Nine years ago our predecessor the CRC for Aboriginal Health was involved in a major project looking at the burden of diabetes and related chronic conditions, such as kidney disease and heart disease, among Aboriginal and Torres Strait Islander people living in and around Darwin. Now, a follow-up study is set to look at how people’s health changes over time.
Research has shown that diabetes significantly increases the risk of cardiovascular disease (CVD), and that both diabetes and CVD represent a serious public health problem among Australia’s First Peoples. Compared with other Australians, Aboriginal and Torres Strait Islander people experience about three times the death rate from CVD and about seven times the death rate from diabetes. However, these differentials are much greater among younger people because they experience diabetes and CVD at a much earlier age. Therefore, the prevention of diabetes and CVD is important to reduce the discrepancies in health status between Aboriginal and Torres Strait Islander and other Australians.
The original Darwin Region Urban Indigenous Diabetes (DRUID) Study included 1004 men and women volunteers aged ≥15 years and was conducted from September 2003 to March 2005. Participants underwent a health examination that involved blood and urine tests, clinical and anthropometric measurements, and administration of questionnaires. Of those aged ≥55 years, half were found to have diabetes. Even among younger people aged <35 years without diabetes, 45 per cent had at least two CVD risk factors, with very few having no risk factors. Thus, the future burden of CVD in this population is likely to be great, and follow-up data on premature mortality, fatal and non-fatal CVD and related conditions is now required.
The next phase – the DRUID Follow-up Study – has received funding from the Diabetes Australia Research Trust, a National Health and Medical Research Council Program Grant (#631947: Improving Chronic Disease Outcomes for Indigenous Australians: Causes, Interventions, System Change) and the Northern Territory Research and Innovation Board. The study will look at how people’s health changes over time, and what factors are important in predicting who gets diabetes, heart disease and other health problems, and who stays well. The study investigators – including several who worked on the original DRUID Study – will work with the Indigenous Steering Group who will provide guidance on the conduct of the study and dissemination of its findings.
To obtain the most complete information on outcomes, while minimising the burden on participants, both passive and active follow-up methods will be undertaken. Passive follow-up will involve data linkage of consenting original participants (~90%) to the National Death Index, Northern Territory and South Australian hospital databases, and NT pathology laboratories. Active follow-up will entail inviting participants who consented to be contacted again (~90%) to answer a short questionnaire and, with permission, participants’ medical records will be reviewed to verify self-reported events.
The DRUID Follow-up Study aims to advance our understanding on the links between diabetes and related metabolic disorders and CVD and mortality in urban Aboriginal and Torres Strait Islander Australians. Additionally, the influence of other factors such as poverty and poor educational outcomes on these relationships will be explored. It is hoped that this new information will assist health workers to find and treat risk factors for diabetes and heart disease much earlier, and help keep people healthy and strong.
A full list of publications from the original DRUID Study, as well as further details on the DRUID Follow-up Study, can be found on the Menzies School of Health Research website.