TY - JOUR
T1 - Complications of diabetes in urban Indigenous Australians
T2 - The DRUID study
AU - Maple-Brown, Louise
AU - Cunningham, Joan
AU - Dunne, Karin
AU - Whitbread, Cherie
AU - Howard, Diane
AU - Weeramanthri, Tarun
AU - Tatipata, Shaun
AU - Dunbar, Terry
AU - Harper, Colin A.
AU - Taylor, Hugh R.
AU - Zimmet, Paul
AU - O'Dea, Kerin
AU - Shaw, Jonathan E.
N1 - Funding Information:
The authors gratefully acknowledge the support of DRUID study participants, study staff, members of the Indigenous Steering Group, and partner organisations. The DRUID Study was funded by the National Health and Medical Research Council (NHMRC Project Grant #236207), with additional support from the Australian Government Department of Employment and Workplace Relations, the Clive and Vera Ramaciotti Foundation, the Vincent Fairfax Family Foundation, the International Diabetes Institute (AusDiab Partnership), and Bayer HealthCare. The DRUID Study is an in-kind project of the Cooperative Research Centre for Aboriginal Health. LMB had a NHMRC Scholarship 2003-5 and is supported by the Centre of Clinical Research Excellence in Clinical Science in Diabetes, University of Melbourne. JC was supported by a NHMRC Career Development Award (#283310). Funding sources played no role in the study design, in the collection, analysis and interpretation of the data, in the writing of the manuscript, or in the decision to submit the manuscript for publication.
PY - 2008/6
Y1 - 2008/6
N2 - Aims: To accurately assess the management and complications of type 2 diabetes in urban Indigenous Australians and compare the risk of complications with a general Australian population (AusDiab Study). Methods: The Darwin Region Urban Indigenous Diabetes (DRUID) Study included 1004 volunteers aged ≥15 years; diabetes status was classifiable for 866. The assessment of diabetic complications and metabolic control was performed in participants with known diabetes (KDM) and diabetes newly diagnosed by the study (NDM) using an interviewer-administered questionnaire and clinical examination. Results: Among 172 DRUID participants eligible for complications assessment, 135 were assessed, including 99 KDM (mean age 53 years) and 36 NDM (mean age 47 years). Percentages of KDM participants meeting therapeutic targets were: HbA1c < 7%, 29%; blood pressure < 130/80 mmHg, 45%; total cholesterol < 5.5mmol/L, 65%. Among KDM, 39% had albuminuria, 21% retinopathy, 12% peripheral vascular disease (PVD), 9% neuropathy. Factors independently associated with diabetic complications were: albuminuria-HbA1c, systolic blood pressure; retinopathy-diabetes duration; PVD-age. Compared to AusDiab participants after adjusting for other risk factors, DRUID participants had 2-3-fold increased risk of albuminuria and PVD and a non-significant increased risk of neuropathy, but no increased risk of retinopathy. Conclusions: Urban Indigenous Australians with diabetes are relatively young and have poor glycaemic control. Compared to the general Australian population with type 2 diabetes, they have greater adjusted risk of albuminuria and PVD but not retinopathy. Urgent action is required to prevent diabetes at a population level and improve diabetes management in this high-risk population.
AB - Aims: To accurately assess the management and complications of type 2 diabetes in urban Indigenous Australians and compare the risk of complications with a general Australian population (AusDiab Study). Methods: The Darwin Region Urban Indigenous Diabetes (DRUID) Study included 1004 volunteers aged ≥15 years; diabetes status was classifiable for 866. The assessment of diabetic complications and metabolic control was performed in participants with known diabetes (KDM) and diabetes newly diagnosed by the study (NDM) using an interviewer-administered questionnaire and clinical examination. Results: Among 172 DRUID participants eligible for complications assessment, 135 were assessed, including 99 KDM (mean age 53 years) and 36 NDM (mean age 47 years). Percentages of KDM participants meeting therapeutic targets were: HbA1c < 7%, 29%; blood pressure < 130/80 mmHg, 45%; total cholesterol < 5.5mmol/L, 65%. Among KDM, 39% had albuminuria, 21% retinopathy, 12% peripheral vascular disease (PVD), 9% neuropathy. Factors independently associated with diabetic complications were: albuminuria-HbA1c, systolic blood pressure; retinopathy-diabetes duration; PVD-age. Compared to AusDiab participants after adjusting for other risk factors, DRUID participants had 2-3-fold increased risk of albuminuria and PVD and a non-significant increased risk of neuropathy, but no increased risk of retinopathy. Conclusions: Urban Indigenous Australians with diabetes are relatively young and have poor glycaemic control. Compared to the general Australian population with type 2 diabetes, they have greater adjusted risk of albuminuria and PVD but not retinopathy. Urgent action is required to prevent diabetes at a population level and improve diabetes management in this high-risk population.
KW - Albuminuria
KW - Diabetes management
KW - Indigenous Australian
KW - Neuropathy
KW - Peripheral vascular disease
KW - Retinopathy
UR - http://www.scopus.com/inward/record.url?scp=43049167539&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2008.01.011
DO - 10.1016/j.diabres.2008.01.011
M3 - Article
C2 - 18294723
AN - SCOPUS:43049167539
SN - 0168-8227
VL - 80
SP - 455
EP - 462
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 3
ER -