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Diabetes Mellitus Among Indigenous Australians

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Introduction

One of the fast-growing diseases in the world is diabetes mellitus. Globally, diabetes poses a great challenge to public health. It has become one of the epidemic diseases presenting much social and economic burden. Indigenous Australia experience an increased level of diabetes as compared to other population. As compared to the non-indigenous population, indigenous Australian is three times likely to suffer from diabetes mellitus. Indigenous Australians have a high chance of dying due to diabetes as compared to other population. Factors which are contributing to the increased level of diabetes among Indigenous Australians are linked to social, historical and cultural factors. Research which was done in Australia showed that most of the Indigenous Australians are overweight, have cases of hypertension and the lipoprotein cholesterol in the body is abnormal. Increased incidences of these cardiovascular diseases and eating habits make indigenous Australia more likely to suffer from diabetes.

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Size and Population Group Most Affected

Older people are highly affected by diabetes, and this can be shown by the facts that 1 out of 7 people who are aged over 55 years have diabetes. High chances of getting diabetes increase as one continues to and men have increased chances of suffering from diabetes. Indigenous Australians are affected by both type 1 and 2 of diabetes. The incidences of Indigenous Australians being hospitalized due to people with diabetes are four times more as compared to other Australians. In some communities of Indigenous Australians, the chances of getting diabetes increases by up to 33 percent. The risk of diabetes among Indigenous Australians is influenced by the social, cultural, behavior of the individual and economic factors.

Factors Contributing to Diabetes among Indigenous Australians

Chances of developing diabetes among Indigenous Australians are increasing by biomedical and behavioral factors. Improvement done on these factors can lead to a reduction of the incidences of diabetes. Protective factors affect the population such that chances of women who breastfeed have low chances of suffering from diabetes as compared to those who did not. Research showed that breastfeeding minimizes the probability of women being overweight. Overweight and obesity is one of the factors which lead to diabetes among Indigenous Australians. More than sixty percent of the people who are aged between 15 years and above have a problem of either obesity or overweight.

The percentage of overweight people is 33 percent while those who were obese is 40 percent or more. As compared to other population in Australia, Indigenous Australians have the highest percentage of those who suffer from obesity and overweight issues. Overweight and obesity are risk factors which lead to diabetes. High blood pressure where the study showed that there were high chances of Indigenous Australians suffering from diabetes due to high blood pressure. Most were adults who had more incidences of high blood pressure. Another risks factor among Indigenous Australians is eating habits where they take fewer vegetables and fruits. The population of Indigenous Australians who were aged over two years did not have access to adequate fruits while 92 percents lacked enough intakes of vegetables. It is hard for this population to meet the daily requirement of taking fruits and vegetables due to their economic status. Inadequate fruits and vegetables contribute to increased chances of diabetes since most of the food consumed will be starch. Another risk factor which makes Indigenous Australians suffer from diabetes is smoking. More than 42 percent of the population aged 15 years and above smoke cigarettes. More than 50 percent of the individual who used to some are suffering from diabetes, and others even smoke after diagnosis.

Biomedical Data

Adults who aged more than 55 years have increased chances of suffering from diabetes. The chances of getting diabetes increase with age and it seems to take place in the early stages of the life of Indigenous Australians as compared to other population in Australia. Adults Indigenous Australian in remote areas have high chances of having diabetes more than those living in town. Live in remote is hard and some of the people end up with inadequate basics needs. The study also shows that half of the Indigenous Australians with diabetes have been detected with symptoms of chronic kidney symptoms.

Description of Diabetes Mellitus

Diabetes refers to the condition that impairs the ability of the body to process blood sugar. There are different types of diabetes and management of them depends on the type and stage. There are three types of diabetes. The first one is Type 1 diabetes which makes it hard for the body to make insulin. People who have this kind of diabetes have to depend on artificial insulin daily for them to stay alive. The second type of diabetes is Type 2 which has impacts on the use of insulin by the body. The body produces insulin but the cells do not respond to insulin as they used to do initially. This type of diabetes was associated with obesity, and it is the most common type. The last type of diabetes is Gestational diabetes takes place in women who are pregnant, and during this time the body is less sensitive to insulin. The condition can be resolved after the woman gives birth.

Origin of Diabetes

Diabetes means comes from a Greek word meaning siphon. It was described in the Egyptian manuscript in early days from 1500BC. The first case of the diabetes was Type 1 diabetes which was identified and classified by the Indians as honeyed urine. This was because the urine was able to attract ants. Greek Apollonius of Memphis were first people to use the word diabetes. Mellitus meant honey because the urine had sugar. The clinical description was done first by Aretaeus of Cappadocia who was an Ancient Greek. This was done in 1st century AD, and he did it after noticing that the excessive urine passing which has to make its way through the kidney. People used to feel that the situation cannot be cured and it was like a death sentence to have it.

Empirical Evidence

In 6th century BCE, it was identified by an Indian healer as ‘madhumeha’ which made sweet urine. Between 980-1037 the Canon of Medicine described the symptoms of diabetes mellitus such as reduced sexual desires, abnormal appetite and urinating sweet urine. In 1889, Minkowski and Von Mering discovered that in diabetes pancreas had a role to play. The study found out the removal of pancreases in a dog made it to experience signs and symptoms of a person who is suffering from diabetes. The dog then died afterward and did not take a long time. In 1910, Sir Edward Albert Sharpey discovered that lack of insulin in the body was a major contributor to diabetes. In Latin, insulin was termed ‘insula’a chemical that is responsible for regulating blood sugar in the body. ‘insula’ meant island which was about the islets of Langerhans found in the pancreas and used in the production of insulin. In 1919, Dr. Frederick Allen suggested starvation as a way of treating diabetes. Allen was emphasizing on the regulation of the diet for the treatment of diabetes. Introduction of therapy on the food intake can help in reducing incidences of diabetes and managing the conditions for those who were already suffering from it. Insulin discovery was also done by Grant Banting and Herbert Best who researched on the work done Minkowski and Von Mering. They tried to reverse the situation by giving a dog which had its pancreas removed islets of Langerhans which had extracted from pancreas of another very healthy dog. In 1922, Best and Banting tool a pancreas from a cow and purified the hormone from it. This was used as an effective way of treating diabetes. Worldwide, millions of people were assisted since Best and Banting made access of insulin to be reliable, and everyone was able to get it. A charity patient, Leonard Thompson from Toronto General Hospital was the first person to get insulin injection in the treatment of diabetes. First biosynthetic human insulin was approved in the market in 1982, and since then people have been using it.

Costs

Generally, Austria spends a lot of money on primary care and treatment of diseases, and the expenditure continues to increase. Australia spends up to 6 billion per on diabetes. The population of the individual suffering from diabetes continues to increase hence presenting a huge economic burden. In Australia, the average cost for people who are suffering from diabetes is estimated to be $ 4,025, and this is calculated when the person does not have any other complication. Those who have other complications the expenses can go up to $ 9,645. Therefore, Indigenous Australian having the largest population of people who have diabetes, more money has to be spending on them.

Determinants of Diabetes

Research shows that age is one of the factors which are increasing the chances of diabetes. The elderly adults are more likely to suffer from diabetes Type 2 while type 1 affects young people. Other risks factors which increase chances of diabetes are a family history of diabetes, lack of physical exercise and overweight. Diabetes occurs depending on the environmental factors, family background and health of the individual. There is no specific cause of diabetes, and this is due to differences in the occurrence of diabetes. However, they can be triggered by infections by virus or bacteria, chemical toxins which are found in foods, bad diet, increased age, and an autoimmune reaction. Generally, one individual in every four people are not aware whether they have diabetes. Prediabetes occurs when people have high than normal blood sugar but not so high to be termed as diabetes. The normal blood sugar ranges between 70 to 99 mg/dl. Those who have between 100 to 125mg/dL are referred to have prediabetes. People who have prediabetes have high chances of developing diabetes Type 2. Those who have blood sugar which is more than 126mg/ dl are said to have diabetes.

Existing Health Promotion Programme

Australian Indigenous is one of the promotional programs which used address diabetes mellitus among Indigenous Australians. The program addresses diabetes as well as other chronic diseases which is affecting people in Australia. It encourages healthy lifestyles and working with the local community to promote development of health plans. It also works on utilizing activities which strengthen people and promote their cultural, spiritual and physical wellbeing. The program integrates Culture Cares of the Indigenous Australians to assist in creating awareness and providing support to people who are suffering from chronic diseases including diabetes. They educate the young people on the impacts which are related to fast foods and nutritional benefits of eating traditional foods. The program encourages people to spend their time where they are physically active and spiritually strengthened. It provides support to mothers and encourages health meals. Physical exercise, healthy diet, and lifestyle changes will assist in eliminating problems which are associated with diabetes.

Another promotional program is Australian National Diabetes Strategy. It prioritizes and updates how the national government is responding to the issue of diabetes at various level of the government. The program assists in reducing the effects of diabetes at community level. It evaluates the current approach which is used in delivering diabetes approach and care with the aim of maximizing the existing resources for betterment of the health services. The program opens opportunity for other potential organization to partner with it and aim towards delivering efficient services to the patients. The program has developed goals and strategies of achieving those goals. One of them is inclusion of the online consultation and clinical advice. Primary care is also used in proving health services and in the improvement of the health outcomes. Additionally, the programs are very effective and efficient in encouraging people to live a healthy lifestyle that are crucial in reducing the risks linked to diabetes.

In conclusion, diabetes is presenting a big challenge to economic due to its fast growth rate. Diabetes is affecting a large population of Indigenous Australians because of their social, economic status, history, eating habits, and sedentary lifestyle. The country has to spend a lot of money on the treatment of diabetes and becomes a social, economic burden. Various discoveries have been made, and types of diabetes are Type 1, Type two and gestational diabetes.

References

  1. Azzopardi, P. S. , Sawyer, S. M. , Carlin, J. B. , Degenhardt, L. , Brown, N. , Brown, A. D. , & Patton, G. C. (2018). Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), 766-782.
  2. Chamberlain, C. R. , Oldenburg, B. , Wilson, A. N. , Eades, S. J. , O’dea, K. , Oats, J. J. , & Wolfe, R. (2016). Type 2 diabetes after gestational diabetes: greater than fourfold risk among Indigenous compared with non‐Indigenous Australian women. Diabetes/metabolism research and reviews, 32(2), 217-227.
  3. Chamberlain, C. , McLean, A. , Oats, J. , Oldenburg, B. , Eades, S. , Sinha, A. , & Wolfe, R. (2015). Low rates of postpartum glucose screening among indigenous and non-indigenous women in Australia with gestational diabetes. Maternal and child health journal, 19(3), 651-663.
  4. Chow, E. , & Chan, J. C. (2017). Explaining the high prevalence of young-onset diabetes among Asians and Indigenous Australians. The Medical Journal of Australia, 207(8), 331-332.
  5. Landers, J. , Liu, E. , Estevez, J. , Henderson, T. , & Craig, J. E. (2018). Presence of diabetic retinopathy is associated with worse 10‐year mortality among Indigenous Australians in Central Australia: The Central Australian ocular health study. Clinical & experimental ophthalmology.
  6. Sorenson, A. , Owens, L. , Caltabiano, M. , Cadet-James, Y. , Hall, R. , Govan, B. , & Clancy, P. (2016). The Impact of Prior Flavivirus Infections on the Development of Type 2 Diabetes among the Indigenous Australians. The American journal of tropical medicine and hygiene, 95(2), 265-268.
  7. Ibiebele, I. , Curry, M. , Smith, G. C. , Boyle, F. M. , Black, S. , Middleton, P. ,. . . & Flenady, V. (2016). Gestational age-specific stillbirth risk among Indigenous and non-Indigenous women in Queensland, Australia: a population-based study. BMC pregnancy and childbirth, 16(1), 159.
  8. Zengin, A. , Maple-Brown, L. J. , Brennan-Olsen, S. , Center, J. R. , Eades, S. , & Ebeling, P. R. (2018). Musculoskeletal health of Indigenous Australians. Archives of osteoporosis, 13(1), 77.
  9. Smith, K. , Sutherland, A. , Hyde, Z. , Crawford, R. , Dwyer, A. , Malay, R. ,. . . & LoGiudice, D. (2018). The assessment, incidence, and factors associated with urinary incontinence in older Aboriginal Australians. Internal medicine journal.
  10. Liu, E. , Ng, S. K. , Kahawita, S. , Andrew, N. H. , Henderson, T. , Craig, J. E. , & Landers, J. (2017). Ten‐year all‐cause mortality and its association with vision among Indigenous Australians within Central Australia: the Central Australian Ocular Health Study. Clinical & experimental ophthalmology, 45(4), 348-356.
  11. Jokanovic, N. , Tan, E. C. , van den Bosch, D. , Kirkpatrick, C. M. , Dooley, M. J. , & Bell, J. S. (2016). Clinical medication review in Australia: a systematic review. Research in Social and Administrative Pharmacy, 12(3), 384-418.
  12. Azzopardi, P. S. , Sawyer, S. M. , Carlin, J. B. , Degenhardt, L. , Brown, N. , Brown, A. D. , & Patton, G. C. (2018). Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), 766-782.
10 December 2020

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