Australians urged to monitor their diabetes management during the COVID-19 pandemic 16 July 2020 This National Diabetes Week, the Royal Australian College of General Practitioners (RACGP) and Diabetes Australia are urging Australians living with diabetes to look after their health and wellbeing during the COVID-19 pandemic. The updated edition of Management of type 2 diabetes: A handbook for general practice (Diabetes Handbook) provides GPs and other health professionals with new information on issues including early-onset type 2 diabetes, the use of technology in helping people with diabetes, how to best to manage type 2 diabetes in older people and the impact of diabetes on mental health. RACGP President Dr Harry Nespolon said that the release of the handbook came at an auspicious time. “People with diabetes need to carefully monitor their condition and should consult with their GP regularly, particularly if any health problems emerge. It is also vital that anyone with diabetes symptoms, including fatigue, urinating often and heightened thirst, consults their GP right away as this may be a sign of undiagnosed diabetes. “Unfortunately, the COVID-19 pandemic has resulted in many people delaying or avoiding a trip to the GP. A June 2020 survey of more than 700 people found 32% of respondents had delayed or avoided a visit to a GP in the last three months. “We need to reverse this trend and it is particularly important that people with diabetes take care of themselves and heed expert medical advice from their GP. Remember that video and telephone consultations are available with your regular GP, you don’t necessarily have to visit a clinic in person.” Dr Nespolon said that the rising prevalence of type 2 diabetes was presenting major challenges for GPs. “We know that the number of people with type 2 diabetes is growing and this can probably be attributed to rising overweight and obesity rates and an aging population.“The number of Australians aged 65 and over is expected to more than double by 2057 and about 15% of this population are currently living with type 2 diabetes. “Within 20 years the number of people living with type 2 diabetes could rise to more than 2.5 million. This is an alarming statistic given that there were an estimated 870,000 people with type 2 diabetes in 2014. “One of the key challenges is that the most socially disadvantaged Australians are twice as likely to develop diabetes. So we must be proactive in helping people adjust their diets and lifestyles to support better diabetes management. “This is where GPs can play a vital role in identifying those at risk and caring for people with diabetes. The handbook provides practical, evidence-based guidance and recommendations for GPs doing all they can to help people with type 2 diabetes.” Dr Gary Deed, Chair of the RACGP Specific Interests Diabetes Network, said that the detection, treatment and ongoing management of diabetes needs to be taken extremely seriously. “We need to improve how we detect and manage diabetes in Australia. Type 2 diabetes can significantly increase the risk of coronary artery disease, stroke, kidney failure, limb amputations and vision loss. “In early-onset type 2 diabetes, life expectancy is reduced by 14 years in males and 16 years in females compared to people without diabetes. This is particularly troubling because in recent years there has been an increase in the incidence and prevalence of type 2 diabetes in children, adolescents and young adults. “One study found 11% mortality over 20 years in a cohort of young adults diagnosed between 15 and 30 years of age, so it is vital that we take positive steps forward and improve the lives of people with diabetes.” Diabetes Australia CEO Professor Greg Johnson said the new Diabetes Handbook would equip GPs with the latest information on diabetes management. “The new areas of focus in the Handbook are very important – early-onset type 2 diabetes, use of technologies, older people and their specific issues, and of course the mental health burden of type 2 diabetes,” Professor Johnson said. “It is very timely in National Diabetes Week when we’ve launched a new campaign – Heads Up on Diabetes – that highlights the mental and emotional health challenges of living with diabetes. “Around half of all people living with diabetes have experienced mental health challenges in the past year related to their diabetes. It is a relentless condition – day in, day out, 365 days a year. “Over one third of people with diabetes feel burned out by their diabetes. So it is essential that GPs are able to recognise and support people with diabetes who might be struggling with the burden of diabetes management.” The Diabetes Handbook provides updated advice and new recommendations on matters including: how to manage early-onset type 2 diabetes, including the referral of all children and young adults under the age of 25 years to an endocrinologist or, if not accessible, a specialist physician with an interest in diabetesemerging evidence on how the acceleration of uptake of technology for managing diabetes, including smart phone apps, wearable technology, insulin pumps and continuous glucose monitoring, is associated with reduced sedentary behaviour and improvements in diet and exerciseavoiding the overtreatment of diabetes in older adults as well as the importance of developing individualised care plans for people in residential aged care facilities and not attributing diabetes symptoms to “old age”helping people with diabetes who are experiencing significant psychological distress related to living with diabetes (severe diabetes distress is experienced by 20% of people with type 2 diabetes who use insulin to manage the condition) and being aware that the metabolic effects of some psychotropic medications can increase the complexity of type 2 diabetes managementdiabetes management advice for people fasting during Ramadan.