It's estimated that half a million Australians have type 2 diabetes without even knowing it.
The potentially fatal condition affects Aboriginal and Torres Strait Islander people disproportionately, as much as four times the rate of non-Indigenous Australians. Because of this, a growing group of experts is calling for drastic change from health authorities in their approach to this epidemic.
In a new and upcoming 3-part series on SBS, Australia’s Health Revolution with Dr Michael Mosley, the cultural factors behind the country’s health issues will be investigated, as well as why the numbers of diabetic patients are on the rise.
Dr Mosley will put his own body on the line, eating a typical Australian diet and measuring its impact on his health.
Joining him on the journey is exercise physiologist and PhD candidate, Ray Kelly, who shares an interest in the same research.
A Gomeroi man who grew up in Western Sydney, a diabetes hotspot with rates more than double that of other Sydney suburbs, Kelly tells NITV that he’s seen firsthand the effects of type 2 diabetes and the devastating impact it can have on lives, though many don’t know that they have the condition.
“(With type 2 diabetes) quite often, people first get diagnosed just through a blood test with their doctor,” Kelly says.
“The doctor might be running tests for a range of things, or they might be in hospital for something. A lot of times it's by chance because the symptoms don't come until you're advanced and progressing along.”
What people may not realise is that by the time they are diagnosed, their pancreas, the organ that maintains healthy blood sugar levels and produces insulin, is only working at 50 per cent capacity.
Along with Dr Mosley, Kelly asserts that the condition is predominantly brought about by lifestyle factors, and that it should be managed in the same way.
“One thing a lot of people don't realise is that Aboriginal people did not have type 2 diabetes prior to colonisation,” Kelly said.
Diabetes: a new disease for Indigenous population
The results of the first national health report in 1979, by the Standing Committee on Aboriginal Affairs, revealed that Aboriginal people who lived traditionally and out of town had practically no diabetes.
“(The numbers were) less than those of European descent who lived in town. And that's why I always say it's not part of our past, and it doesn't have to be a part of our future," Kelly says.
Some communities are affected more than others by diabetes, with many families suffering from poor health.
“You're talking about all the grandparents, and all the uncles and aunts. There are amputations, blindness, heart attacks, and all before the age of 55. It's just not supposed to be that way,” Ray Kelly said.
For over 12 years, he has been working at a community level alongside Aboriginal Medical Services, delivering a successful weight loss program that has been shown to reverse the condition, sometimes in as little as a couple of weeks.
Kelly makes sure that the fundamental principles of traditional lifestyles are the foundation and getting rid of introduced diets that are rich in processed foods and unhealthy fats.
“We know that traditionally we lived on a higher animal-based food diet, which some research will show these days that you might be more prone to heart disease, but there must have been something with the animals or the preparation because there was virtually no heart disease back then either," he said.
“I think it's just moving to keeping our weight down a little and keeping things fresh, unprocessed.
“You can eat some of these richer foods, but so long as you maintain an active lifestyle and just keep your weight down.”
A simple approach
One participant from Bourke, who at 59 years of age had been on 4-5 injections of insulin for over 20 years, stands out in his memory.
“She just was just totally over it. It was affecting her whole life," Kelly said.
“She couldn't walk upstairs very well. She was looking to buy a motor scooter to get around town. She gets into (the program) and she gives it a go and we just started with a walking program.
She got up and walked every morning. We got her to clean up her diet a little bit, just fresh, unprocessed food, and within seven weeks she was off insulin. And that's three years ago now.”
He says that he sees these results through his program all of the time.
In some communities, fresh healthy food is expensive, so when Kelly goes to these areas, he makes sure his program adapts to what’s easiest for the community.
They offer low-carb, low-calorie regimes initially, with some moderate exercise. Foods can be added back into the diet once the initial weight loss and blood sugar regulation is achieved.
Kelly said it's well known that type 2 diabetes is caused by a build-up of fat around the liver, which ends up leading to the breakdown of the beta cells in the pancreas.
“Up to very recently, it was always considered that, once the pancreas goes, it's gone, just like with what happens with type 1 diabetes. But it's just not the case for Type 2," he said.
Changing the way we talk about diabetes
Kelly and Mosley say that by losing weight and in turn losing that fat from around the liver, the pancreas will regenerate and start producing insulin itself again. They state that if participants are on any medication and insulin that they need to work closely with and be supported by doctors before undertaking any program.
They are also on a mission to have the public messaging around the causes and treatments for type 2 diabetes changed, and believe that there needs to be more transparency around the evidence of type 2 diabetes reversal.
Kelly is optimistic that once the Australian health authorities and GPs are able to access and see the results he is achieving with his program, the grim reality of this condition can be alleviated.
In other countries, acceptance of reversing the condition is widely accepted and is being integrated into their health care systems.
"We've been pushing for many years, for the health organisations to admit that Type 2 diabetes is reversible. Overseas it's accepted, but just not here yet. The research is out, so much so in the UK, you have the NHS over there, they're actually funding programs to be going into public medical centres for reversal of type 2 diabetes," Kelly said.
Mosley and Kelly met with the head of Diabetes Australia and lobbied for a change in the way that they described the condition on their website, that type 2 diabetes was a progressive condition, with no mention of remission being possible. As the website may be one of the first places a patient will go for more information on their diagnosis, they argued that the information available there must reflect the data.
Kelly says that Diabetes Australia didn't feel that these were issues but stated they will look over them.
"That meeting was in December and Diabetes Australia have just recently made a change on their website with (messaging about diabetes) but the Dieticians Association weren't so forward with it. That's frustrating because they play such a big role in this. They're part of the answer."
Mosley and Kelly took their findings to the federal government, in a bid to enact change in combating the disease. Setting up a tent outside of Parliament House, ministers and senators were able to come and have health checks including diabetes screening.
There were a few that were surprised to learn that they were in or approaching pre-diabetes stage. It was a result that they hope will engage further assistance in health messaging around the condition.
“I totally believe that anyone out there that's got type 2 diabetes can improve it. Some people will get off medication altogether, and some people just see a reduction in medication," said Kelly.
"Unfortunately, at the moment, all we're seeing is progress from diagnosis to medication to more medication to more medication and more medication and comorbidity after comorbidity. We're not seeing any kind of halt or reversal, and that's what we need to push for.”