There is an alarmingly high rate of diabetes among indigenous communities globally, with some regions having as much as one-third of their adult population affected, according to a new report from the International Diabetes Federation (IDF).
“Despite the incredible diversity among and between indigenous nations, there has been a consistent and rapid increase in type 2 diabetes over time, and diabetes is now one of the most common health disparities among indigenous peoples,” said Courtney Fischer-Claussen, MPH, who presented a summary of the report at the IDF 2022 Congress.
The Indigenous Peoples, a special interest group, conducted a systematic review of literature for the Atlas report, focusing on two age groups: adults over 18 and youth under 30. The researchers noted that the ages between the two groups overlapped because some articles reported prevalence rates for adolescents and young adults.
For this study, the group reviewed forty-nine articles and found that indigenous populations in the Asia-Pacific have high rates of type 2 diabetes, the highest being approximately thirty-nine percent in iTaukei-Melanesian Fijians in 2009. Conversely, the lowest type 2 diabetes prevalence was among the Tapuwai of the Solomon Islands (0%) in 2009.
According to Fischer-Claussen, colonization has caused significant harm to indigenous communities through compulsory assimilation, loss of land and resources, cultural restrictions, language erosion, and long-term psychological trauma passed down through generations.
The study also found that among indigenous communities in North America and the Caribbean, the highest rate of type 2 diabetes was about thirty-nine percent among First Nations people in Ontario, Canada, in 2014. Overall, nearly two-fifths of the sample population had type 2 diabetes.
On the other hand, they found that the lowest prevalence in that region was 0.8% in 2005-2007 among people from the indigenous Tepehuanos and Sonora tribes in Mexico.
“Future research might look towards the practices of the nations with lower diabetes prevalence for guidance,” Fischer-Claussen commented.
Furthermore, the researchers looked at how gender affects disease prevalence. They found that out of the twenty-five studies that presented data specific to both men and women, the lowest rate of type 2 diabetes was among men from the indigenous Tepehuanos and Sonora tribes in Mexico, with a zero percent incidence reported for both tribes between 2006-2007. Conversely, the incidence of type 2 diabetes among women from these tribes was approximately two percent.
They also found that the highest rate of diabetes for men was about thirty-two percent among the Xavante in Mato Grosso, Brazil, in 2008-2011. For women in the same region, that percentage was about forty-two percent.
In general, the studies reported higher diabetes prevalence in women than in men.
However, Fischer-Claussen warned that the data is limited as it only represents 16 out of the 90 countries with indigenous populations, meaning it does not give a complete global view.
Additionally, the group reviewed twenty-seven articles for youth data, but only from 4 countries: the United States, Canada, New Zealand, and Australia. The study found that the highest rates of diabetes among indigenous people were among Central Australia First Nations youth aged 15-24 in 2016-2017. According to the researchers, the data shows that type 2 diabetes is rare in children under ten but increases with age.
Fischer-Claussen recommended that healthcare providers educate themselves about the local indigenous communities and their cultural beliefs about type 2 diabetes.