title: Type 2 diabetes in young Indigenous Australians in rural and remote areas: diagnosis, screening, management and prevention.
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.
authors: Baker IDI Central Australia, Alice Springs, NT.
authors: Peter
authors: P
authors: Azzopardi
authors: Alex D
authors: AD
authors: Brown
authors: Paul
authors: P
authors: Zimmet
authors: Rose E
authors: RE
authors: Fahy
authors: Glynis A
authors: GA
authors: Dent
authors: Martin J
authors: MJ
authors: Kelly
authors: Kira
authors: K
authors: Kranzusch
authors: Louise J
authors: LJ
authors: Maple-Brown
authors: Victor
authors: V
authors: Nossar
authors: Martin
authors: M
authors: Silink
authors: Ashim K
authors: AK
authors: Sinha
authors: Monique L
authors: ML
authors: Stone
authors: Sarah J
authors: SJ
authors: Wren
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control / Q000628:therapy; D006303:Health Services, Indigenous; D054624:Health Status Disparities; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008403:Mass Screening; D040242:Risk Reduction Behavior; D012423:Rural Health; D019035:Rural Health Services
chemical_list: D007004:Hypoglycemic Agents