News in brief: Shameful rate of T2D in Indigenous youth; Central precocious puberty drug listed on PBS; Doctors oppose diabetes screening in pharmacies

3 Nov 2021

Shameful rate of T2D in Indigenous youth

Australia has the dubious honour of reporting the highest rate of youth-onset type 2 diabetes in the world – a crude prevalence of 6·7 per 1000 Indigenous youth across northern Australia.

The prevalence of youth-onset type 2 diabetes during 2016-17 was higher among females than males, and higher in 15–24 year-olds than under 15 year-olds.

“Within Central Australia, the estimated prevalence among females was 23·0 cases per 1000 (95% CI 18·4–28·3) and among people aged 15–24 years was 31·1 cases per 1000,” the study said.

The median HbA1c was a high 9·7% in all regions – “suggesting a concerning trajectory ahead without intervention.”

“We report a very high prevalence of type 2 diabetes among First Nations youth in northern Australia, arguably the highest reported prevalence in any population of youth internationally within the past 25 years.”

“The high proportion of young people with overweight or obesity further supports the need for early primary prevention and reduction of cardiometabolic risk.”

Read more in The Lancet Diabetes and Endocrinology

Central precocious puberty drug listed on PBS

Children with central precocious puberty can now access the GnRH- agonist triptorelin (Diphereline) via the PBS.

From 1 November, the 22.5 mg injection is subsidised for girls 11 years or younger and boys 12 years or younger, whose central precocious puberty symptoms started before their 9th and 10th birthdays, respectively.

Patients must be treated by a paediatric endocrinologist, an endocrinologist specialising in paediatrics, or a medical practitioner who has consulted with one of the former endocrinologists, according to the PBS listing.

The subsidy is expected to help around 800 Australians per year, who might otherwise pay $3,600, Australian Minister for Health and Aged Care Greg Hunt said in a statement.

Doctors oppose diabetes screening in pharmacies

Doctor groups  have expressed strong opposition to proposals for Medicare to fund a program of type 2 diabetes screening in pharmacies.

In submissions to the Medicare Services Advisory Committee (MSAC), the AMA and RACGP said screening in retail pharmacies would lead to fragmented care and would be financial conflicts of interest.

The RACGP  said the Pharmacy Diabetes Screening Trial (PDST) results showed that pharmacy screening had a low detection rate of less than 1%, with 136 cases of undiagnosed diabetes patients identified out of 14,000 participants at a cost of more than $8000 per case.

Medicare funding for pharmacies would “encourage one-off, opportunistic screening for a single medical condition without the background biopsychosocial information of the patient and without the history of previous screening. It therefore fragments patient care,” it said.

The AMA said it was concerned that patients with or at risk of type 2 diabetes “will be subjected to a tick box exercise in retail pharmacies,” and that medical practitioners were “the only health professionals trained to fully assess a person, initiate further investigations, make a diagnosis, and understand and recommend the full range of clinically appropriate treatments for a given condition.”

“The AMA considers these services as outside the scope of practice for pharmacists and represents a push by pharmacies to increase their profits at the expense of evidence-based, cost-effective health care,” its submission said.


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