Diabetes among Aboriginal and Torres Strait Islander people in Australia

This essay discusses diabetes as a health issue suffered by Aboriginal and Torres Strait Islander people and how the statistics compare with those of non-Indigenous Australians. It also looks at how Aboriginal and Torres Strait Islander peoples’ culture has impacted on addressing diabetes.

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Aboriginal and Torres Strait Islander people who are also known as Indigenous Australians were
the first people in Australia. They are the original Australians having lived in Australia about 50
thousand to 120 thousand years. Aboriginal and Torres Strait Islander Australians were hunters
and gatherers before the arrival of the whites’ who colonized them. Aboriginal and Torres Strait
Islander suffered a lot under the rule of the white because many laws made during the time
marginalized them. Indigenous Australians suffered many health issues such as diabetes, oral
health, hearing, sight, and other senses. This essay will be discussing diabetes as a health issue
suffered by Aboriginal and Torres Strait Islander people and how the statistics compare with
those of non-Indigenous Australians. History of Indigenous Australians colonization and its
impact on the health issue diabetes will also be discussed. This essay will also look at how
Aboriginal and Torres Strait Islander peoples’ culture has impacted on addressing diabetes.
Diabetes is an endocrine disease that affects how insulin controls blood sugar in the body.
Diabetes occurs when insulin is unable to control glucose, and the levels of blood glucose are
increased above the normal reference ranges resulting in hyperglycemia. The normal reference
range for blood glucose is 4-5.4 mmol/L when fasting and up to 7.8 mmol/L two hours after a
meal (American Diabetes Association. 2017). There are two common types of diabetes mellitus,
namely diabetes mellitus type 1 and diabetes mellitus type 2, which are insulin-dependent and
non-insulin dependent, respectively. Diabetes mellitus has three classic symptoms which patients
present with before a diagnosis is made, and they are polyphagia, polyuria, and polydipsia and
also type 1 has weight loss as a symptom. The other types of diabetes mellitus are gestational
diabetes mellitus that occurs only in some pregnant women but return to normal after the
pregnancy and diabetes mellitus secondary to other causes such as endocrinopathies. Type 1
diabetes mellitus is called juvenile diabetes mellitus because it occurs mostly before 30 years,

and there is low or no insulin, and these people require insulin to sustain their lives. Type 2
diabetes mellitus, which is the commonest type occurs predominantly after the age of forty years,
and the insulin levels may be normal, raised, or decreased. Obesity is a major risk factor for
diabetes mellitus type 2 because more than 60% of people with type 2 diabetes mellitus are obese
(Katsarou et al. 2017).
Different sources have documented the prevalence of diabetes mellitus among Aboriginal and
Torres Strait Islander people, and the numbers differ among gender and age groups. Australian
Indigenous Health Reviews on March 2016 released a review that reported 9% of Aboriginal and
Torres Strait Islander people were diabetic based on self-reported cases (Salmon et al. 2018).
Eleven percent of Indigenous Australians were also noted to be diabetic based on biomedical
data. In 2015 diabetes mellitus except gestational diabetes mellitus was among the leading causes
of death among Aboriginal and Torres Strait Islander people. Indigenous Health review in 2015
reported that 2.35% of Aboriginal and Torres Strait Islander peoples’ women who gave birth in
hospitals had pre-existing diabetes mellitus and 6.2% of them had gestational diabetes mellitus.
Indigenous Australians between the ages of 10-14 are five times more likely to be admitted in
hospitals due to type 2 diabetes mellitus in comparison to non-Indigenous Australians of the
same age according to age-specific incident rates. Aboriginal and Torres Strait Islander people
are three times more likely to have diabetes mellitus in their lifetime when compared to non-
Indigenous Australians. Indigenous Australians between 15 and 19 years are four times distinctly
possible to have diabetes mellitus than non-Indigenous Australians. Aboriginal and Torres Strait
Islander people are almost two times likely to be hospitalized because of type 1 diabetes mellitus
than non-Indigenous Australians (Brzozowska et al. 2019).

Aboriginal and Torres Strait Islander people were colonized by the British as a colony of
settlement from 1788. The British started ruling the Indigenous Australians who were hunters
and gatherers at the time on the basis that the British race was superior to that of Aboriginal and
Torres Strait Islander people. The British took over the land owned by the Indigenous
Australians and later on started making laws that discriminated against the Aboriginal and Torres
Strait Islander people such as Aboriginal Act 1897 (Kendall et al. 2011). Before the arrival of the
British in 1788, the Aboriginal and Torres Strait Islander people sourced their food from hunting
animals and growing crops. The British took the land owned by Aboriginal and Torres Strait
Islander people meaning that Indigenous Australians could not hunt or grow crops anymore and
from then the health of the Aboriginal and Torres Strait Islander people starting deteriorating.
The British introduced Aboriginal, and Torres Strait Islander people to sugary foods and this
contributed to increased cases of obesity among the Indigenous Australians. Obesity is a risk
factor for diabetes mellitus type 2, and many Indigenous Australians became obese because of
taking sugary foods as opposed to their cultural nutrient-rich foods. Colonization of Indigenous
Australians denied them the opportunity to hunt and gather their food as before, and this resulted
in malnutrition due to lack of food. Malnutrition prevalence among Indigenous Australians
increased, and this resulted in low birth weight among them contributing to high levels of type 2
diabetes mellitus (Sterno, 2014).
Social determinants of health are environmental conditions that relate to where people live,
where they are employed, how they learn, and where they age. These social determinants
fundamentally affect the individuals’ health, the quality of life they live, and their functioning.
Social determinants such as availability and access to health care facilities, social support, social
attitudes and norms, socioeconomic conditions affect the overall health of an individual

(Braveman & Gottlieb, 2014). Social determinants of health that mainly relate to diabetes
mellitus that affect Aboriginal and Torres Strait Islander people are availability and access to
health care facilities and socioeconomic conditions. Health care facilities are inadequate among
Indigenous Australians, and the few that are available are far away from the communities where
these people live. Access to health-care helps in the management of diabetes mellitus and
intervenes to help people with the disease from developing complications associated with
diabetes mellitus. People with good access to health-care facilities have a higher chance of
surviving long with diabetes mellitus because the use of medications helps manage
hyperglycemia resulting from the disease. Poor socioeconomic backgrounds due to poverty and
high unemployment rates among Indigenous Australians put them at high risks of developing
diabetes mellitus. Indigenous Australians from low socioeconomic backgrounds cannot access
quality nutrient-rich foods and depend on high sugar foods that are cheap. Dependence on high
sugar foods contributes to obesity which is a contributor to type 2 diabetes mellitus (Shepherd, Li
& Zubrick, 2012).
Culture is a way of life of a group of people and looks into how these people who are considered
a community does their things as manifested by their behavior, values, and beliefs. Aboriginal
and Torres Strait Islander people tend not to access health care facilities despite their availability.
The use of cultural medications as opposed to conventional medications among Aboriginal and
Torres Strait Islander people has contributed to poor access to health care facilities among them
(Deborah, 2014). Social justice report released in 2005 requested that the Australian
Governments can improve the health of Indigenous Australians by the provision of more health
care facilities. The culture of Aboriginal and Torres Strait Islander people has negatively affected
this proposal because they prefer the use of herbal medication to conventional medications. Sport

is a form of recreation among Aboriginal and Torres Strait Islander people, and this culture can
be used to address diabetes mellitus among Indigenous Australians. Physical activity is a way of
reducing the risks of getting diabetes mellitus and the use of the sporting culture among
Indigenous Australians can help reduce the burden of the disease among them. Indigenous
Australians grow their own traditional crops that provide nutrient-rich diets combined with meat
from domestic animals like cows and goats. The culture of traditional foods can be used to
reduce the burden of diabetes mellitus by educating the people on which crops to grow. Many
pregnant women from Aboriginal and Torres Strait Islander people do not visit antenatal clinics
when pregnant or when giving birth contributing to high mortality rates associated with
gestational diabetes mellitus (Russo et al. 2015).
Diabetes mellitus is a disease that affects blood glucose regulation resulting in hyperglycemia.
There are several types of diabetes mellitus, namely, diabetes mellitus type 1, diabetes mellitus
type 2, gestational diabetes mellitus, and diabetes mellitus secondary to other diseases such as
endocrinopathies. The prevalence of diabetes mellitus is higher among Aboriginal and Torres
people compared to non-Indigenous Australians. Colonization negatively impacted the health of
Aboriginal and Torres Strait Islander people health bringing about diabetes mellitus among them.
Social determinants of health such as availability and access to health care facilities and
socioeconomic status of people affect their health positively or negatively. Indigenous
Australians health has been negatively impacted by lack of health facilities and low
socioeconomic status contributing to high cases of diabetes mellitus. Health issues have to be
addressed in accordance with the peoples’ culture as culture contributes to success or failure of
the efforts aimed at addressing health issues such as diabetes mellitus.

References.
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Indigenous Australians. Reviews in Endocrine and Metabolic Disorders, 1-12.
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