Australia’s diabetes epidemic is now a fast moving disaster of epic proportions
The escalating diabetes epidemic threatens to plunge Australia’s life expectancy into reverse and push health systems to the brink of collapse.
The escalating diabetes epidemic threatens to plunge Australia’s life expectancy into reverse and push health systems to the brink of collapse, with the chronic metabolic condition fast becoming entrenched as a multi-generational disease in the most disadvantaged pockets of the nation.
That’s the assessment of a parliamentary health committee that examined the nationwide sweep of type 2 diabetes. It found that 70 per cent of the adult population of some hard-hit communities had the disease, which is causing widespread renal failure, amputations, blindness and early death.
The report found a desperate need to rebalance healthcare in favour of prevention, rather than treatment, to turn around the trends that are set to ruin millions of lives and cripple government health budgets.
The bipartisan committee chaired by Labor MP Mike Freelander, a pediatrician, warned of an expected massive burden of disease from type 2 diabetes by the middle of this century, with half of all citizens potentially affected unless current trends are reversed.
Already $3.4bn a year is spent on diabetes and 1.5 million Australians have type 2 diabetes.
The report called for: an expedited review of Australian dietary guidelines; consideration of a greater focus on low-carb diet approaches in mainstream food guidance; food-labelling reforms targeting added sugar to allow consumers to clearly identify the content of added sugar from front-of-pack labelling; the introduction of a sugar tax; and tougher regulation of the marketing and advertising of unhealthy food to children.
It also recommended: urban planning reforms; more equitable access to health care for disadvantaged populations; expanded eligibility to glucagon-like Peptide-1 (GLP-1) drugs for disadvantaged communities; and a national public health campaign to increase public awareness of the early signs of all forms of diabetes mellitus to prevent the tide of complications.
Alice Springs doctors told the inquiry the health system was operating like an ambulance “at the bottom of the cliff” for diabetes sufferers, at great expense and trauma to patients, even though it was a preventable problem.
“Although the transformative potential of prevention is widely recognised, inquiry evidence suggests that the Australian health system is more oriented towards reaction rather than prevention,” the report found.
It concluded the disease was one of poverty, with the highest rates of type 2 diabetes found in southwestern Sydney, followed by western Queensland, country South Australia, western NSW and other rural and remote areas. Some areas of the highest incidence included remote Indigenous communities.
“We are very much at a tipping point now,” Dr Freelander told The Australian.
“Diabetes is causing a health emergency. I don't think hyperbole is unwarranted here. Health systems are really struggling to cope, and we are very worried about what the future will bring.
“We’ve already seen in the latest data a slight dip in life expectancies in Australia, and we don’t want that to get worse. Diabetes is putting a brake on improvements in health. We want future generations to have long, healthy and happy lives.”
Diabetes rates have tripled in a generation. It is estimated that as many as 70 per cent of presentations to emergency departments in some areas of high prevalence are associated with type 2 diabetes. Nationwide, 10 per cent of hospital admissions are due to the disease.
The diabetes report adds to evidence documented by The Australian in a recent national investigation of the impacts of the devastating disease at the front lines of the epidemic. It established that central Australia had three times the highest rates of end-stage renal failure as the next worst-hit zone in the world, with an astonishing one in 100 people in Alice Springs needing renal dialysis. The town’s dialysis clinics are overwhelmed, with diabetes patients as young as 23 needing the machines to survive.
The Australian was granted extraordinary access to hospitals at the front lines of the epidemic in the Northern Territory, western Sydney and outer Melbourne as part of the investigative series. Doctors spoke of sheer despair at the disease’s trajectory, describing the diagnosis of children, who tended to have much more severe phenotype of the disease carrying a higher risk of severe and more quickly-developing complications, as “a catastrophe”.
Doctors were seeing at least one diagnosis a week of child type 2 diabetes. The medics begged for a greater focus on prevention to stop the tide of patients losing limbs and lives. One of Alice Springs’ hospitals’ most senior clinicians, Elna Ellis, described the surgical ward there as “the wild west” given the extraordinarily high rate of amputations as a result of diabetic complications.
Doctors in western Sydney described a trail of devastation wrought by type 2 diabetes, severe underfunding to deal with its scale and an unsustainable trajectory for the health system.
David Simmons, a distinguished professor of medicine at the Western Sydney University Macarthur Clinical School and head of Campbelltown Hospital’s endocrinology department, said he was frequently seeing pregnancy complications such as babies being born with holes in the heart as a result of women not being screened for type 2 diabetes in pregnancy.
Dr Freelander said what was abundantly clear was that even though type 2 diabetes affected people across the country, prevalence rates of the disease tracked disadvantage.
Despite the scale of the problem, Australia does not have a specific national diabetes prevention plan, such as the one operating in the UK.
Australia’s 10-year National Preventive Health Strategy, which was signed off on in 2021, is unfunded.
