Type 2 diabetes in Indigenous populations: Quality of intervention research over 20years

McNamara, Beverley; Sanson‐Fisher, Rob; DʼEste, Catherine; Eades, Sandra

doi:10.1016/j.ypmed.2010.11.002

Cited by 40 publications

(39 citation statements)

References 37 publications

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“…Moreover, similar to other reviews of interventions for Indigenous people [29, 30, 56], not only did we find just a small number of studies, but also that most of them were not methodologically strong. The lack of RCT designs across studies limits the overall internal validity of the findings, however, study methodology and evaluation issues are not unique to the South Pacific.…”

Section: Discussionsupporting

confidence: 85%

“…A systematic review, including 64 studies, by Teufel-Shone and colleagues on Indigenous people in the United States and Canada found physical activity interventions to be effective on health outcomes related to physical activity such as fitness and blood pressure [29]. Some reviews have synthesised the findings of different kinds of interventions targeting chronic disease or risk factors for disease in Indigenous Australians and New Zealanders, however, these reviews were not specifically focused on physical activity interventions [30]. A literature review by Clifford and colleagues identified 20 interventions which addressed smoking, nutrition, alcohol misuse, or physical inactivity in Australian Indigenous populations [31].…”

Section: Introductionmentioning

confidence: 99%

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Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review

Sushames

Uffelen

Gebel

2016

Int J Behav Nutr Phys Act

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BackgroundIndigenous Australians and New Zealanders have a significantly shorter life expectancy than non-Indigenous people, mainly due to differences in prevalence of chronic diseases. Physical activity helps in the prevention and management of chronic diseases, however, activity levels are lower in Indigenous than in non-Indigenous people.ObjectiveTo synthesise the literature on the effects of physical activity interventions for Indigenous people in Australia and New Zealand on activity levels and health outcomes.MethodsThe Cochrane Library, MEDLINE, SPORTSDiscus and PsycINFO were searched for peer-reviewed articles and grey literature was searched. Interventions targeted Indigenous people in Australia or New Zealand aged 18+ years and their primary or secondary aim was to increase activity levels. Data were extracted by one author and verified by another. Risk of bias was assessed independently by two authors. Data were synthesised narratively.Results407 records were screened and 13 studies included. Interventions included individual and group based exercise programs and community lifestyle interventions of four weeks to two years. Six studies assessed physical activity via subjective (n = 4) or objective (n = 2) measures, with significant improvements in one study. Weight and BMI were assessed in all but one study, with significant reductions reported in seven of 12 studies. All five studies that used fitness tests reported improvements, as did four out of eight measuring blood pressure and seven out of nine in clinical markers.ConclusionsThere was no clear evidence for an effect of physical activity interventions on activity levels, however, there were positive effects on activity related fitness and health outcomes.Trial RegistrationThe review protocol was registered with PROSPERO (registration number: CRD42015016915).

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review

Sushames

Uffelen

Gebel

2016

Int J Behav Nutr Phys Act

View full text Add to dashboard Cite

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“…Recent studies suggest the 'pre-diabetes' stage presents a critical opportunity for prevention of type 2 diabetes [91]. While the evidence for effective strategies for preventing type 2 diabetes among Indigenous peoples' is scarce [92], studies among non-Indigenous women suggest postpartum weight loss is achievable, and the postpartum period offers unique preventive opportunities for women [93,94] and their infant [95,96] by breastfeeding; and through strategies involving diet and exercise [97][98][99][100][101]. Women with gestational diabetes, and their infants, are more likely to experience interventions and complications during pregnancy and birth which may inhibit breastfeeding, such as caesarean section and neonatal hypoglycaemia, and therefore are likely to require additional support postpartum.…”

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

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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.

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“…A review of the number and quality of published interventional studies in Type 2 diabetes in Indigenous populations of Australia, Canada, New Zealand and the USA revealed the total number of publications about diabetic Indigenous health has increased from 1998 to 2008; however, the research is predominantly descriptive [63]. The proportion of research involving interventions increased from 3 to 12% in the 20 years but only seven out of 28 intervention studies met the Cochrane Effective Practice and Organization of Care standard [64].…”

Section: Interventions For Diabetic Foot Disease In Indigenous Peoplementioning

confidence: 99%

Diabetic foot disease in Indigenous people

Schoen

Norman²

2014

Diabetes Management

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This article will examine what is known about the epidemiology of diabetic foot disease in Indigenous people and what strategies have been used to manage the problem. The prevalence of diabetes is several-fold higher in Indigenous people compared with non-Indigenous people. The prevalence of diabetic peripheral neuropathy varies but in general it appears to be more common and start at a younger age in Indigenous compared with non-Indigenous people. Peripheral artery disease is also more prevalent and the incidence of lower extremity amputation is higher. Various strategies have been shown to be effective in the delivery healthcare for diabetic foot disease in Indigenous people. There are, however, social and political barriers to the implementation and success of these interventions.

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Type 2 diabetes in Indigenous populations: Quality of intervention research over 20years

Abstract: Increases in the amount of high-quality intervention research for prevention and treatment of Type 2 and gestational diabetes among Indigenous populations of these countries are needed.

Cited by 40 publications

References 37 publications

Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review

Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review

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

Diabetic foot disease in Indigenous people

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