Recent estimates indicate that nearly 1.9 million Australians are living with diabetes, with this figure climbing 32% from 2013 to 2023. Among various health disparities, diabetes poses a significant threat to Aboriginal and Torres Strait Islander communities, who face staggering statistics: they are three times more likely to be diagnosed with diabetes compared to their non-Indigenous counterparts and 4.4 times more likely to die from the disease.
Physical activity is a crucial factor in preventing and managing type 2 diabetes, yet our latest study published in the Medical Journal of Australia highlights a concerning gap in knowledge regarding its impact on First Nations peoples.
What is Diabetes?
Diabetes is characterized by elevated glucose levels in the bloodstream, with type 2 diabetes being the most prevalent form. In this condition, the body becomes resistant to insulin, the hormone responsible for regulating blood sugar levels. Key risk factors include a family history of diabetes, obesity, and hypertension.
The elevated incidence of diabetes among Indigenous populations is largely driven by social determinants of health. Food insecurity, particularly pronounced in rural and remote Indigenous communities, complicates the ability to maintain a nutritious diet, which is vital for overall health. Additionally, these communities often face barriers to education, employment, adequate housing, and quality healthcare, all of which contribute to health disparities.
Younger onset type 2 diabetes—defined as diagnosis before age 40—occurs at notably high rates within First Nations communities. If left unmanaged, diabetes can result in severe complications affecting the heart, kidneys, eyes, and feet, as well as impacting mental health.
The Importance of Physical Activity
Lifestyle modifications, particularly diet and exercise, are widely recommended for managing type 2 diabetes. Our research aimed to explore how physical activity interventions could specifically benefit Aboriginal and Torres Strait Islander individuals with diabetes.
Extensive evidence supports the effectiveness of exercise in diabetes management. Regular physical activity is linked to improved glycemic control, reduced cholesterol levels, and weight loss. Moreover, a combination of aerobic and resistance training has shown superior benefits compared to either type of exercise performed alone.
Despite this, our review uncovered only nine studies focused on the effects of physical activity interventions for type 2 diabetes in Indigenous adults. While some evidence suggested positive outcomes from physical activity, the overall findings were undermined by limitations in study design and a lack of Indigenous involvement in research processes.
The Need for Rigorous Research
Many diabetes prevention and management strategies present unique challenges for First Nations communities, particularly those in remote areas. The high costs associated with emerging technologies, such as continuous glucose monitors, further complicate diabetes management.
Access to suitable diabetes support, education, and services is crucial for Indigenous Australians. Cultural and socioeconomic factors can significantly affect participation in physical activity. Previous research indicates that Indigenous Australians are less likely to meet recommended physical activity levels compared to non-Indigenous individuals.
Factors influencing exercise engagement among First Nations peoples include the availability of safe, accessible, family-oriented, and cost-effective exercise locations, which can be scarce in regional and remote areas.
Our findings reveal a critical lack of reliable data on the specific types of exercise that may benefit Aboriginal and Torres Strait Islander individuals with type 2 diabetes. Given the central role of physical activity in diabetes management, it is imperative that future research be meticulously designed and culturally sensitive. Involving Aboriginal and Torres Strait Islander communities at every stage of the research process will ensure that studies are relevant and impactful.
Focused research efforts will help identify effective strategies to promote physical activity and fully understand its benefits for Indigenous populations grappling with type 2 diabetes.
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