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Pre-diabetes is a condition when sugar (glucose) levels are high but not high enough to be called diabetes [34460][45543]. While pre-diabetes is often seen in adults, children and adolescents can also develop the condition.
The risk factors for pre-diabetes are the same as those for type 2 diabetes, including being from an Aboriginal or Torres Strait Islander background [34460]. Pre-diabetes has no symptoms, and people who have pre-diabetes are at a higher risk of developing type 2 diabetes and cardiovascular disease.
A stroke happens when the blood supply to the brain is interrupted. Blood may stop moving through a blood vessel because it is blocked by a blood clot or plaque (ischaemic stroke) or because the blood vessel breaks or bursts (haemorrhagic stroke) [47220].
One way to think about blood supply is to compare it to a river flowing through the body [31070]. Sometimes this river gets filled with junk and gets dammed up, like the blocked blood vessel that causes an ischaemic stroke. Sometimes the river breaks at its weakest point and floods, like the burst blood vessel that causes a haemorrhagic stroke. This way of thinking about stroke was developed by some Aboriginal people in the Hunter New England part of New South Wales, and is illustrated using artwork in the booklet Stroke: Written by the Mob for the Mob.
Aboriginal and Torres Strait Islander people experience stroke often, and at relatively young ages [44195] [41463]. A lot of Aboriginal and Torres Strait Islander people have a disability caused by stroke, and stroke is responsible for many Aboriginal and Torres Strait Islander deaths [41528] [42101] [41463]. In part, this is because the risk factors for stroke, such as diabetes, are fairly common among Aboriginal and Torres Strait Islander people [41528]. The risk factors for stroke include:
It is important that all people who have a stroke receive equally good care, particularly in hospital. Unfortunately, some research has found that Aboriginal and Torres Strait Islander people are less likely to receive best-practice stroke care, often due to the availability of services in rural and remote areas, access to interpreters, racism and being away from Country and their family support for treatment [38136] [38273] [36805]. This could be improved with better telehealth services, practical resources and information for patients and increased cultural understanding among hospital staff and service providers.
Climate change refers to a change in weather patterns due to a rise in the Earth’s temperature. Some of this change is natural, but some changes in climate have also been caused by human actions, such as the burning of fossil fuels (oil, gas and coal). Climate change leads to rising sea levels, increasing temperatures and droughts, and extreme weather events such as floods and fires, all of which negatively impact on the built and natural environments, agriculture and the health and wellbeing of all people [30592].
Aboriginal and Torres Strait Islander people are especially vulnerable to the impacts of climate change, which can limit their access to healthy bush foods and disconnect them from Country, which can negatively impact their health and wellbeing. In remote areas of Australia, where there may be inadequate housing and limited energy supply or cooling appliances [45432], increases in temperature will see a rise in heat-related illness as well as the exacerbation of existing medical conditions [30592] [30675]. Extreme weather events such as cyclones and floods can damage the infrastructure in remote Aboriginal and Torres Strait Islander communities, cutting them off from services for long periods of time [47280].
In Australia, the process of ‘adaptation’ is a key focus for addressing these issues associated with climate change. Adaptation refers to the practical changes that people and communities can make to help them manage the issues that climate change will bring [47280] [44829], such as developing good evacuation and early warning processes for natural disasters, upgrading and strengthening buildings, managing energy use, and teaching people how to stay healthy in higher temperatures [30592]. Indigenous knowledges and traditional land management techniques used in caring for Country activities also contribute significantly to and enhance effective adaptation [46348].
There are also ways that Aboriginal and Torres Strait Islander people and communities can lessen some of the risks associated with climate change, including:
Gestational diabetes mellitus (GDM) occurs during pregnancy and is diagnosed when higher than normal blood glucose levels first appear [42386]. GDM usually goes away when the baby is born however it can return in later pregnancies. There is also an increased risk of developing type 2 diabetes for the mother and child in the future.
GDM can cause complications during pregnancy, labour and delivery. Resources such as Sharing the diabetes in pregnancy story [47946], aim to provide Aboriginal and Torres Strait Islander women with information about GDM and the journey from testing, preparing for the baby’s arrival to after the baby is born.
To improve GDM outcomes among Aboriginal and Torres Strait Islander mothers and babies [44185], the Australian national diabetes strategy 2021-2030 highlights the need to provide and promote pre-pregnancy programs, detect and manage GDM during pregnancy, and coordinate follow-up and postnatal care.
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