Type 2 diabetes in Indigenous Australian children and adolescents

Authors

  • Louise J Maple-Brown,

    Corresponding author
    1. Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Casuarina
    2. Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory
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  • Ashim K Sinha,

    1. Department of Endocrinology, Cairns Base Hospital
    2. James Cook University, Cairns, Queensland
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  • Elizabeth A Davis

    1. Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, West Perth, Western Australia, Australia
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Dr Louise Maple-Brown, Menzies School of Health Research, PO Box 41096, Casuarina, NT, 0811, Australia. Fax: 61 8 89275187; email: louise.maple-brown@menzies.edu.au

Abstract

Rates of type 2 diabetes are higher among Indigenous than non-Indigenous Australian children and adolescents. Presentation may be incidental, part of obesity investigation, symptomatic (polyuria and polydipsia) or in ketoacidosis. Investigation should include assessment of fasting insulin, c-peptide and autoantibodies, as well as assessment of diabetes complications and co-morbidities. Management is a challenge, particularly in a resource-limited setting. Management should involve the whole family and, in some cases, extended family, and community, local health-care providers are key, and a multidisciplinary team approach is essential. The primary initial intervention involves life-style change, but medications (oral and insulin) are frequently necessary. Screening of high-risk individuals is recommended. Waist circumference is a key component of risk assessment. Prevention strategies targeting children and adolescents from this high-risk population are urgently required.

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