This integrative review, “From Compliance to Connection: How Primary Care Providers
Can Support Diabetes Care in a Good Way,” explores how primary care providers (PCPs) can
more effectively support diabetes self-management among Indigenous adults in Canada. Type 2
Diabetes Mellitus (T2DM) disproportionately affects Indigenous communities, a disparity rooted
in colonialism, intergenerational trauma, and systemic inequities. Historically, Western medicine
has pathologized Indigenous bodies and dismissed Indigenous knowledge, reinforcing narratives
of “non-compliance” and undermining trust in care relationships. Using an integrative literature
review methodology, 11 studies were identified through CINAHL, Google Scholar, and hand
searching. These were appraised using the Critical Appraisal Skills Programme (CASP) and an
adapted Aboriginal and Torres Strait Islander Quality Appraisal Tool. Findings were analyzed
through a culturally grounded qualitative synthesis. The review revealed that diabetes is often
experienced not only as a physiological condition, but also as a relational and psychological
disruption. Barriers to effective management included biomedical dominance, lack of cultural
safety, ineffective diabetes education, and the framing of resistance as non-compliance.
However, promising practices emerged: the integration of traditional medicine, use of culturally
resonant strategies like peer support and talking circles, and the alignment of biomedical
concepts with Indigenous worldviews. This review urges PCPs to move from authority-driven
models toward relational, culturally-grounded care. It concludes with implications for practice,
education, and research, centring Indigenous-led approaches in all aspects of diabetes care.
