issue of Canadian Journal of Diabetes (1).This issue of the jour-

nal contains a number on papers on Aboriginal peoples, and I am happy to report that Health Canada’s Aboriginal Diabetes Initiative (ADI) is moving forward now. Type 2 diabetes was virtually unknown among Aboriginal people prior to 1940. It has since reached epidemic propor-tions among First Nations and Métis peoples, with a prevalence 3 to 5 times that of Canada’s non-Aboriginal population (2). In 1999, in response to these excessively high rates of dia-betes, the federal government funded the ADI. It provided some communities with the resources to deliver diabetes care and treatment, and lifestyle support services that are community-based, culturally appropriate and accessible. We have learned much in these first 6 years of ADI’s exis-tence. We have learned the importance of moving from awareness to action by creating environments with tools and supports to foster sustained, positive behaviour change. We have learned that traditional knowledge and practices can be effectively combined with Western practices. We’ve learned that mobile screening programs for complications are effec-tive in increasing access to care and treatment services.We’ve learned the importance of building and strengthening the capacity within communities to deliver comprehensive, quality diabetes programs. However, it is disturbing to note that the trend towards diagnosis at earlier ages is expected to persist, given the high rates of obesity. Diabetes has been diagnosed in Aboriginal children as young as age 5 (2). We also now have a better understanding of the fact that the healthy lifestyle practices required to reduce the burden of diabetes are difficult to achieve because of the socioeco-nomic challenges faced by many Aboriginal people, i.e. inad-equate housing, lack of affordable, nutritious food and a sense that they have no control over their lives. As a result, we have discovered that we must take social determinants into consideration when designing our pro-grams. Comprehensive and integrated actions are essential. This was recently confirmed by the World Healt