A new study by the Diabetes Across the Lifecourse—Northern Australia Partnership highlights the experiences of Aboriginal and Torres Strait Islander young people living with type 2 diabetes (T2D).
The Northern Territory has the highest rates of type 2 diabetes in young people in the world. This rate is 10 times more than for non-Indigenous youth and has doubled in the last 7 years. Given the emerging T2D epidemic in Australia and globally, effective management strategies are needed to improve diabetes outcomes for young people.
The qualitative study involved in-depth interviews with 27 Aboriginal and Torres Strait Islander young people aged 10 to 25 years living with T2D across the Northern Territory.
According to senior author and Deputy Lead of the Partnership, Dr. Renae Kirkham, Menzies School of Health Research, “Our study shows the successful management of type 2 diabetes requires support from health professionals and family; and includes strengthening social networks and educational opportunities. It requires a re-think of traditional ways of delivering diabetes care.”
Findings show that young people experienced a normalization–shame paradox in response to their diagnosis, partly related to “everyone has diabetes,” as well as the fear that friends “might judge [me]”. Young people had a suboptimal understanding of their condition and experienced multiple barriers to managing their T2D, including comorbidities, saying, “I have a rheumatic heart disease […] then they told me that I have diabetes…I have two things”.
“We must work with young people and their communities to design enhanced models of care, in which we focus on shifting norms and expectations about youth T2D to reduce diabetes stigma, broaden social supports and consider the delivery of health information in youth-friendly environments,” Dr. Renae Kirkham said. “It is also essential that the broader context of people’s lives are considered when developing these strategies. Specifically, the social and cultural determinants of health, and impacts of intergenerational trauma.”
Informed by findings of this research, Dr. Renae Kirkham and the Head of the Partnership, Professor Louise Maple-Brown, are now leading a team across northern Australia to co-design enhanced models of care with young people, their communities and health professionals. This project is building diabetes knowledge, strengthening support systems, tailoring educational resources, and giving a voice to young Aboriginal and Torres Strait Islander people living with T2D.