Background Diabetes is a chronic health condition, disproportionally impacting Aboriginal people in Australia. It is also increasing injury risk, with the chance of falling much greater in older individuals with Diabetes. Remission of diabetes has been linked to decreasing risk of cardiovascular disease and is likely to decrease injury risk.

Objective Focusing on recommendations for remission (ketogenic eating), we co-designed an eating program with Aboriginal people on Ngarrindjeri country. Which included important cultural and contextual factors, educational and motivational strategies, group-based activities and exercise for a ketogenic eating program, along with monitoring physiological, social and economic outcomes.

Methods Indigenous knowledge were centred through 1. Knowledge Interface Methodology and 2. Strength-Based Approaches, and the leadership from Aboriginal consumers, researchers and health professionals across the project. Co-design occurred on Ngarrindjeri country where participants needed to be >18 years of age, identify as an Aboriginal person living on Ngarrindjeri country, have a diagnosis of Type 2 diabetes or metabolic syndrome. Community-led Participatory Action Research was employed, with decolonising actions through engaging Indigenous principles of consultation and reciprocity, and Indigenous research methods of yarning and deep listening. This occurred over eight workshops at two locations with >30 Elders and senior community members. Workshops were facilitated by the research team, all were recorded, de-identified, transcribed, and thematically analysed, focusing on protective factors for the Cultural Determinants of Health.

Results A range of themes were identified from workshops, with desires for it to be community owned and built on Ngarrindjeri knowledge, encompassing local produce and cultural laws. Convenience and cost effectiveness were important factors highlighted, along with the need for connection. Community wanted regular catch ups through cooking classes and exercise groups. Co-design resulted in the Nragi Ya:yun initiative, a 28-week program with both a diabetes remission and maintenance phase for participants. During the presentation we will focus further on the co-design aspects and design on the overall Nragi Ya:yun initiative.

Conclusions Aboriginal people on Ngarrindjeri Country are advantaged to address diabetes remission and management through the Nragi Ya:yun program. Co-designed is essential with Aboriginal communities to centralise Indigenous knowledges and create community ownership and capacity.