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Indigenous | Diabetes

‘Giving our kai the respect and mana it deserves’ - a traditional approach to diabetes

Matire Ropiha was diagnosed with gestational diabetes more than 20 years ago and is now encouraging whānau to reclaim their hauora through traditional practices.

“I really had to change and engage with my hauora [like] how I saw kai,” she says.

“Reclaiming what I knew was me and acknowledging [my] understanding of te ao Māori is something to be celebrated, and that actually helps my hauora.”

November is Diabetes Action Month, with more than 300,000 people across the motu living with some form of the condition - Diabetes New Zealand (DNZ) says this is the country’s largest and fastest-growing health crisis.

This year’s theme, ‘Don’t Sugar Coat Diabetes’, aims to bust myths about diabetes and raise awareness and understanding of the condition.

Ropiha was pregnant with her daughter when she was diagnosed with gestational diabetes - the diagnosis later developed to Type 2 diabetes.

“I couldn’t help but think of my mum’s [diabetes] journey [and] my grandmother. I did go through a period of grief of thinking - that’s gonna happen to me.”

Type 2 prevalent among Maōri

Recent data indicates Māori adults are three times more likely to be diagnosed with diabetes than non-Māori.

Pharmacist Kevin Pewhairangi says Type 2 diabetes, which is related to lifestyle and kai, is particularly prevalent among Māori.

“It all starts with kai for a lot of things and as you get older your risk gets higher,” he says.

“You can indulge in kai but if you’re constantly indulging in kai, that’s when it becomes a big issue.”

DNZ clinical services head Liz Dutton says genetics, whānau history, cost of living and environmental changes are all contributing factors.

“Traditional Māori and Pasifika ways of eating and living, they were often centred on fresh homegrown food and a lot of physical activity,” she says.

“But today the changes in lifestyle, diet, also kai poverty - the risk of developing diabetes has increased over time.”

Alternative treatments

Ropiha spent 11 years on insulin and oral diabetes medication before turning to alternative methods.

“I changed my medication from injecting and pills to the kai I ate - how I looked at my kai, movement and feeling happy and that empowerment knowing that my tīpuna and where I’m from really helped my wellness.”

“Medication isn’t just what you inject, it isn’t just the pill you take, but it’s also looking how you sit within your whole hauora with your whānau.”

Ropiha has worked as a kaiāwhina mate huka (head of engagement) with DNZ for four years, supporting whānau living with diabetes in the community.

“[DNZ] acknowledged that there was a gap in support for whānau, so they deliberately looked for someone who was non-clinical, who could provide that support between the clinician and the whānau.”

Ropiha admits that simple changes to her diet - like cutting out soft drinks - showed dramatic improvements for her hauora. She says whānau can still enjoy their kai with these changes.

Giving kai the respect it deserves

“[Māori are] a collective – we love being in a whanau space and we love being social with each other,” she says.

“Giving our kai the respect and mana it deserves, that how we’re eating it will improve our hauora.”

Ropiha has swapped store-bought flour for a homemade alternative made from blended oats, seeds, and nuts, which she uses to bake her own bread.

Insulin, Metformin and Sulfonylureas are just some of the available treatments for Type 2 diabetes in Aotearoa.

Ozempic is another medication used to manage diabetes and support long-term weight loss. While it has gained popularity on social media, it is not available in Aotearoa.

“The injectable that’s available that is sort of like Ozempic is Saxenda and it’s licensed for weight loss in New Zealand,” Pewhairangi says.

‘Not a miracle cure’

“Saxenda [is] really expensive and you still have to have that lifestyle change - you might get some results in terms of weight loss but it’s not the miracle cure that everyone says it is.”

Through her mahi, Ropiha hopes to address the stigma of living with diabetes.

“Even though we have diabetes in my whānau, it doesn’t mean that you would necessarily be diagnosed with diabetes – because there are things you can do to limit diabetes being an issue for you.”

For more information and resources, see the Diabetes NZ website.