Health
Diabetes at crisis levels in Australia
Diabetes, a preventable disease, affects up to 30% of Aboriginal people. It is caused by economic and social factors. Experts talk of Generation Y becoming a "Generation D".
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What is diabetes?
Diabetes – a preventable and manageable disease – is not only a problem for Aboriginal people. Diabetes rates are skyrocketing worldwide and expected to reach 12% of the global population by 2045. It is expected to affect close to 500 million people in 2030 and be the world's fourth leading cause of death behind cancer, heart disease and infectious diseases. [5]
More than 100,000 Australians are diagnosed with diabetes every year, making it the country's fastest growing chronic condition.
The 3 types of diabetes
There are three types of diabetes: "Type 1", "Type 2" and "gestational" diabetes.
Type 1 diabetes is an autoimmune condition where the body's immune system attacks the pancreas and destroys the cells that produce insulin (the hormone that transports glucose from the blood to the cells). It typically affects children and young adults.
Type 2 diabetes accounts for about 90% of cases. It's a progressive condition that occurs when the body becomes resistant to the effects of insulin and/or it gradually loses the ability to produce insulin in the pancreas.
Gestational diabetes is a form of diabetes that affects pregnant women, and although blood sugar levels return to normal after delivery, it does increase a woman's risk of later developing Type 2 diabetes.
Diabetes is "out of control" in Aboriginal communities
Diabetes has been described as "out of control" in Aboriginal communities [6] with some experts fearing the disease could "wipe out" the Aboriginal population across the world by the end of the century.
In the 1980s less than 0.5% of the Aboriginal population had diabetes. [7] 30 years later almost 30% of adults in Aboriginal communities have type-2 diabetes. [6][8] Diabetes is twice as common among Aboriginal people living in remote areas. [4]
A survey by the Australian Bureau of Statistics in 2012/13 found that the older Aboriginal people get the more likely they are to have diabetes [4]. Only around 3% of 25 to 34-year-olds have the disease, but three times as many in the 35-44 years age bracket, almost 18% of the 45 to 54-year-olds and more than 34% of those 55 years and over.
There are no exact figures on how many Aboriginal people are affected by diabetes so that estimates vary widely from 2 to 10 times higher numbers than among other Australians. [9][5] Similarly, diabetes rates vary from community to community—some as low as 4%, others as high as 33%. [2]
In 2015-16, there were around 2,300 hospitalisations with the main diagnosis of type 2 diabetes among Aboriginal people. [3]
The largest dialysis unit in the southern hemisphere is not in an Australian capital city, but in Alice Springs, nearly a fifth of whose 27,000 inhabitants are Aboriginal.
Diabetes complicates 20% of all pregnancies in Alice Springs (Central Australia). [8] Aboriginal leaders and health experts fear that the town will soon have the highest rate of diabetes anywhere in the world.
The death rate from diabetes for Aboriginal people is 17 times higher than for non-Aboriginal people, [10][11] and diabetes begins at an earlier age. [6][11] Diabetes is the second leading cause of death for Aboriginal people. [4][3] However, there is also some good news. The death rate for diabetes decreased by 7% between 2009-2013 and 2014-2018. [3]
Diabetic retinopathy (non-inflammatory damage to the retina of the eye) is one of the leading preventable causes of blindness in Aboriginal people. [7]
Diabetes can lead to cardiovascular disease, end-stage kidney disease, loss of vision, limb amputation and death.
While diabetes is increasing across Australia's entire population (see above), Aboriginal people are more likely to contract the disease because of economic and social factors such as dispossession, lack of access to fresh food, insufficient primary health care services and lower education.
In some communities many Aboriginal people have lost limbs to the disease.
For every person that is diagnosed with Type 2 diabetes, there is a person that remains undiagnosed.
— Cathy Freeman, retired Aboriginal athlete and type 2 diabetes sufferer during pregnancy [12]
Aunty Mary's story
Aunty Mary, 54, a Bundjalong woman from Taree was diagnosed with diabetes in 1986. In 2012, she was declared legally blind.
Story: The grateful patients
Don Palmer is CEO of the Malpa Project which aims to close the gap in Aboriginal health. He remembers a story in the dialysis unit in Alice Springs. [13]
"Late one night at the Flynn Drive Dialysis Unit I was talking with some Indian renal nurses.They mentioned that the patients had given them, 'pet' names, which they thought was sweet.
In fact the patients, so profoundly grateful to the nurses for their care had given them 'skin' names – Nampitjinpa, Napaltjarri, Nangala – names which reach out and embrace the stranger into the family of the Warlpiri and the Pintupi.
What more wonderful gift can be offered.
And no-one in the health service had given any cultural training for the staff so they could feel the generosity of this sweet gift of inclusiveness."
How can you prevent diabetes?
A few simple things can reduce the risk of developing Type 2 diabetes:
- Lose weight if you are overweight. As little as 3 to 5% of your weight can make a difference.
- Monitor blood pressure and blood glucose level.
- Monitor cholesterol levels.
- Exercise.
- Eat fruits and vegetables.
My problem now is sugar diabetes and blood pressure. I don't have sugar in my tea. I've had this problem for a long time, since I've been in Onslow [town in WA]. When I was out in the bush I didn't have it. There are a lot of women here with this sort of problem, like me, and they get it when they come to live in town.
— Judy July, Aboriginal woman [14]
Read more about diabetes on the site of the Australian Institute of Health and Welfare (AIHW).