Abstract

The burden of type 2 diabetes mellitus (T2DM) among Indigenous children and adolescents is much greater than in non-Indigenous young people and appears to be rising, although data on epidemiology and complications are limited. Young Indigenous people living in remote areas appear to be at excess risk of T2DM. Most young Indigenous people with T2DM are asymptomatic at diagnosis and typically have a family history of T2DM, are overweight or obese and may have signs of hyperinsulinism such as acanthosis nigricans. Onset is usually during early adolescence. Barriers to addressing T2DM in young Indigenous people living in rural and remote settings relate to health service access, demographics, socioeconomic factors, cultural factors, and limited resources at individual and health service levels. We recommend screening for T2DM for any Aboriginal or Torres Strait Islander person aged > 10 years (or past the onset of puberty) who is overweight or obese, has a positive family history of diabetes, has signs of insulin resistance, has dyslipidaemia, has received psychotropic therapy, or has been exposed to diabetes in utero. Individualised management plans should include identification of risk factors, complications, behavioural factors and treatment targets, and should take into account psychosocial factors which may influence health care interaction, treatment success and clinical outcomes. Preventive strategies, including lifestyle modification, need to play a dominant role in tackling T2DM in young Indigenous people.

Links

Publisher Full Text

Authors

Azzopardi P, Brown AD, Zimmet P, Fahy RE, Dent GA, Kelly MJ, Kranzusch K, Maple-Brown LJ, Nossar V, Silink M, Sinha AK, Stone ML, Wren SJ, Baker IDI Heart and Diabetes Institute

Institution

Baker IDI Central Australia, Alice Springs, NT.

Source

The Medical journal of Australia 197:1 2012 Jul 2 pg 32-6

MeSH

Adolescent
Australia
Child
Diabetes Mellitus, Type 2
Health Services, Indigenous
Health Status Disparities
Humans
Hypoglycemic Agents
Mass Screening
Oceanic Ancestry Group
Risk Reduction Behavior
Rural Health
Rural Health Services

Pub Type(s)

Consensus Development Conference
Journal Article
Practice Guideline
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22762229