There are over 476 million members of Indigenous groups in at least 90 countries throughout the world, the report notes — accounting for 6.2% of the global population. There is no single standard for defining Indigenous groups or people who belong to them, so the report focuses on Indigenous peoples as defined or recognized by individual counties or local communities. The report notes that Indigenous peoples face unique challenges that may result in health disparities — the result of practices like loss of land and resources, attempts by outside groups to discourage or erase cultural practices and languages, and psychological trauma across generations due to forced displacement, discrimination, and violence. As a result, “one of the most consistent observations has been an increase in type 2 diabetes” in these groups over time.
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The report is divided into two sections — one focusing on adults ages 18 and older, and another focusing on people ages 30 and younger. Each section is based on a wide-ranging review of studies on type 2 diabetes in Indigenous populations.
Type 2 diabetes rates up among Indigenous adults
In their review of studies on Indigenous adults ages 18 and older, the researchers found that in 19 out of 25 studies with sex-specific data, women had a higher rate of type 2 diabetes than men — and in some cases, the rate of type 2 among Indigenous women was more than twice the rate among Indigenous men. There was a wide range of rates of type 2 diabetes in various Indigenous groups around the world, but the rate was over 10% in about 70% of studies included in the review. This review was quite limited due to the lack of available data in most countries — only 16 countries were represented, out of about 90 with known Indigenous populations.
Among North American Indigenous groups, the highest rate of type 2 diabetes was seen in a study that looked at members of Canadian First Nations ages 50 and older, which found that nearly 40% of that population had type 2 diabetes. About 25% of all First Nations peoples had type 2 diabetes regardless of age, and a similar rate was seen among U.S. members of the Chicksaw-Choctaw Nation. Some of the lowest rates of type 2 diabetes were seen among Alaska Natives and Inuit in Canada, with several studies finding these rates to be in the single digits. Many studies found rates of type 2 diabetes between 10% and 20% among Indigenous peoples throughout the continental United States.
Worldwide, some of the highest rates of type 2 diabetes were seen among Indigenous Pacific Islanders, with rates close to 40% seen among populations in Fiji, the Marshall Islands, Micronesia, and Australia. But low rates of type 2 diabetes, int he single digits, were seen among Indigenous groups in the Solomon Islands and New Zealand. Low rates of type 2 were also seen in certain Indigenous groups in Guatemala, Brazil, and India.
Limited data on type 2 among Indigenous young people
Most studies on diabetes among Indigenous younger people (ages 30 and under) didn’t separate type 1 and type 2 diabetes, the researchers note — so it’s difficult to follow trends in type 2 diabetes in these groups. But the researchers did find alarmingly high rates of type 2 diabetes in certain Indigenous youth populations — including Central Australian First Nations, with a rate that exceeded 30%.
In the United States, the highest rate of type 2 among young people — over 10% — was seen in the Cherokee Nation in Oklahoma, and a broader study of Indigenous young people in the Great Plains also found a rate of about 10%. Several groups had a type 2 diabetes rate in the low single digits, but it’s unclear how complete this data is. Overall, there was data on Indigenous youth type 2 diabetes rates from only four countries — the United States, Canada, Australia, and New Zealand.
“Future surveillance should report age-specific [type 2 diabetes] prevalence to capture differences that might be associated with age-related physiological changes in childhood and adolescence,” the researchers wrote, noting that research is also needed on factors that may contribute to type 2 diabetes among Indigenous young people — such as genetic factors, childhood obesity, health access, and other cultural, social, and economic factors.
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