Monday, November 13, 2006

Indigenous diabetes epidemic

In an earlier post I pointed out the problems indigenous Australians have with licit drugs like alcohol and tobacco. If aborigines do drink (and most don't) they tend to drink at destructive levels. The incidence of smoking among indigenous Australians is about twice that of others. Aboriginals also suffer an extremely high incidence – roughly twice again of Type 2 diabetes. This is directly related to obesity and indirectly related to excessive intake of carbohydrates in the form of sugary foods and alcohol as well as due to to lack of exercise. About 1 in 5 aboriginals suffer from this disease. Diabetes leads to higher probabilities of heart attack and stroke and can lead to catastrophic complications such as renal failure, blindness and limb amputation. In the alarmist headlines of this morning's press Type 2 diabetes is claimed to threaten the very survival of the aboriginal race.

High rates of cigarette smoking and excessive drinking compound the health risks caused by diabetes.

As Health Minister Tony Abbott points out Australia spends 18% more on aboriginal health than on the health of others but, on by any objective standard, their health is worse.

According to The Age on the indigenous diabetes issue:
‘The so-called ‘Cocacolanisation’ of traditional cultures, with communities adopting Western lifestyles and fast-food diets, has been blamed for a rapid rise in type 2 diabetes’……'

There are an estimated 350 million indigenous people worldwide. The diabetes epidemic is mirrored in Asia, the Pacific, Canada, New Zealand and North and South America. Up to half the adults on the Pacific island of Nauru and 45% of Sioux and Pima Indians in the US have type 2 diabetes. In Canada and the Torres Strait Islands, 30% cent of the indigenous populations have the disease. In the Torres Strait, children as young as six are being diagnosed and some are suffering heart attacks and renal failure in their early teens’.There does seem to be a genetic basis for obesity and hence a propensity to develop diabetes because people living in these cultures are likely to have ‘thrifty genes’.
To quote my earlier argument:
‘Thrifty genotypes were constellations of genetic factors that encourage the conversion of calories into body fat and which decreased the sensitivity of the body to insulin to ensure adequate blood glucose levels in the brain during famine. This mechanism was essential for people to survive 'bottleneck' periods of extreme stress and food scarcity. ‘Thrifty genes’ became essential for survival given the ebb and flow of food availability.Westernisation of such societies and their transition to stable, reliable food supplies means that the genes which once protected now condemn people to early deaths through obesity and diabetes illnesses. It is not what such people eat – those among them who have white ancestry, because of interbreeding of locals with randy early European settlers, have much lower incidence of such diseases though they share a common diet’.
A conference to keep track of indigenous diabetes issues is being held in Melbourne over the next few days. I’ll keep track of this if I can – there are a few preliminary papers on the topic here.

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