The Deadly Epidemic of Diabetes Expands among the Indigenous

While the prevalence of diabetes in 2011 was 8.3% worldwide, it has reached levels of up to 44% in some indigenous peoples. Considered the world’s largest undiagnosed epidemic, those afflicted do not receive adequate treatment and many die without knowing the reason for their suffering.

Translated from an article by Sybila Tabra and Jorge Agurto on Servindi, published 7th March.

Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body does not effectively use the insulin it produces. This condition eventually damages many organs and systems, especially the nerves and blood vessels.

The World Health Organization (WHO) indicates that there are two types of diabetes. Type 1 begins in childhood and is characterized by insufficient production of insulin, which requires daily administration of this hormone.

Type 2 occurs in adulthood, and is characterized by insufficient insulin use. The WHO indicates that this type accounts for 90% of global cases and is due to excess body weight and physical inactivity.

As reported by Ida Nicolaisen, there are high percentages of diabetes in indigenous peoples, especially among the inhabitants of the Torres Strait Islands of Australia where at least 44% of the population suffer from the disease.

On the Nauru Island in the Pacific, 28% of the population has diabetes, and 22% in Tonga.

According to a special issue of the journal Indigenous Affairs written by the International Work Group for Indigenous Affairs (IWGIA), diabetes levels reach 38% among the Pima people in U.S., 16.5% in the Navajo Indians (U.S. and Mexico) and 6.6% in the Canadian Inuits.

It is also reported that in Kathmandu, Nepal, no less that 19% of the population aged over 40 has diabetes. Furthermore, indigenous peoples of India are a high risk group.

One hypothesis related to the spread of the disease in these indigenous areas is that segments of indigenous people are forced to migrate to urban areas where they adapt to a diet predominating in junk food and packaged products.

This occurs because they can no longer grow on their traditional lands, which are often seized or “legally” dispossessed by mining or construction businesses. Alternatively, they are forced to leave their homes because of war or environmental disasters.

The dependence on industrialized food consumption has brought an alarming rise in the rates of obesity-related diseases and type 2 diabetes.

This is demonstrated by the inhabitants of the Pacific Islands, where over the last forty years there has been a steady and consistent erosion of food security.

In Tonga, consumption of imported meat with high fat content such as sausages, leftover lamb, leftover chicken and corned beef increased dramatically over the last 20 years, and reached about 56 kg per person per year in 1999.

Indigenous peoples receive little public attention despite being one of the most vulnerable groups to diabetes, due to changing consumer habits and social and genetic factors, among other reasons.

Most of the indigenous peoples from diverse parts of the world are not diagnosed with diabetes during early stages of the condition, do not receive adequate or sufficient treatment and die without knowing the reason for their suffering.

Paul Zimmet, director of the Diabetes Institute opened the three-day international conference in Melbourne on diabetes in 2006 by stating that we are facing the biggest epidemic in world history.

He also said that without urgent action there is a real risk of a major disappearance or mass extinction of indigenous communities by the end of this century.

Faced with this problem, a number of indigenous groups are taking steps to try to change their situation.

Among the inhabitants of the Pacific islands, it has been possible to return to traditional models of cultivation and consumption of foods with low energy content in order to reduce the epidemic of obesity-driven diabetes.

Diabetes in Mato Grosso, Brazil

A survey conducted in 2011 by the Universidad Federal de São Paulo (Unifesp) found 30 cases of diabetes in each group of one thousand indigenous people in the State of Mato Grosso, which is 1500% higher than in the white population, where there are two cases per thousand.

The main causes of the spread of the disease include a changing diet, that traditionally compromised of foods such as corn, squash, beans, yams, cassava and game meat, and a sedentary lifestyle, which extends alarmingly between tribes.

The research was conducted on 3200 indigenous people in two villages of the Xavante ethnic group; Sangradouro, located between the cities General Carneiro, New Joaquim and Poxoréu, and San Marcos, 120 km from Sangradouro.

A group of 382 Indians over 30 years of age were studied. Type 2 diabetes, which has a strong relationship with obesity and sedentary lifestyles, was confirmed in 21% of them. The prevalence was higher in women over 40 years, where the rate reached 50%.

Facts and figures about diabetes

A report by the International Diabetes Federation (Atlas of the IDF, 5th Edition, 2011), stated that the number of people with diabetes in the world today aged between 20 and 79 years is 366 200 000, which corresponds to 8.3% of the population.

By 2030 it is estimated that the total number of diabetics will be 551.8 million (one in every ten adults), which would mean an increase of 51% compared to 2011.

Additionally, considering that in 2011 280 million people suffer from Impaired Glucose Tolerance, the stage prior to the development of diabetes as a disease, the total number of people who could become diabetic is 646.2 million. This is an alarming statistic given the consequences of cardiovascular, neurological, kidney, eye and dermal diseases.

Overall in 2011 there were 4.6 million deaths from diabetes, an increase of 13.3% compared to 2010. Of this total, 48% occur in people under 60 years of age, which is considered preventable from the point of view of public health.

80% of people with diabetes live in low and middle income countries, severely exacerbating their capacity to prevent it.
Health costs due to diabetes account for 11% of total 2011 health expenditure, which amounted to 465 billion dollars in the United States. It is worth noting that only 20% of this sum was invested in countries of low and middle income, even though 80% of diabetics in the world live in these countries. This indicates the great inequality of resources for treatment. US$ 271 is invested per person in countries of low and middle income compared to US$ 5,063 in the developed world.

Deborah Rivett, Saturday, 09 March 2013