Louise Maple-Brown is Head of Department of Endocrinology, Royal Darwin Hospital and an NHMRC Practitioner Fellow with Menzies School of Health Research. Louise leads the clinical research program within the Wellbeing and Preventable Chronic Diseases division of Menzies, with a focus on diabetes and related conditions in Indigenous Australians. Currently Louise is the lead investigator on several large NHMRC-funded projects, including The eGFR study (Accurate assessment and progression of kidney damage in Indigenous Australians) and the Northern Territory and Far North Queensland Diabetes in Pregnancy Partnership. After completing the majority of her physician and endocrinology training at St Vincents Hospital Sydney, Louise moved to Darwin in 2002 to pursue her passion for improving the health of Indigenous Australians. Louise is currently on the Australian Diabetes Society Council and was previously a member of the Council of the Australasian Diabetes in Pregnancy Society. Louise has been providing clinical diabetes services to urban and remote NT communities for over 14 years, including more recently via telehealth. ABSTRACTS Maple-Brown L1,2 1 Menzies School of Health Research, NT, Australia 2 Division of Medicine, Royal Darwin Hospital, NT, Australia In the context of the escalating epidemic of chronic diseases among Indigenous Australians, it is vital that we reduce risk as early as possible in the life course of an individual. We have developed a partnership between researchers, health care providers and policy organisations in the Northern Territory (NT), to address the issue of diabetes in pregnancy (DIP) in the high-risk population of the NT (where 38% of babies are born to Indigenous mothers). The aims of the NT DIP Partnership are to: improve systems and service delivery for all women in the NT with DIP; reduce the gap between evidence and clinical practice in relation to screening, management and post-partum follow-up of women with DIP and their babies; and to establish systems that enable close monitoring of relevant clinical outcomes for mothers and babies. The NT DIP Partnership is working to improve coordination of care between different healthcare providers, and we have established a central electronic clinical register to assist with improved care coordination. We are working to increase support and communication between health professionals by increasing the use of telehealth facilities, holding regular stakeholder forums for communication, conducting regular education sessions for remote primary health care staff, and providing regular updates with local data from the DIP Clinical register to maintain clinician engagement. Facilitating clinical forums between disciplines has allowed simple issues to be resolved in a timely manner. We are working with health service providers to develop strategies to improve maternal health pre-conception and between pregnancies, particularly among young women with Type 2 diabetes themselves. We have been overwhelmed by the enthusiastic engagement of health service providers to improve our models of care for DIP in the NT, and look forward to continuing to work together to improve outcomes in this important area. Strategies to address the challenges of youth-onset Type 2 diabetes among Aboriginal and Torres Strait Islander communities Maple-Brown L1,2 1 Menzies School of Health Research, NT, Australia 2 Division of Medicine, Royal Darwin Hospital, NT, Australia Rates of type 2 diabetes among Indigenous Australian youth are greater than among non-Indigenous youth and appear to be rising. Recent data from Western Australia revealed a twenty-fold higher mean incidence of youth-onset type 2 diabetes among Indigenous than non-Indigenous Australian youth. Indigenous youth with diabetes are more likely to be female, are frequently (but not always) obese, and experience complications of diabetes at a relatively young age. Challenges as a health care provider for this high risk population include addressing the social determinants of health, psycho-social stressors, issues of remoteness and limited resources. Strategies to address the emerging epidemic of type 2 diabetes among Indigenous youth need to commence as early as possible in the life-course. Opportunities to address the intergenerational nature of type 2 diabetes among Aboriginal and Torres Strait Islander communities include improving maternal health pre-conception and between pregnancies, particularly among young women with Type 2 diabetes themselves, optimising antenatal care, supporting breastfeeding and other early nutritional interventions. |
