Although it is well established that glycaemic control is closely linked to development of diabetes-related complications, elevated glycaemic control indicates a reduced adherence to treatment measures and/or the necessary lifestyle changes (eg, diet care, physical activity, use of medication, blood glucose monitoring).] Treatment inertia and undertreatment are also associated with individuals not reaching target levels.] Adequate T2D management among Indigenous populations in particular has been identified as a challenge that requires urgent attention.] Barriers experienced by Indigenous peoples with T2D relating to glycaemic control include an obesogenic environment, geographic isolation and fragmented services,] ongoing impacts of colonisation, political and social challenges] and cultural differences between health services, medical professionals and Indigenous communities.] These structural-level barriers have a cumulative effect on Indigenous peoples. Diet, exercise and lifestyle prescriptions in primary care achieve mixed results, suggesting there may be an “unknown” factor. In New Zealand’s current primary care environment, treatment is heavily focused on medicine. Treatment of type 2 diabetes mellitus (T2D) seeks to reduce blood glucose levels through diet, exercise, lifestyle changes and, where necessary, the use of medication.
DOWNLOAD SPSS 21 FREE TRIAL DRIVER
Diabetes is being experienced at epidemic rates and is disproportionately affecting Indigenous peoples.] In Aotearoa New Zealand, diabetes age-standardised prevalence is 1.6–2.4-times higher for Māori compared to those of European ethnicity.] This is associated with significant complications from the burden of diabetes, with increased rates of cardiac complications, renal failure and amputation] and, most importantly, avoidable mortality for Māori.] Overall, Māori have a 1.8-times greater health burden than non-Māori and a nine-year lower average life expectancy.] Research into the different rates point towards obligations under Te Tiriti o Waitangi as a fundamental driver of the unequal distribution of the determinants of health and inaction in the face of need.]