[PHP Nepal Vol 2 Issue 10 Oct Nov 2012] | Worldwide diabetes is a challenging public health problem. Australia, like many other countries, is facing a rising tide of people with diabetes. Approximately one million Australians have been diagnosed with diabetes. The onset of type 1 diabetes is typically at an early age, and is the most common form of childhood diabetes. Australia is ranked 7th highest in the world for prevalence of type 1 diabetes in children aged 0-14 years and 6th highest for incidence. The prevalence of type 2 diabetes, rises with age and is higher in men than in women.
Australian Bureau of Statistics 2009 Canberra says, "Within 20 years, there may be more than three million Australians with diabetes". Such increases will fuel rises in the complications of diabetes, for example foot, eye, kidney and cardiovascular complications. The consequence of a continued and uncontrolled rise in the numbers of people with diabetes may be that the children of today will be the first for many centuries to have a shorter life expectancy than their parents or grandparents.
Thankfully the last few decades have seen a steady decline in deaths from cardiovascular disease, due to many actions including a reduction in the rate of smoking and improved treatment of cholesterol and blood pressure, together with better management of heart attacks and strokes. However, the rising prevalence of diabetes and obesity may reverse these trends, because of the increased risk of cardiovascular disease associated with diabetes.
For older adults in many Indigenous communities in Australia, diabetes has become the norm, and many families have at least one person on dialysis due to diabetes-related kidney disease. Therefore the future for Indigenous Australians is even more challenging.
Right now diabetes is a huge challenge to our nation’s health and economy. Diabetes is frequently seen in younger adults; as such the development of serious complications of diabetes occurs at a working age with major consequences on employment. The health care costs of diabetes to the Australian economy, at $6 billion annually, are already enormous. Further increases in the numbers of people with diabetes will add substantially to this figure.
The European Union and the United Nations have both acknowledged the growth of diabetes as a major issue. They recognize the importance of preventive measures alongside effective management and care.
In Australia, we are beginning to develop strategies for diabetes prevention programs, but there is a need for further investment and the development of a multi-sectoral approach to prevention. National diabetes strategies will only be effectively implemented if organizations, governments and individuals work together. No single agency can achieve the requirements by working alone. Right now diabetes is a huge challenge to our nation’s health and economy. Much more work still needs to be done to continue to improve outcomes and alleviate the burden on individuals, families and the community.
Projections of the burden of diabetes in Australia suggests that if there are no changes in the incidence of diabetes (the number of new cases per year), there will be at least two million adults over the age of 25 years with diabetes by 2025. However, if diabetes incidence increases at current rates, there will be 2.5 -3 million people with diabetes by 2025 and around 3.5 million by 2033 (Magliano DJ eta., 2009). Estimates predict one third of today’s young adults will develop diabetes during their lifetime. Based on current information and mortality rates, this means that on average 14% of their remaining life will be lived with diabetes. Whilst most of the increase is due to type 2 diabetes, the incidence of type 1 diabetes in Australian children aged 0-14 years is also rising - at an average rate of 2.8% per year (Catanzanti et al., 2009). This places Australia among the top 10 countries in relation to incidence rates of type 1 diabetes in children.
Accurate and up to date information on the burden of disease and successful intervention strategies for individuals, professionals, and policy makers will all facilitate better outcomes. Adequate government funding for research to help find a cure and improved treatments as well as individuals adopting a healthy lifestyle require both societal support and governmental leadership. In conclusion, diabetes represents a huge challenge to health and economy of Australia.
Dawn Skidmore— MBA, MSc Healthcare (Physiotherapy), Australia