Budyari Community Health Centre at Miller in South West of Sydney offers a comprehensive program for the local Aboriginal population with or at risk of chronic disease. The health care team consists of Aboriginal health care workers, Diabetes Educator, Dietitian, Renal Nurse, visiting Endocrinologist, Renal Physician, Podiatrist and Optometrist. A peer-led education program for the local community with chronic disease is planned.
1. Assess in patients with type 2 diabetes (T2DM) the trend over time in demographic, anthropometric and metabolic parameters and diabetes related complications.
2. Identify areas that require targeted education to improve outcomes.
39 patients with T2DM were included. The first patient was enrolled in 1999. T2DM treatment and complications, body mass index (BMI), blood pressure (BP) and metabolic parameters were assessed at enrollment and most recent review.
Mean age 60.5 years, 26 females and 13 males. 31 (79%) patients are Aboriginal. Average duration of diabetes is 13 years. Mean duration of follow up 4.2 years. 26 (66.7%) patients are on oral hypoglycaemic agents (OHA), 11 (28%) on OHA and insulin. 22 (56%) patients have macrovascular complications (IHD 64%, PVD 22%, strokes 14%) whereas 29 (74%) patients have microvascular complications (nephropathy 57%, peripheral neuropathy 29%, retinopathy 14%). Mean BMI remained stable from 37.5 kg/m2 to 37.7 kg/m2. HbA1c decreased from 9.1%, to 8.6%, lipid profile improved from cholesterol 4.9, triglycerides 2.4 mmol/l to cholesterol 4.4, and triglycerides 2.1mmol/l. Percentage of patients achieving target BP increased from 59% to 67%. 26.3% of patients continued smoking. Urine albumin creatinine ratio remained elevated around 23 mg/mmol and creatinine increased from 77.6 to 94.4 umol/L.
Aboriginal individuals with T2DM receiving multidiscinplinary care can achieve improvements in HbA1c and lipid profile. The planned peer-led education program will focus on weight loss, stabilisation of renal function and smoking cessation.