Abstract
BackgroundIndigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.MethodsWe compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).ResultsThe three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.ConclusionsAlthough there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.
Highlights
Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease
Rates of current cigarette smoking were higher in both remote Indigenous Australians and Canadians compared to urban Indigenous Australians
The remote Canadian group displayed significantly lower body mass index (BMI) and waist-hip ratio compared to the urban Indigenous Australian group
Summary
Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. The burden of type 2 diabetes, chronic kidney disease (CKD) and cardiovascular disease (CVD) has had devastating effects on Indigenous populations of both Australia and Canada, and there appear to be close similarities in the disease presentation and impact between the Indigenous populations of these geographically disparate continents. Both populations have earlier onset of Despite the high prevalence of diabetes, CVD and CKD among Indigenous populations globally, there is little published data from studies using detailed participant examinations for assessment of complications of diabetes [6,7]. Measured at the point yielding the Measured at the point of maximum maximum circumference over the buttocks maximum circumference over the buttocks extension of the buttocks as viewed from with the tape in a horizontal plane over with the tape in a horizontal plane over the side; using an inelastic tape in very light clothing very light clothing horizontal plane over light clothing Weight
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