Diabetes among Maori and other ethnic groups in New Zealand

The population of Aotearoa, New Zealand, has changed significantly since the signing of the Treaty of Waitangi between the indigenous people, Maori, and the British Crown in 1840. Several waves of immigration by Polynesians from various Pacific Islands since the 1960s and from Asia since the 1980s, along with migration by Maori into cities, have exposed these populations to Westernisation with resultant increases in obesity and type 2 diabetes. Since the early studies in the 1960s, Maori and Pacific peoples have been shown to experience two- to fourfold rates of type 2 diabetes as European New Zealanders, an excess now shown in Asian New Zealanders. Overall, Maori and the Pacific people have poorer blood glucose, blood pressure and blood lipid control with their diabetes. Associated with these are substantially higher rates of end-stage renal disease (with, e.g. up to 25-fold need renal replacement therapy among Maori), diabetic eye disease (including blindness), amputation and cardiovascular disease. Significant investment is clearly required into well-organised approaches that will reduce the incidence of type 2 diabetes, improve metabolic control and reduce the very high rates of diabetes complications that are now being seen.