Diabetes summit forms action plan to fight epidemic

In 2006, about 200 leaders and decision makers in the area of diabetes signed a declaration agreeing that diabetes is everybody’s business.

The attendees at the Diabetes in New South Wales Summit held in Sydney on 10 April, 2006 agreed that the diabetes epidemic needed more urgent and coordinated action. The summit presented more than 40 recommendations for the prevention and management of diabetes. This was in response to the latest diabetes numbers released at the summit by Diabetes Australia-NSW, which showed significant increases in all types of diabetes.

More than 542,000 people in New South Wales have diabetes, but half of them don’t know it. The number has increased 300% in the last 10 years.

The number of people with type 2 diabetes – the so-called lifestyle disease – has doubled in just 5 years. The number of children with type 2 diabetes is increasing at between five and 10 percent a year.

Type 1 diabetes in children is increasing at three percent a year. Nationally, there are 1.4 million people with diabetes. This number is expected to reach 2 million by 2010.

The summit made up of diabetes experts, health professionals, government representatives, industry leaders, people with diabetes and groups at risk – agreed that strategies to prevent type 2 diabetes and to prevent the onset of complications in all types of diabetes need to be funded and further strengthened.

President of Diabetes Australia-NSW, Dr Neville Howard, said there was a real risk of type 2 diabetes getting out of control if we could not stop the continuing upward trend of diabetes.

Opening the summit, NSW Health Minister John Hatzistergos said he would lead a push for changes to the advertising and marketing of “junk food” to children. He said current practices that used competitions and toys to promote these foods were “not acceptable.”

Keynote speaker, leading American endocrinologist, Professor Francine Kaufman stated that “unless our environment changes, the diabetes epidemic imperils human existence as we know it”. She called on individuals, communities, government, business, healthcare and educators to help “turn the tide of one of the largest epidemics in the history of man”.

"We have to reverse this obeseogenic environment that our society has instilled... into a healthy lifestyle environment," Professor Kaufman said.

Professor Stephen Colaguiri of the University of NSW spoke on the costs of diabetes both to an individual with diabetes and to the Australian Government.

"The direct cost of diabetes for each person who does not have any diabetes complications is $4025," Professor Colaguiri said.

On the other end of the scale, the cost more than doubles to $9645 for a person with serious complications including nerve or kidney damage, heart disease, stroke or amputation.

Professor Gary Whittert from the University of Adelaide explained why overweight people were particularly at risk for type 2 diabetes if their fat was mostly stored around their abdomen.

"I tell my patients that they are deficient in vitamin EX. It's vitamin exercise and you need to take it twice a day," Professor Wittert said.

Dr Michael Booth from the NSW Centre for Overweight and Obesity said Australian children continued to grow heavier and more are being diagnosed with type 2 diabetes.

He said the rise in overweight children was also contributing to an alarming rate of early liver damage in young people.

"There needs to be an emphasis on reducing 'extra foods' consumption among the children. This can be achieved through reduced marketing and accessibility to these foods," Dr Booth said.

Aboriginal Diabetes Educator Laurie Clay of the Northern Rivers Project, which is investigating type 2 diabetes in Indigenous Australians, said rates of diabetes were as high as 31% in some Aboriginal communities.

"We've got something that money can't buy," Mr Clay said, "we've got poverty."

Mr Clay described the hardships face by Aboriginal people that contributed to the diabetes rates including lack of services in the regional areas, the cost of medical care or participating in organised sports, high unemployment, smoking and alcohol.

Dr Roger Chen from Ryde Hospital talked about why certain ethnic groups in Australia were at higher risk for developing type 2 diabetes, especially people of Asian or Middle-Eastern background.

He said advising some people to walk for exercise or to eat certain healthy foods would not work as the suggestions do not fit into the person's culture.

"We need to work with the ethnic media so they can get our health messages out in a way that is culturally appropriate," Dr Chen said.

Former Mayor of Holroyd City Council, Councillor Mal Tulloch spoke of his personal experience with developing type 2 diabetes and making a switch to healthy lifestyle in order to control it.

"Regular physical exercise is also a big part of my life now. Its opened up a whole new world and breathed life back into what was a rapidly ageing body. Everything is exciting again and no challenge too great," Cr Tulloch said.

"I believe my diagnosis of diabetes has done me a favour. When I was diagnosed, I also had high blood pressure, high cholesterol and high triglyceride levels. I have brought those down now and probably added another 15 years to my life."

The recommendations
Key recommendations included changes to the roles and responsibilities of health care professionals, ethical food advertising, GP accreditation in diabetes care, better links with multicultural and indigenous communities, mandatory lifestyle education and programs for schools.

The top 11 priorities were identified as:

1. Support for a paradigm shift in roles and responsibilities of the health care professionals

2. Non Government Organisations to maintain independence and assist with paradigm shift required in health care

3. Enjoin clubs and communities to promote good health strategies

4. Improved education and accreditation for General Practitioners and support their involvement in assisting in lifestyle changes

5. Train more health providers in aspects of diabetes management

6. Map and understand existing services and programs

7. Support collaboration between stakeholders

8. Lifestyle education to be mandatory in schools in an effort to raise parental awareness and schools to recognise duties of care

9. Have better links to Indigenous and Multicultural Communities to promote improved health structures

10. Support better food labelling to overcome public confusion and support environment change to enable a healthier lifestyle

11. Better financial support for research

President of Diabetes Australia-NSW, Dr Howard, described the summit as a great success.

He said that by working together to provide a coordinated and integrated action plan, including distribution of resources and new systems for healthcare, the people involved in the summit could find the solutions to the diabetes epidemic.