Aboriginal and Torres Strait Islanders

Aboriginal and Torres Strait Islander people are almost four times more likely than non-Indigenous Australians to have diabetes or pre-diabetes. Improving the lives of people affected by all types of diabetes and those at risk among Aboriginal and Torres Strait Islander communities is a priority for Diabetes Australia.

Watch the short video below for a quick guide to the benefits of the National Diabetes Services Scheme (NDSS).

You can reduce the risk of developing type 2 diabetes by eating a more healthy diet and being physically active which will help maintain a healthy weight to keep your sugar (glucose) levels normal and your body strong.

If you have any worries about diabetes, check the symptoms below and find out more from your Aboriginal Health Worker, Health Clinic/Community Centre, Aboriginal Medical Service or doctor.

The following information is from the ‘Keep Culture Life & Family Strong; Know Early About Diabetes’ flipcharts for Indigenous Australians. It is of a general nature only and should not be substituted for medical advice or used to alter medical therapy. It does not replace consultations with qualified healthcare professionals to meet your individual medical needs.

The ‘Keep Culture Life & Family Strong; Know Early About Diabetes’ resource was originally developed by Healthy Living NT with funding provided by the Department of Health and Ageing through Diabetes Australia. The reprinting and distribution of the most recent addition has been made possible with funding by the National Diabetes Services Scheme (NDSS) – an initiative of the Australian Government administered by Diabetes Australia.

How do you feel? (Symptoms)

If you have any of the following symptoms you should talk to your doctor, health worker or nurse.

  • Feeling tired or weak
  • Go to the toilet a lot
  • Feeling thirsty
  • Leg cramps
  • Feeling itchy
  • Sores and boils that won’t heal
  • Blurry vision
  • Pins and needles
  • Feeling grumpy or angry.

Through a simple test, a doctor can find out if they’re the result of diabetes.

What is it? (About diabetes)

Sugar (glucose) gives your body energy. The sugar (glucose) moves from your blood into your muscles with something called insulin. With diabetes your insulin isn’t working properly, so the sugar (glucose) doesn’t get into your muscles and body easily and there is too much sugar (glucose) in your blood.

Everyone has a little bit of sugar (glucose) in their blood. The optimum sugar (glucose) level is between 4 to 6 mmol/L (after fasting).

Sugar (glucose) is fuel that comes from some of the food you eat and drink. It gives your body energy to do all sorts of things:

  • Walk
  • Think
  • Play sports
  • Hunt
  • Work
  • Rake
  • Gardening
  • Resting.

To help the sugar (glucose) move into your muscles and body cells your body needs something called insulin. Insulin is made in the pancreas - a body part which is near your stomach.

Insulin helps keep your sugar (glucose) levels normal.

With diabetes, the insulin isn’t helping the sugar (glucose) move from your body into your muscles and body cells. So it stays and builds in your body, making your blood sugar (glucose) level high.

Type 2 Diabetes

There are different types of diabetes. A lot of Aboriginal and Torres Strait Islanders have type 2 diabetes. Type 2 is when your body stops the insulin working properly.

Fat bellies, not being active enough, eating a big mob of fatty food can stop the insulin working properly in your body.

Being active, eating healthy and being a healthy weight can help your insulin work better to keep your sugar (glucose) normal. Sometimes people might need to take tablets and insulin everyday to keep their sugar (glucose) levels normal.

Gestational Diabetes

Another type of diabetes is gestational diabetes. This happens when you are pregnant, but not all women get it. It goes away after pregnancy but you and your baby can get type 2 diabetes later in life.

Pre Diabetes

There is also Pre Diabetes or Impaired Glucose Tolerance (IGT). This happens when your sugar (glucose) level is high, but not high enough to be called diabetes. It doesn’t mean you have diabetes now, but it does mean you might get it later. Being active and eating healthy you can slow down the start of type 2 diabetes.

Type 1 Diabetes

Some Aboriginal and Torres Strait Islanders have type 1 diabetes. This usually happens in kids and teenagers. Type 1 diabetes is when your body kills the insulin making part in the pancreas and no insulin is made in your body. To give the body the insulin it needs, insulin injections are needed every day for the rest of their life.

What do I do? (Management of diabetes)

When there is too much sugar (glucose) in your blood it damages your heart, kidneys, feet, eyes and nerves.

You can keep your sugar (glucose) levels normal by:

Eating healthy

  • Have plenty of bush tucker and have shop foods and home cooked meals that are low in fat, sugar and salt.
  • Have something from each of the core food groups every day. They give you energy, fight sickness and help care for your body to keep it strong.
  • Drink plenty of water.

Avoiding and eat less fat, sugar and salt

  • Eat less fat as it makes you put on weight and gives you problems with your heart.
  • Pick meat with no fat or only small bits of fat on it. Cut the fat off the meat and take the skin off chicken.
  • Drain the juices (fat) after cooking meat and scoop out the fat from the top of stews.
  • Avoid cooking with or having fats like butter, oil, margarine or dripping.
  • It is better to boil, steam, stew, grill, microwave or stir-fry food.

Being a healthy weight (not too fat and not too skinny)

  • Do this by eating less, eating healthy and being more active.

Keeping active

  • It helps you lose weight and keep it off and it keeps you healthy.
  • It helps your insulin to work properly.
  • Walk, job, play sport, hunt, garden, work around the place.
  • Be active for 30 minutes or more every day OR do 10 minutes 3 times a day.

Taking your medicine

  • Take your medicine at the times the doctor tells you.
  • Take them with or after eating in the morning, afternoon and supper time every day.
  • Refill your medicine box in the morning (get some more medicine before it gets low and so you don’t run out).
  • Take your medicine with you when you go to see family, walkabout or away from home.
  • Put your medicines somewhere cool, dry and safe so they won’t go bad.
  • Keep your medicines out of reach of kids.

Remember to:

  • Have your check-ups with your doctor, health worker or nurse. Have regular check-ups for your eyes, feet, kidneys, blood pressure, skin and teeth. If you notice anything different about your body talk to your doctor, health worker or nurse.
  • Check your sugar (glucose) levels at the times your doctor, health worker or nurse tells you.
  • See your doctor, health worker or nurse straight away if you feel sick.
  • Check your feet and skin for sores and/or cracks every day.

Why take medicine for? (Medications for diabetes)

Diabetes medicine helps to keep your body strong and well and it helps to keep your sugar (glucose) levels normal.

When eating healthy, being active and being a healthy weight isn’t working at keeping your sugar (glucose) levels normal, you might need to take tablets and/or insulin.

The doctor might put you on tablets called Metformin to help your insulin work better and to lower the amount of sugar (glucose) in your blood.

After a while the pancreas gets tired from working too hard and can’t make enough insulin, so your doctor might put you on tablets called Sulphonylurea. This medicine helps your body make more insulin.

Or, after awhile, the doctor might need to add another lot of tablets called Glitazone or Acarbose.

Remember to have your medicine with or after eating, in the morning, afternoon or supper time. Take them at the time the doctor tells you to.

All tablets work differently and some can have side effects.

If the following problems don’t go away or if you are still worried about them, then talk to your doctor.

  • Feel sick like you want to vomit (nausea)
  • A sore belly
  • Diarrhoea
  • Sugar (glucose) levels going too low
  • Have fluid build-up (retention)

When your sugar (glucose) levels get too high and stays high the doctor might put you on tablets and give you insulin.

  • Having insulin doesn’t mean you have type 1 diabetes.
  • Insulin isn’t like tablets so it shouldn’t be swallowed.
  • You inject the insulin under your skin in different places on your belly.

Talk to your doctor, health worker or nurse about insulin and what is right for you.

Having too much insulin or taking too many Sulphonylurea tablets can make your sugar (glucose) levels go too low (under 3) and make you hypo (hypoglycaemia).

You can also go hypo (hypoglycaemia) if you are:

  • Not eating, not eating enough or eating too late
  • Being extra active
  • Drinking grog (alcohol).

You might not feel anything when you have a hypo (hypoglycaemia), but sometimes you might feel:

  • Shaky
  • Hungry
  • Get headaches
  • Weak
  • Confused
  • Angry
  • Talk like you’re drunk when you’re not
  • Sweaty.

When you have these feelings or think you are having a hypo (hypoglycaemia), get your sugar (glucose) level up fast by drinking or eating something sweet.

Keep your sugar (glucose) level normal and stop having another hypo (hypoglycaemia) by eating a sandwich or meal after you have something sweet.

Remember, after taking your tablets or insulin:

  • Keep them somewhere cool, dry and safe (maybe in the fridge at home or at the clinic) so that they won’t go bad
  • Keep them out of reach of children
  • Get rid of your syringes/needles and finger pricking needles by putting them in a “sharps container” or “hard plastic” empty container with a lid (see if the clinic has one).

Remember when you go see family, walkabout or are away for home take your tablets and/or insulin with you.

Why me? (Risk factors)

Nobody knows how or why some people get diabetes but there are some things we know that can add to your chances of getting it. You have more chance of getting it when you are Aboriginal or Torres Strait Islander, but not all Aboriginal or Torres Strait Islande people have diabetes.

Aboriginal or Torres Strait Islander people live different to how they used to live. Changes that add to your chances of getting diabetes are:

  • Not as active
  • More overweight
  • Eating fatty salty, sugary foods.

People living the old way were:

  • Active
  • Leaner and fit
  • Eating healthy food (bush tucker).

Other chances of getting diabetes include:

  • It is in your family tree or when someone in your family has diabetes
  • You had diabetes when pregnant
  • You get older
  • You eat too much and you eat too many fatty and sugary foods
  • You are overweight
  • You are not active enough
  • You have pancreatitis (a sickness of the pancreas).

There are things you can’t change or stop you from getting diabetes:

  • It’s in your family
  • You are Aboriginal or Torres Strait Islander
  • You are pregnant with diabetes
  • You are getting older.

The things you can do to slow down the start of diabetes:

  • Eat healthy and be a healthy weight
  • Be active
  • Don’t drink too much grog.

Nobody knows why or how people get diabetes. After a while it can damage your heart, kidneys, eyes, feet and nerves making you really sick.

Talk to your doctor, clinic, nurse or health worker about having a test to find out if you have diabetes. You can’t always feel it or see it happening, so you might not know you have it.

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