Annual Report 2003/2004 Menzies School of Health Research
Tabled paper 1523
Tabled Papers for 9th Assembly 2001 - 2005; Tabled Papers; ParliamentNT
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Menzies School of Health Research 2003 Annual Report | Population Health & Chronic Diseases Division | 15 Diabetes, kidney and heart disease in the Indigenous people of Darwin Commenced a five-year study that aims to identify how many Aboriginal and Torres Strait Islander people living in Darwin, Palmerston and the Darwin rural area have diabetes and related conditions (such as heart and kidney disease). Known as DRUID (Diabetes and Related conditions among Urban Indigenous people in the Darwin region), this project also seeks to discover which people are at greatest risk of getting diabetes and its associated conditions, and how prevention strategies and health services for these conditions might be improved. We are also planning a lifestyle intervention for those who do not yet have clear-cut disease but are deemed to be at high risk. Kidney disease Completed and published a national cohort study of all patients starting dialysis treatment in Australia during 199398. This study revealed that Indigenous patients received kidney transplants at approximately onethird of the rate of non-Indigenous patients. We also found Indigenous patients faced barriers to get onto waiting lists and in moving from a waiting list to receiving a transplant. This is highly significant as, compared to long-term dialysis, transplantation usually results in better quality of life, longer life expectancy and lower cost to the health care system. We are currently developing protocols for a study aimed at uncovering key barriers to accessing kidney transplants for Indigenous people with end-stage renal disease. Comparison of diabetes and heart disease in different Australian populations Recently completed a 10-year follow-up of deaths from cardiovascular disease among Australian-born Melbourne residents and migrants from Mediterranean countries. In contrast to Indigenous Australians, Greek migrants have a lower than average death rate from coronary heart disease. Given that they have maintained important aspects of their traditional Mediterranean diet, we are examining whether this diet gives protection from heart disease and stroke by lessening the impact of risk factors, such as diabetes, high blood pressure and high cholesterol. These findings could have important implications for Indigenous populations. Commenced collaboration with the AusDiab Study Group at the International Diabetes Institute in Melbourne to look at the relationship of body mass index to health in different Australian populations. A study examining the associations between body mass index and mortality rates in Aboriginal people in the Northern Territory has found an excess risk of death related to low body weight. These findings are of great public health concern and will need to be thoroughly investigated in future research. They highlight the different pathways to ill health in very poorly nourished communities. We are using our extensive database to identify the range of body mass index most consistent with prevention of diabetes and related conditions in Aboriginal and Torres Strait Islander populations. Clinical studies of diabetes and heart disease in Indigenous populations Detailed clinical assessment of the complications of diabetes in a remote East Arnhem Land community indicated very high rates of heart disease risk (smoking, high blood pressure, kidney disease, and high blood fats). However, in this remote clinic there was also very good primary care in detection and follow-up clinical management. We are investigating the use of a number of non-invasive techniques to look for early signs of heart disease in Indigenous and nonIndigenous people with diabetes estimating thickening and stiffness of artery walls. The work is helping us gain insight into how diabetes and other risk factors contribute to the onset of heart disease. The technique may also be used to monitor whether interventions, such as exercise, diet or medications, are having a positive effect on the cardiovascular health of those with diabetes or high blood fats. Key achievements MSHR 2003 Research & Education Report provides detail on all research projects and is available online at www.menzies.edu.au