Live Life Well: Initiatives in NSW
Prevent Diabetes Live Life Well program
Some facts about type 2 diabetes
What is type 2 diabetes?
Type 2 diabetes is the most common form of diabetes and occurs mostly in people aged 50 years or over. People with type 2 diabetes produce insulin but may not produce enough or cannot use it effectively (insulin resistance).
Type 2 diabetes develops gradually over time: organ damage may occur before symptoms are noticed. Early diagnosis of those at risk is essential to allow those at risk to reduce their personal likelihood of developing the disease by making simple healthier lifestyle choices.
How many Australians have type 2 diabetes?
The 2006 Australian Institute of Health and Welfare report estimated that 950,000 Australian adults aged 25 years or above had type 2 diabetes (7.5% of the population). Based on NHS self-reported data, 582,800 people (3.0% of Australians of all ages) had diagnosed type 2 diabetes in 2004-05. Prevalence estimates from measured data are higher than those based on self-reports because they include people with undiagnosed diabetes: data indicates that for every diagnosed case, there is another one undiagnosed.
Rates of diabetes are increasing. Prevalence more than doubled between 1989-90 and 2004-05. Australia is in the middle of an epidemic of type 2 diabetes with 275 people developing type 2 diabetes every day. Of those, half are not aware of their condition.
Why is it a problem?
Type 2 diabetes can cause disability, poor quality of life and premature death. People with type 2 diabetes are at higher risk of heart attack, coronary artery and peripheral vascular disease, stroke, dementia and memory loss, kidney failure, blindness, amputations, impaired mobility and falls. Diabetes and its complications were responsible for around 8% of the total burden of disease in Australia in 2003.
Some population groups are at much higher risk
- Males have higher prevalence rates than females.
- Aboriginal people are 3 times as likely as non-Indigenous people to have diabetes and have much greater hospitalisation and death rates.
- Prevalence and death rates for the worst-off fifth of the population are nearly twice as high as for the best-off fifth of the population.
- People born in some overseas countries also have higher rates (those born in North Africa, the Middle-East, South-East Asia, Southern and Eastern Europe and Oceanic countries excluding Australia).
Risk factors for type 2 diabetes
A number of genetic, biomedical, demographic and lifestyle and behavioural risk factors are implicated in the development of type 2 diabetes. Some of these can be changed (being physically active, eating more healthily, being a healthy weight and stopping smoking) whilst others can not (getting older, being male, being born overseas and family history).
What are the solutions?
Type 2 diabetes is largely preventable: control of modifiable risk factors - such as physical activity, overweight and obesity - can reduce the complications associated with type 2 diabetes and even prevent it developing.
What is being done to address the issue?
As part of NSW Health's commitment to the National Diabetes Strategy, and under the Australian Better Health Initiative, NSW Health is funding a Prevent Diabetes Live Life Well program from 1 June 2008 until 30 June 2010. The Prevent Diabetes Live Life Well program educates, demonstrates and motivates participants to make healthier lifestyle choices to reduce their personal risk of developing type 2 diabetes.
Control of modifiable risk factors is the key to prevention.
Risk factors for type 2 diabetes are amenable to change
Studies have shown that it is possible to prevent type 2 diabetes by improving eating habits and increasing physical activity. Each of these affect overweight and obesity: a key risk factor for developing type 2 diabetes and one that is increasing. In 2004-05, an estimated 51% of Australians aged 15 years and over were overweight or obese (based on self-report) and an estimated 70% of Australians aged 15 years or over did insufficient physical activity.
International evidence
Five randomised controlled trials of lifestyle modification for prevention of type 2 diabetes have been published since 1997. These trials took place in China, Finland, the USA, India, and Japan. In each study, personalised goal setting, on-going support, regular assessment and feedback, and self-monitoring of behaviours and outcomes formed a part of the behavioural strategy.
All trials were successful in reducing the risk of incident type 2 diabetes by between 29% and 68%. The achievement of a greater number of lifestyle modification goals was associated with greater efficacy for diabetes prevention. The preventive effect persisted, although to a lesser extent, 3 year after the trials concluded.
The Prevent Diabetes Live Life Well program is a first for NSW to see whether these reductions in risk can be realised by people at risk of developing type 2 diabetes.