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Research

Islet autoantibodies herald early type 1 diabetes. However, less is known of the evolution of autoantibodies to the islet autoantigen ZnT8. Our primary aim was to characterise the development of islet autoantibodies in a pregnancy-birth at-risk cohort and to provide new knowledge about ZnT8A.

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We aimed to synthesise global prevalence estimates of type 2 diabetes among Indigenous youth aged under 25 years, and examine age- and gender-specific differences and secular trends.

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Youth-onset type 2 diabetes is an emerging condition impacting Indigenous populations worldwide. Schools have an important role in supporting students to manage their health. We undertook a qualitative study to (i) explore the lived experience of type 2 diabetes, diabetes management and support in school environments and (ii) co-design recommendations for age-appropriate, culturally safe school-based strategies and supports. Interviews and focus groups were undertaken with Aboriginal and Torres Strait Islander youth, caregivers, health professionals and school-based staff. Aboriginal and Torres Strait Islander youth were involved in determining the research topic.

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Type-2 diabetes is a systemic condition with rising global prevalence, disproportionately affecting Indigenous communities worldwide. Recent advances in epigenomics methods, particularly in DNA methylation detection, have enabled the discovery of associations between epigenetic changes and Type-2 diabetes. In this review, we summarise DNA methylation profiling methods, and discuss how these technologies can facilitate the discovery of epigenomic biomarkers for Type-2 diabetes. 

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Alex Brown BMed, MPH, PhD, FRACP (hon.), FCSANZ, FAAHMS Professor of Indigenous Genomics +61421278314 alex.brown@anu.edu.au Professor of Indigenous

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Indigenous populations globally have significantly high rates of type 2 diabetes compared to their non-Indigenous counterparts. This study aims to implement and evaluate the effectiveness of a culturally and contextually informed Aboriginal Diabetes Workforce Training Program on Aboriginal primary health care workforce knowledge, attitude, confidence, skill and practice relating to diabetes care.

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While advancements in the treatment of diabetes continue to rapidly evolve, many of the newer technologies have financial barriers to care, opposing the egalitarian ethos of Banting who sold his patent on insulin for a nominal cost to allow it to be made widely available. Inequity in access to new therapies drives disparity in diabetes burden with potential for these gaps to widen in the future.

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Premature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of care. We describe the methods for the codesign, implementation and evaluation of enhanced models of care with Aboriginal and Torres Strait Islander youth living with type 2 diabetes across Northern Australia. 

Research

Iatrogenic hypoglycaemia is one of the main limiting factors in the glycaemic management of diabetes. It causes negative biological, psychological, and social consequences in most people with type 1 diabetes and in many with advanced type 2 diabetes. This chapter explores physiological homeostatic mechanisms that prevent hypoglycaemia through glucose counter-regulation, before discussing specific acquired defects of glucose counter-regulation in diabetes, which provides an insight into risk factors for hypoglycaemia.

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Type 2 diabetes mellitus (T2DM) is highly prevalent within the Indigenous Australian community. Novel glucose monitoring technology offers an accurate approach to glycaemic management, providing real-time information on glucose levels and trends. The acceptability and feasibilility of this technology in Indigenous Australians with T2DM has not been investigated.