Indigenous health: update on the impact of diabetes and chronic kidney disease

Yeates, Karen

doi:10.1097/01.mnh.0000247495.54882.e4

Cited by 18 publications

(15 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consistent with previous reports, obesity and related comorbidities were also very common in all groups [10,26]. Interestingly, all 3 groups displayed relatively well controlled blood pressure, with mean values within each group within the targets of systolic < 130 and diastolic < 80 mmHg.…”

Section: Discussionsupporting

confidence: 90%

“…Diabetic nephropathy has been well described in both Indigenous Australians and Canadians [8,9], but there are fewer available data on retinopathy, neuropathy and peripheral vascular disease (PVD). CVD is the leading cause of premature mortality among Indigenous Australians and Canadians [1,4,5,10], and rates of CVD and of CVD-related mortality appear to be increasing among these populations, despite a reduction in the non-Indigenous populations of both nations [11-13]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

Maple-Brown

Cunningham

Zinman

et al. 2012

Cardiovasc Diabetol

View full text Add to dashboard Cite

BackgroundIndigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.MethodsWe compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).ResultsThe three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.ConclusionsAlthough there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

Maple-Brown

Cunningham

Zinman

et al. 2012

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…While little is known about barriers for Indigenous women, one study suggests low health literacy among Indigenous people in Far North Queensland in relation to diabetes [59], which is likely to impede the decision-making capacity of women with gestational diabetes. There is evidence of disparities in access to treatment for the complications of diabetes [60][61][62][63][64][65], including diabetes in pregnancy [66], which may be helpful for understanding some of the barriers to postpartum glucose screening among Indigenous women with gestational diabetes. Women in Far North Queensland also experience additional challenges, including long distances to travel to receive an OGTT, real or perceived costs associated with tests from limited private laboratory services, high staff turnover, and high population mobility.…”

Section: Discussionmentioning

confidence: 99%

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

Chamberlain

McLean

Oats

et al. 2014

Matern Child Health J

View full text Add to dashboard Cite

Women with gestational diabetes have a high risk of type 2 diabetes postpartum, with Indigenous women particularly affected. This study reports postpartum diabetes screening rates among Indigenous and non-Indigenous women with gestational diabetes, in Far North Queensland, Australia. Retrospective study including 1,012 women with gestational diabetes giving birth at a regional hospital from 1/1/2004 to 31/12/2010. Data were linked between hospital records, midwives perinatal data, and laboratory results, then analysed using survival analysis and logistic regression. Indigenous women had significantly longer times to first oral glucose tolerance test (OGTT) [hazards ratio (HR) 0.62, 95 % confidence interval (CI) 0.48-0.79, p < 0.0001) and 'any' postpartum glucose test (HR 0.81, 95 % CI 0.67-0.98, p = 0.03], compared to non-Indigenous women. Postpartum screening rates among all women were low. However, early OGTT screening rates (<6 months) were significantly lower among Indigenous women (13.6 vs. 28.3 %, p < 0.0001), leading to a persistent gap in cumulative postpartum screening rates. By 3 years postpartum, cumulative rates of receiving an OGTT, were 24.6 % (95 % CI 19.9-30.2 %) and 34.1 % (95 % CI 30.6-38.0 %) among Indigenous and non-Indigenous women, respectively. Excluding OGTTs in previous periods, few women received OGTTs at 6-24 months (7.8 vs. 6.7 %) or 2-4 years (5.2 vs. 6.5 %), among Indigenous and non-Indigenous women, respectively. Low rates of postpartum diabetes screening demonstrate that essential 'ongoing management' and 'equity' criteria for population-based screening for gestational diabetes are not being met; particularly among Indigenous women, for whom recent guideline changes have specific implications. Strategies to improve postpartum screening after gestational diabetes are urgently needed.

show abstract

“…Moreover, diabetes increases one’s chances of having heart disease by as much as four to six times, while end stage renal disease, a common consequence of poorly managed diabetes, increases one’s risk of heart disease by twenty times [13]. With increasing rates of kidney disease in some Indigenous communities, we can expect to see this adding to the increasing burden of chronic illness among Aboriginal and Torres Strait Islander people [14].…”

Section: Introductionmentioning

confidence: 99%

Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

Aspin

Brown

Jowsey

et al. 2012

BMC Health Serv Res

124

204

View full text Add to dashboard Cite

Background Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness. Methods Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. Results Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities. Conclusions Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal. Strategies to ensure that this knowledge is integrated into care and support programs for Aboriginal and Torres Strait Islander people with chronic illness should achieve major improvements.

show abstract

Indigenous health: update on the impact of diabetes and chronic kidney disease

Cited by 18 publications

References 54 publications

Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

Contact Info

Product

Resources

About