Global complication rates of type 2 diabetes in Indigenous peoples: A comprehensive review

Diabetes Res Clin Pract. 2008 Oct;82(1):1-17. doi: 10.1016/j.diabres.2008.07.017. Epub 2008 Sep 2.


Introduction and objective: The world's Indigenous peoples are experiencing an unprecedented epidemic of type 2 diabetes [T2DM] but little has been published describing the complications burden. The objective of this paper was to conduct a systematic review of T2DM complications in Indigenous populations worldwide.

Methods: A literature review was conducted using PubMed and EMBASE to examine available complications data. Country, Indigenous population, authors, publication year, total sample size, Indigenous sample size, age, methodology, and prevalence of nephropathy, end-stage renal disease, retinopathy, neuropathy, lower extremity amputations, cardiovascular disease, hospitalizations and mortality due to diabetes were recorded.

Results: One-hundred and eleven studies were selected. Results revealed a disproportionate burden of disease complications among all Indigenous peoples regardless of their geographic location. Complication rates were seen to vary widely across Indigenous groups.

Discussion: Gaps were found in the published literature on complications among Indigenous populations, especially those living in underdeveloped countries. These gaps may be in part due to the challenges caused by varying operational practices, research methodologies, and definitions of the term Indigenous, making documentation of rates among these peoples problematic. Comprehensive surveillance applying standardized definitions and methodologies is needed to design targeted prevention and disease management strategies for Indigenous peoples with T2DM.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Nephropathies
  • Diabetic Retinopathy / epidemiology*
  • Diabetic Retinopathy / etiology
  • Humans
  • Indians, North American / statistics & numerical data*
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data*
  • United States / epidemiology
  • Young Adult