Diabetes is known to be common among New Zealand Maori. This study shows that nearly half of the adult population surveyed on the East Coast of the North Island have insulin resistance. Insulin resistance is believed to be the earliest identifiable phase of type 2 diabetes and a major risk factor for heart disease. The fact that insulin resistance is particularly prevalent in young people endorses the need for early lifestyle intervention.

This paper investigates risk factors associated with type 2 diabetes in 3377 postmenopausal New Zealand (NZ) women. A diabetes risk analysis tool revealed that over half were at ‘high risk’ for developing diabetes in the future. Over half of this predominantly NZ European sample had modifiable risk factors including overweight or obesity, and physical inactivity. These data highlight the urgent need to identify those with modifiable risk factors before they develop type 2 diabetes in order to appropriately target lifestyle intervention programs.

The New Zealand population is becoming increasingly overweight and it is well known that this is an important cause of disease and death. This study measured health-related quality of life among 250 participants in a weight loss trial and compared results with the general population. Findings showed that overweight and obese adults experience significantly impaired quality of life compared to population norms, particularly in the physical function domains. Small reductions in body weight did not improve quality of life in this substantially overweight population. The study confirms that obesity has a significant negative impact on the health-related quality of life of New Zealand adults.

The results of gastric bypass surgery performed at the Wakefield Clinic (Wellington, New Zealand) in over 300 severely obese individuals are presented. They show a mean percentage of excess weight loss of around 70% within 2 years of surgery with good maintenance of weight loss out to 5 years. In the majority of those with serious comorbidities including type 2 diabetes, hypertension, dyslipidaemia, asthma, and obstructive sleep apnoea, these were either resolved or substantially improved following surgery.

Physical activity counselling in primary healthcare using the Green Prescription is not only effective but also cost-effective. A randomised controlled trial in the Waikato showed that brief advice (to become more active) from a general practitioner or practice nurse, accompanied by a Green Prescription, increased exercise levels over 12 months. And with increases in exercise levels, savings in healthcare are likely in the long term—because active people have lower rates of heart disease, diabetes, stroke, osteoporosis, and other diseases.

Diabetes remains an important cause of morbidity and mortality among young people. Despite improvements in technology, maintenance of good glycaemic control is hard to achieve particularly during the teenage years. Young people with diabetes in Waikato have poor glycaemic control (HbA1c 9.2%) and after 10 years over a quarter have evidence of early kidney and eye complications. These results are similar to published European studies but little is known about the outcomes of care in the rest of New Zealand.

In New Zealand, little information is known about the under-reporting of diabetes on death certificates—a recognised problem worldwide. This study (using data from the Otago Diabetes Register) found that diabetes was not mentioned on the death certificates of 45% of 508 patients known to have diabetes. If the impact of the diabetes epidemic on mortality is to be monitored appropriately in New Zealand, attention needs to be given to improving the completion of death certificates, including always recording diabetes when it is present, irrespective of whether it is considered to be the underlying or a contributing cause of death.

Indigenous peoples suffer from poor health and lower life expectancy. This study compares indigenous mortality with non-indigenous mortality in New Zealand, Australia, Canada, and the United States. Findings show that New Zealand Maori and Australian Aboriginals and Torres Strait Islander suffer from the highest levels of mortality and also the largest levels of inequity when compared to their non-indigenous population. Diabetes mortality is especially high for all indigenous peoples included in this study. Action is required to address indigenous health disparities and to improve the quality of indigenous mortality data.