Diabetes in Australia: A Chronic Disease and Prevention Strategies

This report critically examines diabetes as a chronic disease in Australia, highlighting its impact as the fifth leading cause of health risks and deaths. It explores the causes and symptoms of diabetes, differentiating between Type 1 and Type 2, and discussing risk factors like sedentary lifestyles and poor diets. The report details the social determinants influencing diabetes, its global and local burden, and the economic impact on healthcare. It discusses management strategies, including insulin therapy and preventive measures. The report also addresses the significance of public health initiatives and government policies in managing and preventing diabetes, including Medicare and Pharmaceutical Benefits Scheme provisions, and research funding. The report concludes with an assessment of the effectiveness of current strategies and suggests areas for improvement.

1DIABETES: A CHRONIC CONDITION AND PREVENTION
Diabetes: A chronic condition and prevention
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1Diabetes: A chronic condition and prevention
Abstract
The aim of this paper is to critically examine diabetes as a chronic disease in Australia.
Diabetes has been marked as the 5th highest cause for health risks like cardiovascular disorder
and kidney failure and also deaths for the Australians. Diabetes is further exacerbated by a
cluster of social determinants like sedentary lifestyle, drinking, consumption of fast food to
name a few. The medical expenses to borne on diabetes is quite enormous and accounts to
twice as more than the non[-diabetic patients (Hill, Nielsen & Fox, 2013). The WHO has
been proactive in formulating areport to study the incidence, impact and the hospitalization
rate of diabetes patients. However, the broader goal should to be to collaborate with the
multiple stakeholders in relation to the disease to develop a holistic approach.
Key words: Diabetes, Chronic disease, Australia, risk factors, social determinants, insulin and
prevention of diabetes

2Diabetes: A chronic condition and prevention
Diabetes: A chronic condition and prevention
Introduction
This research report is concerned with the examination of diabetes as a chronic
disease in Australia. It also attempts to understand the causes and symptoms of diabetes, the
rationale behind choosing diabetes as a chronic disease, the impact of diabetes on a local and
the global level, some of the individual risk factors related to diabetes, management of
diabetes, its prevention and remedies and the critical assessment the preventive and
management strategies for mitigating diabetes. This essay further delves into the
hospitalisation, prevalence and incidence of deaths.
Why diabetes is a chronic disease?
Diabetes also known as diabetes mellitus is responsible for affecting 200 people. It is
believed to be the fifth cause of disease all over world. As a chronic disease, diabetes is
characterized by when there is excess amount of glucose in the human body. Diabetes can
People with Polycystic Ovary (PCOS) may develop diabetes due to the excess
consumption of sugar. There are two types of diabetes Type 1 and Type 2 diabetes. Type 1
diabetes is an outcome of the destruction of the cells in the pancreas by the immune system
(McKnight et al., 2015). These cells are called beta cells. These cells are responsible for the
production of insulin. In, diabetes, the beta cells are damaged. There is an obstruction in the
movement of the glucose into the cells due to the absence of insulin. It has been reported that
5 per cent of people suffering from diabetes have type 1 diabetes (Wen et al., 2016).There has

3Diabetes: A chronic condition and prevention
been more interesting results in this light. Type 1 diabetes have been reported to be higher
among the whites compared to African-American people. Diabetes may occur at any age but
it causes harm to men and women in equal measure. Patients of type 1 diabetes have shown
the sign of heart attacks. These attacks are known as autoantibodies.
High blood sugar can lead to a multiple factors. First condition is dehydration. This is
a condition when there is excess sugar in the blood and the patient show the symptom of
continuous pee. This is the response of the body to get rid of the excess sugar from the
system of the body. In this condition, a large amount of water is released from the body along
with the urine as a waste product. Therefore, the body becomes excessively dry and
dehydrated. Another symptom is weight loss. The glucose that is released from the body
propels quick weight loss of the body. When the body is deprived of glucose, which is a
source of fuel, the fat cells are disintegrated. This produces chemicals known as ketones.
Then the liver liberates sugar from the body (NCD Risk Factor Collaboration, 2016). This is
known as ketoacids which is an outcome of dehydration, extra glucose and the excess
development/ accumulation of acid in the body. The accumulation of ketoacidosis can have
life threatening repercussions. The stockpile of high glucose levels in the body for a
prolonged period of life can also damage the nerves. Additionally, it may also be adverse for
the small blood vessels present in our eyes, heart and kidney. Another consequence maybe
the stiffening of the atherosclerosis or the arteries, the result of this would be strokes and
heart attacks. People with high blood sugar level in their body have been reported to have
diabetes. Some of the common symptoms of diabetes are a sudden increase in hunger,
dryness of the mouth, vomiting and nausea, pain the belly, frequent sensation of urination,
feeling of perpetual weakness, blurred vision, heaviness in breathing and a sudden loss of
weight of the body, infections on the skin, infections in the vagina or infections in the urinary
tract. Type 1 diabetes is a condition when the pancreas do not produce insulin. It is reported

4Diabetes: A chronic condition and prevention
that 10to 15 per cent of all the cases pertaining to diabetes are of Type 1 (Huo et al., 2016).
It is also a common chronic childhood disease among the children. Type 1 diabetes mostly
occurs under the age of 30 (Guariguata et al., 2014). People with Type 1 diabetes if they do
not get insulin, their body would burn its own fats as an alternative to chemical substances in
the blood. Type 1 diabetes is said to have link with the hereditary of the family and hence, it
becomes difficult to prevent it.
According to an important study conducted by Harding et al. (2014), around 1, 136,
617 Australian citizens who are affected with diabetes and are registered with the National
Diabetes Services Scheme between the span of 1997 and 2010 were connected to the death
index. The study also demonstrated that the SMR (Standard Mortality Ratio) for males in the
year 1997 was 4.20 and in 2010 it is 3.08. In case of females, there is dip from 3.92 SMR to
3.46 SMR (Hendrieckx et al., 2017). This change is being perceived as negligible (Reports,
2018). While this was for Type 1 diabetes, the next set of revelations for Type 2 diabetes,
there has been a reduction in Cardio-vascular disease (CVD) from 44.5 to 29. 2 per cent in
males. In case of the females, there is a reduction from 45.5 to 31.3 per cent. This study has
important implications to examine the mortality pattern in relation to diabetes (Reports,
2018).

5Diabetes: A chronic condition and prevention
Figure 1- Rate of diabetes among men and women in Australia
Source- (aihw.gov.au)
Figure 2- Rate of diabetes among men and women in different zones of the city
Source- (aihw.gov.au)
The burden of the diabetes on global and local level
Diabetes is on a rise and it is found that the incidence of diabetes has shot up in
middle-income countries. This surge in the rate of diabetes can be attributed to the lack of a
proactive approach of the government to promote a culture of healthy lifestyles. The glaring

6Diabetes: A chronic condition and prevention
paucity the treatment and prevention of premium quality and cutting-edge healthcare services
for people with modest incomes is being touted is another cause for the burgeoning of
diabetes in Australia.
The public health significance of diabetes in Australia
Diabetes as a chronic disease is of immense public significance. It is estimated that if
diabetes continue to rise, more than three million people are predicted to be hit by this silent
pandemic (Australia, 2014). There is a prognosis that by the year 2025, people above the age
of 25 years are set to be hit by diabetes. The prevalence of type 2 disease can be attributed to
the proliferation in the ageing population, transformation in the dietary habits, increase in
obesity and a predilection towards sedentary lifestyle are being considered as the major
reasons for Type 2 diabetes.
On the financial front, the economic burden on people with diabetes huge. It is found
that the average medical expenditure for diabetic patients are twice as compared to patients
who do not suffer from diabetes (Hill, Nielsen & Fox, 2013).
Individual risk factors for the condition
According to Bouillon et al., (2013), being female, increase in age, quitting smoking,
low level of physical activity and the non-consumption of vegetables and fruits have been
connected with prefailty or frailty with odd ratios that increases by 1 SD. The study proved
that the selection of certain risk factors and certain risk scores for diabetes for diabetes are
ultimately related to frailty. These risk scores have the possibility of utility for the prediction
of frailty in clinical practises. Some of the risk factors associated with diabetes are
cardiovascular diseases (CVD). In Australia, diabetes along with chronic kidney disorder and
CVD constitutes for about a quarter of diseases for the population in Australia (Reports,

7Diabetes: A chronic condition and prevention
2018). In case of Type 2 diabetes, the cardinal determinants of risk cannot be altered that
includes the increase in age, ethnicity, family heredity and genetic make-up.
The broad determinants of diabetes
A range of complex determinants both social environment and physical environments
impinge the health. All these elements are together known as the social determinants of
health. Internationally, it has been found that social determinants like education, income,
access to nutritional food resources and housing have been identified as key determinants.
The pervasion and incidence of Type 2 diabetes have correlation with social and
economic status of the individual. For example, people in the lower-income group and with
no education are 2 to 4 times more prone to be affected by diabetes in compared to people
who are economically privileged (Risk factors to health, 2018). Hence, attention needs to be
directed at the social determinants of diabetes as it continues to pose barrier in the
amelioration of the health condition of the population.
Management of diabetes: Prevention and remedies
Insulin is basically a hormone. The function of insulin is to help in the movement of
glucose or sugar into the tissues of the body (Holmes-Truscott et al., 2016). It is then in turn
is used by the cells as a fuel. The common remedy for Type 1 diabetes is the use of insulin
injection or the use of insulin pumps.
The first step towards the mitigation of diabetes are the consultation of GPs (General
Practitioners). Diabetes needs to be regulated in a collaborative arrangement. This would
entail a continuous surveillance of the loss of weight of the patient, level of blood, the
average status of health, and there needs to be an approach that thoroughly examines the feet
and eyes of the patients (Baxter et al., 2016). In case, complication is observed in a diabetic

8Diabetes: A chronic condition and prevention
patient, they should be referred to cardiologists, endocrinologists, obstetricians, nephrologists
or ophthalmologists depending on the condition.
On a national level, diabetes is addressed through a range of endeavours and
policies that is committed towards the management and treatment of patients with diabetes.
Australia has also shown dedication in conducting clinical research and funding for the
treatment of diabetes. There is the provision of Medicare Benefits Schedule that distributes
subsidies for the care of patients and incorporates medicare products for the management and
planning of terminal and chronic conditions (World Health Organization, 2016). Patients who
are referred by the GPs can also avail the subsidised Medicare health services that are
connected to the amelioration of chronic condition, in this regard diabetes. Second, provision
is the Pharmaceuticals Benefits Scheme that caters to the medicine for the treatment of
diabetes. Another provision is the National Diabetes services Scheme that is supervised by
Diabetes Australia in collaboration with the Department of Health. The function of this
provision is to provide subsidized items like needles and syringes, test strips, blood glucose,
insulin pump and urine test strips. There are other remarkable investments in diabetes
research through the intervention of National Health and Medical Research Council
(NHMRC) for the research into the plight of diabetes. The aim of this scheme is to work on
patient care with different and convoluted disease that also includes diabetes. It has been
recognized by NHMRC as a key focus for 2013-2015 Strategic Plan.
Another key intervention has emerged from the Australian Institute of Health and
Welfare (AIHW) that provides patronage to support surveillance and monitoring of vascular
diseases including diabetes and chronic kidney disorder on a national scale.
In the 2030 Agenda for sustainable development, member states to proposed for an
Agenda of Sustainable Development and Member States embarked upon an ambitious target

9Diabetes: A chronic condition and prevention
to minimize NCDs that are responsible for the premature mortality. This also includes
diabetes which is responsible for one0third deaths in Australia (World Health Organization,
2015). It was decided that by 2030 there will be the disbursal of universal health coverage
and the provision of of the accessibility to affordable indispensable medicines. The WHO
Global Report on Diabetes has been devised by WHO as an endeavour to collect data on the
incidence, hospitalization and consequences of diabetes in Australia. The report would
engage in a understanding the trends in diabetes, high blood glucose (diabetes) that leads to
premature mortality.
Critical review of the management of diabetes
Insulin has been perceived as an important remedy to mitigate diabetes. There is a
belief among 51 per cent people that taking recourse to insulin is suggestive of the further
exacerbation in their diabetic condition (Holmes‐Truscott et al., 2015). There is also a
prevalent belief that insulin as a remedy leads to the increase in weight. Consumption of
insulin also means to some people that their diabetes has increased (39 per cent of the people
are of that view). The Australian Bureau of disease Study (ABDS) 2011 identified four
complications as a result of diabetes. Some of these symptoms are diabetic foot ulcer, visual
impairment, diabetic neuropathy and amputation of the lower limb. In the year 2011, it was
found that about 730, 000Australians have been diagnosed with diabetes. Out of which
around 1.7 per cent have faced amputation of the lower limb (Silvestre et al., 2016). It was
further found that there have been detrimental effects on health as a result of lower limb
amputation. In 2015, around 28, 775 people started taking recourse to insulin- out of which

10Diabetes: A chronic condition and prevention
63 per cent were suffering from type 2 diabetes, 26 per cent people had gestational diabetes, 9
per cent type 1 diabetes and 2 per cent were suffering from other kinds of diabetes (World
Health Organization 2015).
In case of the WHO Report, There would also be an effort in examining the role and
onus undertaken by the government to mitigate and alleviate the bane of diabetes. Although,
the WHO initiative is commendable, however it is important to engage the civil society and
people with diabetes as important social actors in the prevention of diabetes. Another key
strategy would be to involve the manufacturers of medicine and the producers of food to
come up with sustainable and effective strategies that mitigate the rise of diabetes. The
Report has also brought out that it is important to address diabetes not just on singular level
but through the development of collective consensus. The different stakeholders in the
diabetes need to realize their potent role in this regard. The civil society and different health
groups need to create persistent pressure on the government for public expenditure on
diabetes. The WHO Report should not be limited to a five year analysis. On the contrary, it is
pragmatic to adopt a longitudinal study approach to keep a track on the performance of the
multiple stakeholders in relation to diabetes awareness and prevention.
Another strategy that needs to be included in the WHO Report on Diabetes is to
engage school children to create awareness and explain the plight of diabetes. This will create
an early sensitization that would enable them to understand the different preventive measures
that propels to diabetes and hence, the glaring rise of diabetes can be brought down.
Conclusion
Therefore, the above discussions on the impact of diabetes in Australia highlighted
the cause of diabetes and the mortality rate and concomitant diseases that have rose due to the
prevalence of diabetes. It was found that the Australian government has shown enthusiasm in

11Diabetes: A chronic condition and prevention
mitigating the incidence of diabetes, however there is an urgency to collaborate different
stakeholders related to diabetes and sustain a culture of awareness and prevention on a long-
term basis.
References
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(2016). Estimating the impact of better management of glycaemic control in adults
with Type 1 and Type 2 diabetes on the number of clinical complications and the
associated financial benefit. Diabetic Medicine, 33(11), 1575-1581.
Bouillon, K., Kivimäki, M., Hamer, M., Shipley, M. J., Akbaraly, T. N., Tabak, A., ... &
Batty, G. D. (2013). Diabetes risk factors, diabetes risk algorithms, and the prediction
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Medical Directors Association, 14(11), 851-e1.
Guariguata, L., Whiting, D. R., Hambleton, I., Beagley, J., Linnenkamp, U., & Shaw, J. E.
(2014). Global estimates of diabetes prevalence for 2013 and projections for
2035. Diabetes research and clinical practice, 103(2), 137-149.