An innovative study, co-designed by Aboriginal women, has led to a 30 per cent remission of type 2 diabetes.
The study described and measured how using Shared Medical Appointments, continuous glucose monitors and a sustainable, culturally relevant food program can develop self-management knowledge, skills and motivation to drastically improve glycaemic control in First Nation women.
This research was the first of its kind in Australia, led by South Coast Women’s Health and Wellbeing Aboriginal Corporation (Waminda) in collaboration with Southern Cross University and the Australasian Society of Lifestyle Medicine.
The study also incorporated culturally responsive activities, including food appreciation sessions tailored to First Nations people of the Yuin Nation, on the South Coast NSW.
Lead investigator and Southern Cross University lecturer Associate Professor John Stevens said of the 25 women who’d been living with diabetes for more than 10 years, seven women completely reversed their diabetes for at least 12 months, and 18 women reduced their blood sugars to a healthier level.
‘These women were empowered to make decisions about what was going to happen, and led to high engagement in the program and remarkable success,’ said Associate Professor Stevens.
‘The tailored eight-week lifestyle medicine course used the Shared Medical Appointment process, where the clinician – in this case a general practitioner – was just another member of the group, adding their knowledge and skills to the mix, encouraging self-management and pride in the way these women had already managed their health, and offering guidance on behavioural change techniques that really made a difference.
‘Statistically significant improvements were also observed for weight, systolic blood pressure, liver enzymes, blood glucose time-in-range, and diabetes scores indicating improved self-management of type 2 diabetes mellitus,’ said Associate Professor Stevens.
‘It’s amazing how quickly these group bond with each other because everyone really empathises with where each person is at.’
In control
Hayley Longbottom, Waminda Chief Executive Officer and co-author says the approach gives Aboriginal women the tools to feel in control to create self-determining outcomes.
‘The Continuous Glucose Monitoring, alongside health coaching from diabetes educators, provided a unique experience for these women to learn about their own bodies and not only manage but reverse their diabetes, with Aboriginal Health Practitioners providing long-term support,’ said Ms Longbottom.
Southern Cross University is the first in Australia trialling the concept of Shared Medical Appointments (SMAs), with Professor Stevens – cofounder of the Lifestyle Medicine movement in Australia – explaining how SMAs are one of the best ways to deal with chronic disease.
The format consists of groups of eight to 15 people who share a common health issue or diagnosis with a health care practitioner, such as a GP or nurse, who facilitates a discussion about beneficial lifestyle changes for all participants as well as individual consults within the group setting.
Participants have said in feedback that ‘Shared Medical Appointments are how Aboriginal people have always done health care … and so now we are keen to re-engage with services that we had been avoiding’.
Professor Stevens says this innovative study represents a significant step forward in addressing the disproportionate impact of type 2 diabetes on First Nation communities in Australia and overseas, offering a promising model for culturally appropriate diabetes care.
The full study was published in the American Journal of Lifestyle Medicine: https://journals.sagepub.com/doi/pdf/10.1177/15598276241312084.
You can learn more about studying Lifestyle Medicine at Southern Cross University here.
