Australian surgeons wield their scalpels while we wait for diabetes plan

Hospital beds filled with amputees is a phenomenon most Australians would associate with last century's world wars, not the 21st century. If only it was confined to history. Modern Australia, like the rest of the world, is fighting a battle with type 2 diabetes that it is losing. Our energy-dense diets and sedentary lifestyles are making us sick. Hospital wards are filled with the casualties.

Today The Sun-Herald reports that a rise in the prevalence of type 2 diabetes has led to a 25 per cent increase in amputations in just two years. The foot clinic at Sydney's Royal Prince Alfred Hospital has a long waiting list. One Tasmanian surgeon is conducting an amputation a week.

But losing a foot or a lower leg is only one of many serious consequences arising from the condition. It can cause heart attacks, strokes, kidney failure, deafness and blindness, depression and anxiety.

Around 1.1 million Australians have been diagnosed with diabetes and a further 500,000 are estimated to have undiagnosed type 2 diabetes. While all types are increasing, type 2, associated with lifestyle factors such as poor diet, lack of exercise and obesity, accounts for 85 per cent of all cases.

Already the rise in type 2 is placing a strain on the medical system, with diabetes accounting for around one third of all preventable hospital admissions, and it is destined to get worse. Diabetes is predicted to become the single biggest contributor to the cost of disease on the Australian health system by 2017.

As individuals we can make difference to our chances of contracting type 2 diabetes or slow its progression. While certain risk factors – our age, genetic inheritance and ethnicity – are beyond our control, diet, weight and exercise are not. And even small lifestyle adjustments can help.

But to make the biggest advances in this battle, we need governments to lead the effort. The federal Coalition has made some headway in doing that. In 2013, it made an election pledge to deliver a national diabetes strategy. In government it established a National Diabetes Strategy Advisory Group, which included some of the top experts in the field. The group delivered its advice to government in August last year and in November, the Minister for Health Sussan Ley released the strategy.

Unfortunately, it has disappointed key members of the advisory group. A proposed National Diabetes Commission to drive change was omitted, while "major recommendations for prevention and care on maternal and child health" were also missing, group co-chair Paul Zimmet and his colleague Stephen Colagiuri wrote in an opinion piece this weekend. Now that COAG has adopted the strategy, Zimmet and Colagiuri want diabetes experts to be involved in the next stage of the federal and state governments' response: planning how to implement it.

The government has promised the strategy and the advisory group's earlier document will both be taken into account in this next stage and that it will continue to consult with advisory group members.

We would feel more confident with these assurances if a specific role was created for these experts to help translate the strategy into action. We're also worried there is no commitment to a specific time when the health ministers will unveil the implementation plan. Meanwhile, the surgeons are kept busy.

http://www.smh.com.au/

Graham