Global study highlights Australian diabetes program as best practice 23 June 2023 The Menzies School of Health-led Diabetes across the Lifecourse: Northern Australian Partnership, which includes Diabetes Australia, has been recognised by one of the world’s leading medical journals as an example of best practice to improve diabetes in minority ethnic groups. The Lancet is this week publishing Addressing Global Inequity in Diabetes: International Progress as part of a series on diabetes research. The paper highlights best practice approaches to achieve equity in diabetes care and outcomes. It chose Diabetes across the Lifecourse: Northern Australian Partnership as the best practice case study to show how to effectively “change the ecosystem”. Diabetes Australia works collaboratively with the program. The Partnership was selected because it applies research recommendations and equity principles to real-world situations related to diabetes among Aboriginal and Torres Strait Islander people, including the growing number of young people developing diabetes in Australia. It addresses structural inequity and its consequences by looking at changes in policy, social systems, and the environment to improve diabetes care and outcomes. Recent Menzies research across northern and central Australia has found the youngest youth-onset type 2 diabetes diagnosis was a 4-year-old. The highest prevalence of diabetes (3.1%) among Aboriginal and Torres Strait Islander youth aged under 25 years was in females aged 15 to 24 years in central Australia, with Aboriginal and Torres Strait Islander females more likely to be diagnosed with type 2 diabetes. Those higher rates of youth-onset type 2 diabetes contribute to high rates of pre-gestational diabetes, which is up to 8.4% in pregnant Aboriginal women in central Australia. The study highlighted that as a result of the widening diabetes inequity, Australian Aboriginal and Torres Strait Islander communities experience significant and premature morbidity and mortality from type 2 diabetes and its complications. In 2021, diabetes-related mortality and hospitalisation rates were more than 4 times higher among Aboriginal and Torres Strait Islander people than non-Indigenous Australians. The median age of death was 62.5 years compared to 82.2 years for the general Australian population, with cardiovascular disease and diabetes among the two leading causes of death. Co-authors of the Lancet diabetes series, the Menzies School of Health’s Professor Louise Maple-Brown and Sian Graham, found that structural racism and geographic inequity are accelerating the soaring global rates of diabetes, which is outpacing most chronic conditions around the world. Prof Maple-Brown said they were delighted and honoured to see more than a decade of work through The Partnership acknowledged on the international stage. “The Partnership strives to address diabetes inequity in the real world by raising the voices of Aboriginal and Torres Strait Islander people with lived experience of type 2 diabetes, thinking about their larger social context and addressing structural inequity.” “These ways of working allow us to create sustainable and equitable change in diabetes in our own backyard and around the world,” Prof Maple-Brown said. The Lancet series is in response to a call by the 2020 Lancet Diabetes Commission and the World Health Organisation Global Diabetes Compact to reduce diabetes. It draws attention to the growing number of people developing diabetes, despite increased awareness and ongoing efforts to relieve this trend.