Menzies research has shown very high rates of diabetes among Aboriginal and Torres Strait Islander Australians. Of particular concern is that this epidemic is intergenerational.
Our research in the Northern Territory (NT) is showing that there are increasing numbers of women with diabetes in pregnancy. Children exposed to diabetes in-utero are more likely have a number of health risks (including developing type 2 diabetes early in life) when compared to children not exposed to diabetes in-utero. Our research results are similar to other research findings in countries with similar histories of colonisation of Indigenous peoples.
We are now seeing young children being diagnosed with type 2 diabetes. Our work aims to address this intergenerational cycle in Aboriginal and Torres Strait Islander people, with a focus on early-life prevention: pre-conception, pregnancy and childhood.
The DIABETES across the LIFECOURSE: Northern Australia Partnership commenced initially in the Northern Territory (NT) in 2011. The partnership is between researchers, policy makers and health service providers. It aims to improve systems of care and services for people with diabetes in remote northern Australia. The Partnership includes work to improve the care and outcomes for Aboriginal and Torres Strait Islander youth with diabetes and women with diabetes in pregnancy and their babies.
After starting in 2011 as the NT DIP Partnership, further funding in 2015 enabled development of an alliance with Far North Queensland (NT & FNQ Diabetes in Pregnancy Partnership) and collaborating with Canadian researchers.
Early 2019 saw the change of the Partnership name to DIABETES across the LIFECOURSE: Northern Australia Partnership. This was to encompass the movement of the program from mothers in pregnancy, to including a focus on: children born to mothers with diabetes in pregnancy, diabetes prevention in children, and Aboriginal and Torres Strait Islander youth with type 2 diabetes.
Diabetes in pregnancy (DIP) is associated with an increase in short-term and long-term health risks for mothers and their babies. It also provides a unique opportunity to improve the future health outcomes of women and their babies.
Our research impact:
- Has supported the response to intergenerational diabetes by building the responsiveness and health system capacity and further defining research priorities;
- Improved identification of diabetes in pregnancy among women at high risk of diabetes in pregnancy (80% increase in the NT); enhancing early screening practices (20% increase in earlier diabetes in pregnancy diagnosis) and improving data about diabetes in pregnancy, including maternal/baby’s outcomes (through implementation of the NT and FNQ Diabetes in Pregnancy Clinical Registers and Models of Care activities)
- Directly influenced national and state/territory policy including: the Australasian Diabetes in Pregnancy Society’s audit policies, the National Diabetes Strategy and the priorities of the Northern Territory Diabetes Network
- Been translated into clinical guidelines ensuring that clinicians are cognisant of factors relating to intergenerational diabetes (including the first CARPA guidelines relating to type 2 diabetes in children) and the remote context.
Key staff:
- Associate Professor Renae Kirkham - Principal Research Fellow and Lead of the Diabetes across the Lifecourse: Northern Australia Partnership
- Professor Louise Maple-Brown - Menzies Deputy Director of Research and Principal Chief Investigator
- Sian Graham - Aboriginal & Torres Strait Islander Advisory Group Chair
- Anthony Gunther - Program Manager
- eGFR study: accurate assessment of renal function and progression of chronic kidney disease in Indigenous Australians
- PANDORA
- A life course approach to reduce intergenerational diabetes in remote northern Australia through improved systems of care and consumer engagement
- NT & FNQ Diabetes in Pregnancy Partnership – Clinical Register & Models of Care
- Improving pre-conception health
- Youth Diabetes
- Diabetes Prevention
- Intergenerational Health in the Northern Territory (I-HiNT)
- The DRUID study: diabetes and related disorders in urban Indigenous people in the Darwin region
- Live Strong, COVID-Safe and frailty free after starting dialysis
- Cardiovascular Risk in Indigenous People (CRISP) study
- Dias T, MacKay D, Canuto K, Boyle JA, D’Antoine H, Hampton D, Martin K, Phillips J, Bartlett N, Mcintyre HD, Graham S, Corpus S, Connors C, McCarthy L, Kirkham R and Maple-Brown LJ (2024) Supporting healthy lifestyles for First Nations women and communities through co-design: lessons and early findings from remote Northern Australia. Front. Clin. Diabetes Healthc. 5:1356060. doi: 10.3389/fcdhc.2024.1356060. Supporting healthy lifestyles for First Nations women and communities through co-design: lessons and early findings from remote Northern Australia
- Kirkham R, Puszka S, Titmuss A, Freeman N, Weaver E, Morris J, Mack S, O’Donnell V, Boffa J, Dowler J, Ellis E, Corpus S, Graham S, Scott L, Sinha AK, Connors C, Shaw JE, Azzopardi P, Brown A, Davis E, Wicklow B, Maple-Brown L. Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol. BMJ Open. 2024 Mar 7;14(3):e080328. doi: 10.1136/bmjopen-2023-080328. Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol – BMJ Open
- Correa-Rotter, R., Maple-Brown, L.J., Sahay, R. et al. New and emerging therapies for diabetic kidney disease. Nat Rev Nephrol 20, 156–160 (2024). doi.org/10.1038/s41581-023-00782-1. New and emerging therapies for diabetic kidney disease
- Graham S, Wood A. Working in Partnership with Aboriginal and Torres Strait Islander people to change the diabetes story. Australian Diabetes Educator. 2023 Dec. Volume 26:4. Working in Partnership with Aboriginal and Torres Strait Islander people to change the diabetes story
- McLean A, Barr E, Tabuai G, Murphy HR, Maple-Brown L. Continuous Glucose Monitoring Metrics in High-Risk Pregnant Women with Type 2 Diabetes. Diabetes Technol Ther. 2023 Oct 30. doi: 10.1089/dia.2023.0300. Epub ahead of print. Continuous Glucose Monitoring Metrics in High-Risk Pregnant Women with Type 2 Diabetes – Diabetes Technology & Therapeutics
- Walker AF, Graham S, Maple-Brown L, Egede LE, Campbell JA, Walker RJ, Wade AN, Mbanya JC, Long JA, Yajnik C, Thomas N, Ebekozien O, Odugbesan O, DiMeglio LA, Agarwal S. Interventions to address global inequity in diabetes: international progress. Lancet. 2023 Jun 22:S0140-6736(23)00914-5. doi: 10.1016/S0140-6736(23)00914-5. Epub ahead of print. Interventions to address global inequity in diabetes: international progress – ScienceDirect
- Agarwal S, Wade AN, Mbanya JC, Yajnik C, Thomas N, Egede LE, Campbell JA, Walker RJ, Maple-Brown L, Graham S. The role of structural racism and geographical inequity in diabetes outcomes. Lancet. 2023 Jun 22:S0140-6736(23)00909-1. doi: 10.1016/S0140-6736(23)00909-1. Epub ahead of print. The role of structural racism and geographical inequity in diabetes outcomes – ScienceDirect
- Wicks M, Hampshire C, Campbell J, Maple-Brown L, Kirkham R. Racial microaggressions and interculturality in remote Central Australian Aboriginal healthcare. Int J Equity Health. 2023 May 25;22(1):103. doi: 10.1186/s12939-023-01897-4. Racial microaggressions and interculturality in remote Central Australian Aboriginal healthcare
- Hare MJL, Maple-Brown LJ, Shaw JE, Boyle JA, Lawton PD, Barr ELM, Guthridge S, Webster V, Hampton D, Singh G, Dyck RF, Barzi F. Risk of kidney disease following a pregnancy complicated by diabetes: a longitudinal, population-based data-linkage study among Aboriginal women in the Northern Territory, Australia. Diabetologia. 2023 May;66(5):837-846. doi: 10.1007/s00125-023-05868-w. Epub 2023 Jan 18. Risk of kidney disease following a pregnancy complicated by diabetes: a longitudinal, population-based data-linkage study among Aboriginal women in the Northern Territory, Australia – SpringerLink
- McLean A, Sinha A, Barr E, Maple-Brown L. Feasibility and Acceptability of Intermittently Scanned Continuous Glucose Monitoring for Women With Type 2 Diabetes in Pregnancy. J Diabetes Sci Technol. 2022 Sep 19:19322968221124956. doi: 10.1177/19322968221124956. Epub ahead of print. Feasibility and Acceptability of Intermittently Scanned Continuous Glucose Monitoring for Women With Type 2 Diabetes in Pregnancy – PubMed (nih.gov)