Diabetes: a preventable epidemic

As a mother of 2 boys under 5, I always worry about my children: are they getting enough exercise? Are they eating enough fruit and vegetables? Do they watch too much TV? Government guidelines recommend no TV for children under 2, and only 1 hour for children aged 2 to 5 – but I find it very hard to stick to this limit when trying to get housework done – and I could confidently assume I’m not alone. Without a doubt, our lives are becoming more comfortable, more sedentary and more calorie-packed, which is inevitably contributing to the “epidemic” of non-communicable diseases not only in Australia, but in many countries around the world. So what can the government, NGOs, and we as citizens do about it? A lot. In early July, Diabetes Australia and Novo Nordisk launched a new campaign called “Let’s Prevent Diabetes.” To be honest I had no idea of the immensity of the issue; apparently 1.7 million Australians currently live with diabetes (known and diagnosed) and a further 100 000 Australians develop diabetes each year. Type 2 diabetes represents the vast majority of diabetes in Australia (85-90 per cent) and is largely preventable. Notwithstanding, Australia has not yet established an effective system to prevent type 2 diabetes in the high-risk population. Of particular concern is the risk to Indigenous Australians, who are twice as likely as non-Indigenous Australians to be obese and are ranked the fourth-highest population in the world that is likely to develop type 2 diabetes. The goal of the Let’s Prevent Diabetes campaign is thus to call on Federal and State governments to fund a national type 2 diabetes prevention program.

Australia: leading the way in the fight against NCDs?

For decades Australia has been a leader in developing effective strategies to fight preventable illnesses. According to a recent report by the Australian Institute of Health and Welfare, the number of people in Australia aged under 75 dying from non-communicable illnesses such as cancer, diabetes, heart disease and mental illness has dropped by almost a fifth. Smoking rates (17%) are among the lowest in the world, through controls on advertising, heavy tobacco taxes and changing attitudes to passive smoking, as well as new measures such as plain packaging.

The Australian Government has developed a variety of strategies to promote healthy lifestyles, address obesity, and improve the health of all Australians, including a ban on the sale of junk food in school canteens, Get set 4 Life – Habits for Healthy Kids, The Stephanie Alexander Kitchen Garden National Program, and Healthy Spaces and Places, a wonderful program that collaborates with local governments, the Planning Institute of Australia, and the Heart Foundation to plan for “healthy and active” communities.

Meanwhile, organisations such as the Heart Foundation, Diabetes Australia and the Cancer Council Australia play a vital role in bringing together civil society groups, industry, politicians and health professionals to promote treatment and prevention of many NCDs. As emphasised by Stephen Leeder, Director, Menzies Centre for Health Policy, University of Sydney, “All of these agencies alongside the National Health and Medical Research Council have been both powerful advocates for and major supporters of research that has provided the insights necessary for action.”  Nonetheless, we lack a coordinated federal approach to address diabetes.

Diabetes: what more needs to be done

Federal and state governments should heed the call of Diabetes Australia and follow in the footsteps of the United States, which established a National Diabetes Education Program over 15 years ago. The NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations. Since the program’s induction, people with diabetes are taking steps to better manage their diabetes and reduce complications, there is greater awareness that diabetes is a serious disease, and more Americans now know that type 2 diabetes can be delayed or prevented.

According to Dr Clark, who has been dedicated to the program for many years, “Over the past 15 years, public awareness of diabetes has increased from less than 10% to over 80%. Special populations have developed and implemented awareness and treatment programs in their respective communities. Collaborative care has [since] become the standard and is now endorsed by the Institute of Medicine.”

Diabetes Australia CEO Lewis Kaplan believes a national type 2 diabetes prevention program is necessary to give 2.5 million high-risk workers the best chance of preventing the disease. He argues that by investing $582 million over the next four years, Australia can save an estimated $1.37 billion in healthcare costs.

Finally, it is up to each of us as citizens to take more responsibility in the lifestyle choices we make. Research indicates that type 2 diabetes can be prevented by getting at least 30min of exercise a day, 5 days a week, and eating smaller portions of healthy foods (in my case, this might mean finding other ways to entertain the kids while doing the housework – or better still, getting them involved!).  By following these simple guidelines, along with the support of government and organisations such as Diabetes Australia, we can each play our part in the fight against NCDs.

AUSDRISK

The AUSDRISK (Australian Type 2 Diabetes Risk Assessment Tool) assesses a person’s risk of developing type 2 diabetes within the next five years.

To find out your risk of developing Type 2 diabetes, you can take the test here.