Meeting the challenges of the diabetes epidemic 15 December 2021 This op-ed by Diabetes Australia Group CEO Justine Cain was published in Australian Community Media on Sunday 12 December 2021. The COVID-19 pandemic has taught us a lot. We have seen, over the last two years, how strong the Australian health system is. Time and again our health system has innovated and adapted to meet evolving challenges. Potentially many thousands of lives have been saved. Our ability to meet the challenges of COVID-19 gives me hope that we can meet the challenges of the other major health epidemic of the 21st century, diabetes. There are now more than 1.9 million Australians currently living with all types of diabetes and that number continues to increase. Almost 120,000 people have been diagnosed with all types of diabetes in the last 12 months alone. It is a serious lifelong chronic condition that can have a massive impact on mortality and cause a range of debilitating complications. It is a contributing factor in more than 10% of all deaths in Australia and is the leading cause of vision loss, limb amputation, kidney failure and heart disease. Diabetes also comes with a hefty price tag. It is currently estimated to cost the Australia economy almost $17 billion per annum but that will rise as more people develop the condition in the years ahead. The good news is we know what needs to be done. The new National Diabetes Strategy 2021 – 2030 outlines clear policies that can reduce the impact of diabetes and, as the COVID-19 pandemic has shown, great things are possible when we focus on meeting a health challenge. Firstly, as a community we need to do more to prevent type 2 diabetes. We know type 2 diabetes can be prevented or delayed in up to 58% of people. A number of Australian states are currently running type 2 diabetes prevention programs, but we need national leadership and access to funding to achieve a national impact. Concerningly, there are almost two million people who are living with prediabetes and are at high risk of developing type 2 diabetes. We need to help as many people as possible reduce their risk. We can also do more to ensure people are diagnosed early so the condition can be managed. Up to 500,000 people are living with silent, undiagnosed type 2 diabetes. A number of hospital-based programs have cost-effectively diagnosed tens of thousands of people who might otherwise only have become aware of the condition when a serious complication started to develop. Adopting these programs more broadly would have major impact. Reducing the impact of complications is an area that requires urgent action, particularly coming out of COVID-19, where lockdowns and other pandemic measures disrupted normal health care. Australia already has world-class diabetes blindness prevention (KeepSight) and amputations prevention (FootForward) programs. We can take what we have learned from these programs and apply them to other challenges like reducing the impact of chronic kidney disease on people with diabetes. In the last couple of years there has been welcome attention on improving the quality of care in residential aged care. One area we would like to see more focus on is improving the specialised diabetes care residents can access. At least 20% of people in residential aged care live with diabetes. They have a right to high-quality consistent aged care wherever they live in Australia. This is essential to giving people the quality of life they deserve. Finally, we need to do more to address the impact of diabetes on First Nations communities where people are up to four times more likely to develop type 2 diabetes and much more likely to die from the condition. First Nations people are developing type 2 diabetes younger than ever which makes them even more susceptible to complications. We need to offer culturally appropriate support and care much earlier to give people the best chance of minimising the impact of the condition. Meeting the challenges of the diabetes epidemic will not be easy, but nor is it impossible. We have seen what our health system can achieve when it is focused on meeting the challenges of a health epidemic, and we can do it again.