RISE OF DIABETES

Rise of Diabetes in Indigenous People

Abstract

The world's Indigenous peoples are experiencing an unprecedented epidemic of type 2 diabetes [T2DM] but little has been published describing the complications burden. The objective of this paper is to conduct a systematic review of T2DM complications in Indigenous populations worldwide.

Introduction

Diabetes has been a major world-wide health issue for many years, with numerous treatments developed to manage this condition. The disease primarily affects affluent individuals; hence most of those affected have access to the health care they require to effectively manage the condition. There are two types of diabetes. Type 1 is an autoimmune disease in which the immune system attacks and destroys beta cells in the pancreas. The body, in turn, produces little to no insulin, and the sufferer must take insulin to live. In type 2 diabetes, the pancreas is producing insulin, but the body cannot effectively utilize it, a condition called insulin resistance (Watson, 2001).

Over time, insulin production decreases, glucose builds up in the blood, and the body cannot use its main source of energy. 5 to 10 percent of diabetes in the United States is attributed to type 1. Scientist don't know specifically what causes the immune system to attack the beta cells, but autoimmune, environmental, genetic, and viral factors are involved. Type 2 is responsible for other 90 to 95 percent of diabetics in America. Unlike type 1, type 2 diabetes can be directly correlated to “older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities.

Health Status Disparities

Controversy about origins and nomenclature does not extend to dispute over the health status of indigenous people, now numbering some 300 million worldwide. Indigenous populations, relative to non-indigenous populations as well as other disadvantaged minority groups, have more of just about every category of disease. Disparities in health are widening in many regions. Relative to national population averages, indigenous people die ten to thirty years earlier, have infant mortality rates two to three times greater, and experience significantly greater morbidity and mortality from infectious and non-communicable diseases (Welty et al, 1995).

The health issues confronting indigenous populations did not rise out of an historical vacuum (Campbell, 1989). Political, economic, and social subjugation, along with warfare and genocide, led to voluntary and involuntary adoption of elements of an external culture (Will, 1999).

Improving Indigenous Health

Poverty, limited education, cultural barriers, discrimination, jurisdictional problems, and power imbalances with historic precedents are the basis of the health and social problems facing indigenous people at the start of the twenty-first century. Means for improving indigenous health require the development of personal skills and individual and collective capacities and the strengthening of community action at local and national levels.

This means supporting the aspirations of indigenous people for self-determination together with attempts to change behavior at the individual level and by organizational and environmental support for behavioral interventions. Culture is of great importance to such initiatives. Indigenous logics often recognize a reciprocal relationship between the health of individuals and ...