Diabetes Strategy: Paul Zimmet’s 10 priority areas for implementation

Two years after its launch, the national diabetes strategy has 10 priority areas that have not yet received appropriate attention, a leading endocrinologist says .

The approval of several high-priority projects worth millions of dollars being funded outside the Australian National Diabetes Strategy 2016-2020 is very welcome, says Paul Zimmet, Professor of Diabetes at Monash University.

“But to date there hasn’t been a significant allocation to say we are going to implement appropriate funds to implement all of the strategy” he told the limbic.

He welcomed announcements of new programs being managed by Diabetes Australia, such as:

However there are at least 10 areas that have priority for implementation in the national strategy, according to Professor Zimmet.

These are:

  • Prevention of type 2 diabetes
  • Early detection of type 1 and type 2 diabetes
  • Greater focus on pregnancy planning and gestational diabetes mellitus
  • Complications screening and prevention
  • Vulnerable groups
  • Action in Indigenous communities
  • Diabetes workforce
  • Technology development
  • Research, data and monitoring
  • Implementation of a National Health Survey every five years

This top-ten list was identified by an expert group tasked with advising the federal government on the national diabetes strategy. But Professor Zimmet, who co-chaired the group, said they were either missing or minimised in the final document.

Thankfully, he said, the diabetes community had found a “sympathetic” ear in Health Minister Greg Hunt, who has appointed a committee of five diabetes experts to advise the government on how to turn the top 10 list into actionable projects.

The group meets every three months, to tackle three priorities at a time.

The latest meeting focusing on technology developments, complication screening and the diabetes workforce, Professor Zimmet said.

“There is a lot of new technology in diabetes, for example the insulin pumps, continuous glucose monitoring, flash monitoring, all of  which requires diabetes educators to be suddenly thrust with the need to know all about the technology and instruct people with diabetes to monitor their treatment”.

“I would have preferred that the strategy we proposed as the National Diabetes Strategy Advisory Group in 2015 was carried out in an integrated fashion.”

“But the positive thing is the Minister for Health Greg Hunt has been hugely supportive of diabetes, and he is committed to ensure that various things are happening to help people with diabetes, Australia’s fastest growing chronic illness.”

Professor Zimmet also stressed the pressing need for a National Health Survey measuring and monitoring key health indicators for progress against the goals of Australian National Diabetes Strategy 2016-2020 and other chronic disease strategies to be run every five years.

As one of the “strongest” recommendations by the National Diabetes Strategy Advisory Group, it was designed to provide hard data on how well Australia was tracking against strategy goals.

But the idea was ignored by government bureaucrats, who did not include it in the strategy.

Instead, the AIHW has just released a set of 55 indicators. But Professor Zimmet and colleagues are critical of the indicators, which he said “do not related directly to the problem of diabetes”.

He noted that for Goal 7 of the strategy, “strengthen prevention and care through research, evidence and data”, the AIHW group noted “no potential indicators have been identified.”

“We considered this was rather disappointing as it is a most important aspect of the strategy,” he said.

“When you set out to monitor a major national health program such as diabetes, surely you want indicators that have direct relevance to the disorder and its prevention and management.”

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