prevalence of gestational diabetes mellitus (GDM) is dramatically higher in Indigenous compared with non-Indigenous populations in Canada. In this scoping review, we synthesize the existing literature regarding GDM among Indigenous peoples in Canada, including social and structural determinants that contribute to its higher prevalence in this population. Seven themes related to GDM in Indigenous populations emerged from a synthesis of the 44 included articles. The themes were GDM prevalence and trends; risk factors; screening; diagnosis and treatment; maternal outcomes; child outcomes; systemic barriers; and Indigenous perceptions, concerns and health behaviours. The findings from this review suggest culturally appropriate health care and improved screening practices may help to mitigate the high prevalence and poor health outcomes associated with GDM in Indigenous communities across Canada. More community-driven, participatory research that includes the social determinants of health and a culturally safe lens is required to assess the effects and reduce the impact of GDM in this population.

      Résumé

      La prévalence du diabète sucré gestationnel (DSG) est nettement plus élevée au sein des populations autochtones que des populations non autochtones du Canada. Dans la présente étude de portée, nous avons fait la synthèse de la littérature existante sur le DSG au sein des personnes autochtones du Canada, notamment les déterminants sociaux et structurels qui contribuent à sa plus grande prévalence au sein de cette population. Sept thèmes liés au DSG au sein des populations autochtones sont ressortis de la synthèse des 44 articles retenus. Les thèmes étaient la prévalence et les tendances du DSG; les facteurs de risque; le dépistage; le diagnostic et le traitement; les issues maternelles; les issues de l’enfant; les obstacles systémiques; les perceptions, les préoccupations et les comportements de santé des Autochtones. Les conclusions de cette revue suggèrent que l’adaptation des soins de santé culturellement appropriés à la culture et l’amélioration des pratiques de dépistage peuvent aider à atténuer la forte prévalence et les mauvais résultats cliniques associés au DSG au sein de toutes les communautés autochtones du Canada. Davantage de recherches participatives communautaires qui tiennent compte des déterminants sociaux de la santé et offrent une perspective culturellement sécuritaire sont nécessaires pour évaluer les effets et réduire les répercussions du DSG au sein de cette population.

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