Why Is Australian Aboriginal Diabetes Much More Prevalent?

Diabetes mellitus (DM) is among the most common chronic conditions in Australia. The disease seems to be affecting predominantly aboriginal people, as opposed to the general population of the Australian continent. Recent clinical studies have revealed that aboriginal diabetes is up to 4 times more prevalent, compared to non-aboriginal diabetes. And this is not the only bad news.

What is even more worrying is the fact that the disease appears in a much earlier life stage among the aboriginal population than in the rest of the Australian people. But why is diabetes higher in the aboriginal population? What causes the medical condition in Indigenous Australians in the first place and why is this demographic group more prone to developing the chronic condition? In the following article, we are going to explore these questions in greater detail.

What causes diabetes in Indigenous people from Australia?

The main reasons behind the higher prevalence of aboriginal diabetes are to do with evolution, diet, and lifestyle. Clinical research has shown that the number of cases varies across the different areas of the continent, and yet, when compared to non-Indigenous Australians, the disease is more likely to affect the aboriginal population.

Among the main causes of the condition among Australian aborigines are:

• Evolution – the bodies of aboriginal people have evolved in a way that strives for higher energy expenditure and a diet rich in vitamins, minerals, and fibre. With the increase of fast food chains in Australia and the decrease in physical activity, the two factors mentioned above have been strongly impaired;
• Obesity – due to the increased consumption of unhealthy food and sedentary lifestyle, the rates of obesity among aboriginal people have gone up significantly. When it comes to DM, obesity has been found to be one of the biggest developmental factors;
• Lack of physical activity – the westernised way of living, characterised by more frequent car commutes, amenities with closer proximity, and less spare time, has led to a significant decrease in physical activity and energy expenditure among Australian aborigines.

Why is aboriginal diabetes more prevalent?

Diabetes mellitus develops when the function of the pancreas becomes impaired leading to decreased insulin production in the body. Another common reason for the occurrence of the disease is the inability of the cells to uptake insulin, which is known as insulin resistance. The end result is abnormally high glucose levels in the blood.

The main factors that lead to the development of DM include lack of physical activity, bad diet choices, poor lifestyle habits, and obesity. The clinicians have established that all of the above factors are especially common among the aboriginal population of Australia, which gives the answer to the question of why is diabetes higher in Indigenous people from Australia.

This statement is further supported by the lack of evidence that aboriginal people are more likely to develop the condition due to hereditary reasons, such as genetic predisposition. Furthermore, some scientists support another reason for the higher prevalence of DM among the aboriginal population of Australia, which is to do with evolution.

They believe that the Indigenous people of the continent have evolved as hunter-gatherers and are more used to traditional diet lifestyles, high in fibre and low in processed foods. Unfortunately, the higher exposure to fast food, cigarettes and reduced physical activity, has led to the impairment of their metabolism and a higher chance of developing diabetes.

Why do indigenous Australians have a higher risk of diabetes?

Even though scientists are not 100 per cent sure about the reasons that have led to the higher risk of diabetes among the indigenous population of Australia, there are several elements that have been agreed upon by clinicians.

It is a well-known fact now that the local population of Australia has a 3 – 4 times higher risk of developing the disease when compared to the general Australian population. And yet, some aboriginal people are more likely to get the disease than other aboriginal people. The clinical studies have discovered that the likelihood of an aboriginal person becoming diagnosed with diabetes increases significantly if the person:

• Is overweight or obese
• Includes little to no physical activity in his or her weekly schedule
• Consumes foods that are high in fat, processed sugar and salt, and low on fibre, vitamins, and minerals
• Have pancreatitis
• Is of older age (even though recently diabetes has been found to also affect younger aboriginal people)

What is the percentage of Indigenous Australians who suffer from diabetes?

According to research conducted by the Australian Bureau of Statistics, in 2018 the number of Australian people who suffered from diabetes was 1.2 million or just about 5%. The male population was at greater risk of developing the disease, compared to the female representatives with 5% and 3% respectively.

As to the prevalence of diabetes among the aboriginal population, the percentage has been found to be much higher. Data from the 2019 National Aboriginal and Torres Strait Islander Health Survey revealed that about 8% of Indigenous Australians suffer from diabetes. After taking into consideration the variations between different populations and age structures, it has been estimated that the percentage of diabetes sufferers in aboriginal people was over 12.5%, compared to 4.3% in non-aboriginal subjects.

Final thoughts

Diabetes is a serious health condition which if ignored can lead to further health complications, including limb amputations, loss of sight and even death. The major factors for developing this medical condition include obesity, lack of physical activity, unhealthy diet patterns, and poor lifestyle habits. Recent data has indicated that Australian people are more likely to develop diabetes, compared to the rest of the world. Among them, the aboriginal population was at greater risk, with some studies showing up to four times bigger likelihood of occurrence.

According to dietitians and health representatives, the chance of developing diabetes can be significantly reduced by the implementation of several diets and lifestyle changes. That includes a diet high in fruits, vegetables, pulses, nuts and seeds, and low on processed meat, high sugar foods and fizzy drinks. Furthermore, people should aim to include at least 150 minutes of moderate physical activity into their weekly schedules and maintain a healthy weight with a BMI within the range of 18.5 – 24.9 kg/m2.

References (in order of appearance)

Keel, S., Foreman, J., Xie, J., van Wijngaarden, P., Taylor, H. R., & Dirani, M. (2017). The Prevalence of Self-Reported Diabetes in the Australian National Eye Health Survey. PloS one, 12(1), e0169211

Burrow S, Ride K (2016) Review of diabetes among Aboriginal and Torres Strait Islander people. Australian Indigenous HealthInfoNet.

ABS (2019). National Aboriginal and Torres Strait Islander Health Survey, 2018-19. ABS cat. no. 4715.0. Canberra: ABS.

By: Nikolay Terziev