Impact of an integrated diabetes service involving specialist outreach and primary health care on risk factors for micro‐ and macrovascular diabetes complications in remote Indigenous communities in Australia

Abstract

A collaborative health care approach to deliver diabetes care to remote Indigenous Australian communities was associated with an improvement in glycosylated haemoglobin and total cholesterol, both important risk factors, respectively, for micro- and macrovascular diabetes complications.

Feasibility of once weekly exenatide‐LAR and enhanced diabetes care in Indigenous Australians with type 2 diabetes (Long‐acting‐Once‐Weekly‐Exenatide laR‐SUGAR, ‘Lower SUGAR’ study)

“…[21][22][23] Specialist outreach care can also lead to improved outcomes for people with diabetes. 8 The current study demonstrates the feasibility of an alternative diabetes model of care with supervised weekly injectable medication, which is safe and can lead to significant improvements in glycaemic management in remote Indigenous communities.…”

“…When staffing is consistently maintained and individuals are engaged and willing to accept care, clinical management structures with training and workshops for staff importantly for indigenous healthcare workers can result in improvement in the proportion of individuals achieving glycaemic targets 21–23 . Specialist outreach care can also lead to improved outcomes for people with diabetes 8 . The current study demonstrates the feasibility of an alternative diabetes model of care with supervised weekly injectable medication, which is safe and can lead to significant improvements in glycaemic management in remote Indigenous communities.…”

“…Previous large, multicentre clinical trials have demonstrated that a range of medications are effective in reducing blood glucose and consequently the complications of diabetes including CVD and death 6 . However, thousands of Australians with diabetes do not meet target levels for blood glucose (4–10 mmol/L), 7 particularly Indigenous Australians living remotely 8,9 …”

“…6 However, thousands of Australians with diabetes do not meet target levels for blood glucose (4-10 mmol/L), 7 particularly Indigenous Australians living remotely. 8,9 The development of the class of glucagon-like peptide 1 (GLP-1) receptor agonists represents one of the major advances in diabetes management in the past decade. 10 As well as leading to glucose lowering, GLP-1 receptor agonists lead to significant weight loss, along with improvements in other cardiovascular risk factors including blood pressure, 11 albuminuria 10 and have beneficial effects on lipid profile.…”

Barriers and enablers to health service access amongst people with diabetes: An exploration of the perceptions of health care staff in regional Australia

“…The inaccessibility of a service associated with cultural issues and diabetes management was found to be a complex issue in our study. There is a clear need for culturally acceptable models of care (MoC) to improve diabetes outcomes for Indigenous people in Australia (Hotu et al, 2018). Moreover, given the overrepresentation of diabetes complications in Indigenous people (Maple- , additional factors need to be considered.…”