11 July 2022
Under The Microscope feature article

Diabetes is one of the most significant health problems in South Western Sydney.

Overall, diabetes or high blood sugar affects 14.5 per cent of people in South Western Sydney, higher than the state average of 11.3 per cent – and that number is steadily growing.

People with type 2 diabetes make up the greatest proportion of these numbers. Type 2 diabetes is strongly associated with overweight and obesity and is therefore, largely preventable.

SWSPHN partners with South Western Sydney Local Health District (SWSLHD), healthcare providers and community to reduce the risk of diabetes, and support primary care providers in managing diabetes.

This National Diabetes Week, 10-16 July, learn more about our work.

About diabetes

Diabetes is a chronic condition which affects the whole body.

Diabetes is a leading cause of blindness, chronic kidney disease and dialysis, lower limb amputations, heart disease, stroke, complications in pregnancy and poor pregnancy outcomes. These complications have significant impacts on individuals, communities and the health system as a whole.

There are three main types of diabetes, they are:

Type 1 diabetes, a genetic condition which often shows up early in life

Type 2 diabetes, mainly lifestyle-related and develops over time

Gestational diabetes, occurs during pregnancy

People are at a higher risk of getting type 2 diabetes if they:

  • have a family history of diabetes
  • are older (over 55 years of age) – the risk increases as we age
  • are over 45 years of age and overweight

Some population groups within South Western Sydney have a higher than expected prevalence rate of diabetes and/or experience greater complications as a result of their diabetes than those in other groups. These priority populations include: Aboriginal communities; people from the pacific islands; people from culturally and linguistically diverse communities; people from rural areas; people; experiencing socioeconomic disadvantage; people with mental health issues; the frail aged; and those living with disability.

Integration

SWSPHN and SWSLHD partnered in 2019 to develop an Integrated Diabetes Plan for the region. The plan is guided by the South Western Sydney Diabetes Framework to 2026 and the partnership has so far delivered: 

General Practice

The Integrated Diabetes Program funds hospital specialists to provide case conferencing in general practices to manage complex patients. Case conferencing assists GPs to support patients with type 2 diabetes. An Endocrinologist and Diabetes Educator will come to the practice, the GP works with the endocrinologist to identify the patient’s care needs, identify outcomes to be achieved by each team member; and identify tasks which need to be undertaken to achieve these outcomes. The Diabetes Educator will work with the patient to provide education and support developing skills in self-management.

Education including the Western Diabetes Education Program which is delivered by Western Sydney University’s School of Medicine and is designed to increase awareness of the impact of diabetes, as well as build knowledge and develop skills in the management of diabetes for healthcare providers like GPs and general practice nurses. Through this program, healthcare providers gain a better understanding of complex and evolving diabetes care including: different types of diabetes; risk factors of diabetes; effect of diabetes on the normal regulation of blood glucose; common diabetes tests and screening procedures; complications associated with diabetes; management of diabetes, including lifestyle modifications and medical therapy; appropriate referral systems; impact of diabetes both in Australia and globally.

Community

Diabetes Contraception and Pre-Pregnancy Planning

High rates of congenital malformations exist in South Western Sydney in women with type 1 and type 2 diabetes. The Diabetes Contraception and Pre-pregnancy Program has been designed to develop a more integrated approach to supporting women of childbearing age with type 1 and type 2 diabetes. This program has been implemented elsewhere and has reduced the rates of congenital malformations, miscarriage and stillbirths by up to 70 per cent.

We’re working with Western Sydney University and South Western Sydney Local Health District (SWSLHD) to implement this program which:

  • raises awareness of risk of unplanned pregnancy and contraception methods in healthcare providers and women
  • provides easy access to best practice pre-pregnancy care for women who have decided to become pregnant

DiRECT-AUS Study

SWSPHN provides funding and support for the Australian arm of the Diabetes NSW DiRECT (Diabetes Remission Clinical Trial) Study. The program found that in the UK almost half of participants in the overweight or obese range who followed an intensive low-calorie diet of around 850 calories a day, for between eight and 20 weeks, were able to put their type 2 diabetes into remission.

Five general practices in South Western Sydney are participating in the trial, including Tharawal Aboriginal Medical Service. Download media release

The DiRECT study will be completed in July, with a full report to be released in January 2023. Additional research has also begun to look at how to effectively scale up the program.

Other sources of information/support

Health Pathways South Western Sydney

Access to clinical guidance and resources through HealthPathways South Western Sydney which provides evidence-based and localised clinical guidance to support the prevention, assessment and management of type 1 and 2 diabetes as well as gestational diabetes. The site also provides information on local health services, including referral processes.

Health Resource Directory

Health Resource Directory is a website developed by SWSPHN which provides reliable, local health information for your patients. It provides information on the main types of diabetes, as well as where to access supports and strategies to manage the condition.

GP representative invited to join diabetes sub-committee

SWSPHN is looking for one GP and one community representative to join our South Western Sydney Diabetes Framework to 2026 Primary and Community Diabetes Care Sub-Committee.

The sub-committee provides direction and clinical leadership on primary and community-based diabetes service provision in our region. It has representatives from SWSPHN and South Western Sydney Local Health District, in addition to endocrinologists, and local GPs.

Meetings occur every two months, on the fourth Tuesday of the month, from 6pm to 7pm via Microsoft Teams. Participants will be required to attend meetings to provide input based on their experience and expertise, and to read meeting papers prior to meeting (including the previous meeting’s minutes).

If you have an interest in improving diabetes care in South Western Sydney, please apply by contacting Kathryn Dovey at Kathryn.Dovey@swsphn.com.au