The growing problem of diabetes is a key contributor to the gaps in health and life expectancy in Indigenous Australians. The causes of the gap are multifactorial and complex, with links to poverty, remoteness and low levels of health literacy and education. Management of diabetes in the Indigenous population requires new, aggressive and innovative management approaches, focusing on primary care resources and new therapies to reduce the burden of complications and disability.
• The gap in life expectancy between Indigenous and non-Indigenous Australians is about 10 years, with chronic disease accounting for two-thirds of the gap.
• Diabetes is highly prevalent in Indigenous Australians, with a prevalence three times that of the national rate.
• Diabetes in Indigenous populations is associated with poorer blood glucose control and higher morbidity due to multiple complex factors, including genetics, poverty, remoteness and poor health literacy.
• The Australian Government has introduced important long-term goals and initiatives aimed at reducing the gap; however, to date these have not had a significant impact.
• Urgent support and resources at a primary care level, including new therapies and models of care, are needed to reduce the shocking outcomes that may ultimately widen rather than narrow the gap.