TYPE 2 diabetes was significantly more prevalent among Indigenous adult populations than global averages in every decade from 1980 to 2020, a 2026 systematic review has found.1
The proportion of Indigenous populations with Type 2 diabetes above the average estimated global prevalence was markedly high for each monitored decade: 93% in the 1980s, 61% in the 1990s, 72% in the 2000s, and 65% in the 2010s, coming to an average of 73%.
Persistent Higher Prevalence of Diabetes in Indigenous Populations
Studies included in the review represented at least 187 Indigenous adult populations across 37 countries. Notably, some studies did not name specific Nations, Tribes, or Groups for populations from different regions.
Diabetes prevalence ranged from 0 to 40% and it increased over time and with age for many populations. The highest reported prevalence, standing at 50.5%, was in those aged 45-54-years-old.
In terms of gender differences, 73% of studies analysed reported a higher prevalence of Type 2 diabetes for Indigenous women than for Indigenous men.
Type 2 Diabetes was Rare Among Indigenous Populations Pre-Colonisation
Before various experiences of colonisation, many Indigenous Peoples consumed nutritious and biodiverse foods, practising ways of life that offered protection against chronic conditions.1, 2 In fact, chronic conditions such as Type 2 diabetes were rare among Indigenous populations living traditional lifestyles.3
Researchers noted factors contributing to epidemic levels of chronic disease among Indigenous populations, including: the ongoing impacts of colonisation, disruption of Indigenous ways of life and traditional food systems, land and resource displacement, geographic isolation, historical and intergenerational trauma, limited healthy food access, structural racism, and social inequity and exclusion.1, 2, 4
A Call for Indigenous-Led Health Practices
Findings highlight the persistent and disproportionate burden of diabetes that many Indigenous communities have faced for decades, researchers reported.
They called for representative data on Type 2 diabetes prevalence across global Indigenous populations and the investigation of contributing factors to alarmingly high and significantly low diabetes prevalence.
Authors also appealed for Indigenous-led, culturally safe, Indigenous population-specific health practices to prevent and manage Type 2 diabetes, with a view to equitable outcomes.
They reported: “This study was designed in a culturally appropriate manner, and the findings serve as an impetus for global leaders to rectify the epidemic levels of Type 2 diabetes among Indigenous Peoples through actionable, strengths-based, and community-tailored efforts.”
References
1 Claussen C et al. Prevalence of type 2 diabetes among global Indigenous adult populations: a systematic review. Diabetologia. 2026;69(3):582–599.
2 Crowshoe LL et al. Educating for Equity Care Framework: addressing social barriers of Indigenous patients with type 2 diabetes. Can Fam Physician. 2019;65(1):25–33.
3 Lipski E. Traditional non-Western diets. Nutr Clin Pract. 2010;25(6):585–593.
4 Warne D, Wescott S. Social determinants of American Indian nutritional health. Curr Dev Nutr. 2019;DOI:10.1093/cdn/nzz054.
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