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Diabetes ‘tsunami’ looming for Australia

A high number of people are presenting to the ED with elevated blood sugar levels but are unwilling to do anything about it, new research shows.

More proof of Australia's looming diabetes "tsunami" has emerged, along with signs many of those affected are ignoring the seriousness of the disease.

A study focused on a Melbourne hospital's emergency department (ED) has found a high rate of people walking in with elevated blood sugar levels and a low level of willingness to do anything about it.

Professor George Jelinek led the research at St Vincent's Hospital, which sought to check the diabetes status of 725 random people who presented for emergency-related treatment.

It found 19 per cent of those coming through the ED's door had diabetes - about double that expected - but these patients knew about their condition and so were receiving treatment.

The rest who were apparently diabetes-free were given a finger-prick screening test, when more than a third (36 per cent) were found to have "suspicious" markers for the disease and they were asked to come back for a further test.

It was at this point the research hit a significant - and telling - hurdle.

"The whole aim of our study was to screen people so that we found how many of those had diabetes, but about three-quarters of that group who tested with a suspicious level didn't come back for formal testing," Jelinek, medical director of the Emergency Practise Innovation Centre at St Vincent's, said.

"They simply wouldn't come back despite the risk they had diabetes - we rang them many, many times and sent them letters.

"... it’s a real concern that people are underestimating the seriousness of this disease, and are not bothering to come back and be tested for it."

Of the minority in the at-risk group who did return for a follow-up test, 13 per cent were found to have type 2 diabetes while a further 18 per cent had pre-diabetes and were "on their way" to the disease.

"If we have this huge cohort of people who aren't yet diagnosed out there in the community, then we have a very major problem for the health system coming," Jelinek said.

"We have what people have called a tsunami of type 2 diabetes that is in the process of hitting the health system.

"The health system will find it extremely difficult to cope with that load of serious chronic illness."

Type 2 diabetes is a disease in which the body builds up resistance to insulin and so it works less effectively to regulate blood sugar levels.

While the condition can run in families, "lifestyle" factors such as being overweight or obese, lack of exercise, and poor diet can combine to significantly increase a person's risk of developing it.

When unaddressed, type 2 diabetes is a major cause of lower limb amputation, blindness, renal failure and the number one reason for those Australians on the waiting list for a life-saving kidney transplants.

Jelinek said it was concerning that some GPs also appeared to share the community's general "apathy and lack of knowledge" on type 2 diabetes, and they should redouble their efforts to detect and prevent the disease.

"We know that if people change their lifestyle, change their diet, lose weight, exercise, they can reduce that risk very dramatically, much more so than if they simply start taking medicine for it," Jelinek said.

"This is a very significant wake up call for people, if they are listening."

The research, conducted along with the University of Melbourne, is published in the journal Emergency Medicine Australia.


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