Discuss the current status of Australian Indigenous health focusing on Diabetes.-Briefly outline the extent of Diabetes that indigenous Australian experience (i.e. epidemiology)[<1 page]-Briefly describe the clinical aspects of the condition[1 paragraph] -Analyse the possible reasons for the current health status of Indigenous people in relation to Diabetes. -Discuss the implications for nursing practice and finally a)briefly outline the current interventions that the government or other organisations are taking and b)briefly describe any possible future solutions that might improve Indigenous health for diabetes. Introduction Australia is one of the most developed countries in the world with one of the best Gross Domestic Product (GDP) growth rates and Producer Price Index (PPI). It has one of the best health systems as well. The health system is however biased as some people in Australia do not have access to good healthcare especially the Aborigines who are the natives of Australia. They live in marginalized areas where there are no hospitals or clinics do not earn well from employment and do not feed well. As such Aborigines health is very poor compared to other Australians. Statistics indicate that only about forty percent of Aborigines are in good health compared to more than 80% of other Australians. This affects the mortality rate of these people which is more than two times the non-indigenous Australians. Poor healthcare to Aborigines and their lifestyles increase chances of getting chronic diseases like diabetes. Diabetes is one of the diseases that has increased Aborigine mortality rate in the recent years. There are few clinics and healthcare centers in regions where aborigines live and their diet is also poor. At the same time many cannot afford medication. More than 30% of the entire Aborigine population has diabetes. In addition the government has been doing little to Aborigine health. Less than one percent of the national budget was used on Aborigine health. This is little money and may not have a high impact on the Aborigine health. Health experts and civil rights have lobbied the government to invest more in Aborigine healthcare. This paper will discuss Australian Indigenous Health specifically diabetes the current trends why Aborigines are affected more than Non-Aboriginal Australians strategies used to mitigate Diabetes and what can be done to improve the current intervention measures and strategies. Epidemiology Diabetes is one of the most common chronic conditions in the world today. The disease is as a result of low production of insulin which is responsible for regulating blood sugar in the body. Diabetes is characterized by high levels of blood sugar and can adversely affect the general health of the patient. The condition makes the body weak making the patient susceptible to opportunistic conditions which can even lead to death. There are two common types of Diabetes Type 1 and Type 2. Type 1 diabetes is caused an autoimmune disease of the beta cells of the pancreas. These cells are responsible for the production of insulin which regulates blood sugar. Type 1 diabetes is most common in young people and accounts for 5 to 10% of the total diabetes patients. Type 2 diabetes is caused by health factors that have suppressing factors on the pancreas. Excess fats make it almost impossible for the beta cells to produce insulin and regulate body sugar. In fact more than 75% of people having type 2 diabetes are either overweight or obese. Type 2 is common in adults and accounts for 90 to 95% of all diabetic patients (Hawley and Dunstan 2008). There is no cure for either of the two types of diabetes but research and experiments are underway to find a cure. Currently diabetes is management is done to mitigate the risks that are associated these conditions for example (Thomas and Nestel 2007). Type 1 diabetes patients have to live on insulin shots. They inject insulin on their hands every day according to the physician instructions. Type 2 diabetes patients are advised to exercise to lose weight and cut fats in the body. They can also use pills if the former strategy does not work. Diabetes patients have to eat healthy and exercise often to mitigate the effects of the condition (Speight 2013). Prevalence of diabetes in Australia is relatively high currently ranked the fifth country. Diabetes is common among the elderly people. There is a higher prevalence of diabetes to Aborigines in Australia compared to non-Aborigines. According to Australian Institute of Health and Welfare prevalence in aborigines was three times that of other Australians in the year 2011. The number of diabetes caused deaths in aborigines was at a staggering seven times the number of other Australians. There is a high prevalence to diabetes in Aborigines in remote areas compared to aborigines living in urban centers (Marley et al 2012). Factors contributing to high diabetes prevalence in Australian Aborigines There are number of factors that contribute to the high vulnerability and prevalence of diabetes in Australian Aborigines Genetics Genetic composition of the Australian aborigines is relatively different from that of European Australians. Genetic researchers found that Aborigine body and genetic predisposition is that of making them efficient hunters. They have long legs small bodies narrow hips and narrow shoulders. This body structure makes them adapted to hunting as their ancestors did. Researchers confirmed that this body structure requires less energy for survival compared to other Australians. Trend has been changing fast and aborigines can no longer be hunters as they used to be in the past. Nowadays they have to integrate and blend with the other population and do what they do (Nabhan 2006). Aborigines no longer hunt and they do not have a lot of energy- cut fats consuming activities presently. Their bodies accumulate fats very fast because they are adapted to low energy consumption. Any excess food in the body is converted to fat and stored as fats. Therefore Aborigines are very susceptible to weight gain and obesity subsequently. A lot of fat in the body affects the beta cells of the pancreas by suppressing them making it impossible to produce the much- needed insulin. The amount of insulin produced keeps on decreasing leading to diabetes (Colagiuri et al 2010). Other researchers and experts have also found out that Australian Aborigines are less sensitive to insulin. People that are less sensitive to insulin need large amounts of the hormone for proper function in regulating blood sugar. When insulin levels start decreasing as aborigines gain weight there is a high chance that they will get diabetes type two sooner than other Australians. Non Aboriginal Australians are not at risk of getting diabetes even when insulin levels reduce slightly because they are more sensitive (Nolan Damm and Prentki 2011). According to Qiao the Australian Aborigines are likely to develop insulin resistance faster than other Australians. This is a condition in which there is genetic predisposition making the body reject insulin (Qiao 2012). This means that insulin is either not produced or not utilized when produced. It is thought insulin resistance and insulin insensitivity is caused by a defect in the stimulatory G-protein pathway that is responsible for secretion of insulin. Consequently body sugar is not regulated leading to increased blood sugar subsequently leading to diabetes mellitus (Lee and Kim 2007). Lifestyle The lifestyle of the Australian Aborigines is not only very different from other Australians but also extraordinary to some extent. According to the ancestors of the Aborigines consuming fats is good for their health. It was believed that fats have medicinal value and should be taken often. Most Aborigines still continue with this cultural practice to date. They isolate what they call good fats from animals and take them raw. The lifestyle of Australian Aborigines has changed much. Unlike in the past when they used to walk long distances and hunt they do not do much nowadays. Fats are likely to accumulate in their bodies and this could have an effect on the islets of Langerhans that are responsible for the production of insulin (Ghosh 2012). Aborigines are used to foods with high concentrations of fats. According to McDonald (2006) Aborigines like fatty foods as their ancestors taught them. Food to Aborigines shows a sense of belonging connection to a family link and to the past. McDonald approached a number of Aborigines in Kimberly region of Northern Australia and asked them about foods. All interviewees stated that were used to fatty foods which could be categorized into family food fast foods and diet foots. Family foods are taken together with other members of the family. Family means a lot to these people and taking food together shows a sense of f linkage. Fast foods are usually taken to satisfy hunger and have no social meaning to Aborigines. On the other hand diet foods are those that are taken without any preparation for instance raw fat or bush plants (McDonald 2006). Nutrition The traditional Aborigine hunter gatherer diet has been replaced with the western type of diet which is high in sugars and fats. Aborigines living in urban centers usually prefer fast foods which are usually much cheaper. Their income is relatively low and cannot afford to spend a lot of money on food. Aborigines in the rural areas take food with low dietary fibre high in fats saturated fats and sugar as (Dussat 2009) . In addition they do not have enough money to afford fruits which are sources of vitamins and important co-factors. Most urban-based Aborigines have also started using cigarettes and alcohol. Aborigines living in rural areas do not have access to fresh food supplies and fruits.