Diabetes Archives

27 November 2024

GPs with patients who observe Ramadan, and who also have a diabetes diagnosis, are being urged to offer them a pre-fasting assessment.

The Diabetes and Ramadan risk calculator allows GPs to calculate a patient’s risk of fasting based on their specific treatment. The assessment calculates a patient’s possible risk based on aspects such as level of glycaemic control, type of medication used, comorbidities and complications.

GPs can also discuss monitoring and how to treat a hypo, or manage high BGL, as well as prescribing any Ramadan-specific changes in the dose and/or timing of their patient’s diabetes medication or insulin regime.

Patients need to be reminded a hypo is a medical emergency, and treatment means they will have to break their fast. A visit to their GP to adjust their insulin regime before they begin fasting can help to avoid this.

GPs can advise their patients with diabetes that fasting or refraining from using medications, insulin and drinking water during Ramadan will affect their BGL and can lead to potential risks including high BGL (hyperglycaemia), low BGL (hypoglycaemia or hypo), dehydration, blood clots and diabetic ketoacidosis (DKA).

According to religious tenets, fasting should not create excessive hardship on an individual and those with diabetes should be reminded of any associated risks.

By using the Diabetes and Ramadan tool, GPs can make recommendations around the risk involved with fasting, based on their assessment.
It is also useful to conduct a post-Ramadan assessment to see what worked well, and what didn’t, so diabetes management can be adjusted in the future.

GPs are also able to access Telehealth case conferencing for specialist advice in the case of complex patients.

Find out more:

DAR Academy 

Diabetes Australia 

Telehealth case conferencing

14 October 2024

Take control of your type 2 diabetes with free education sessions in Vietnamese and Arabic. Led by bilingual educators, these sessions in Fairfield area help you manage your condition and prevent complications. Join the Live Well program to gain valuable support, manage type 2 diabetes and improve your health.

Why attend?

- Learn simple tips to improve your daily health and well-being
- Lean about your medication and how they work
- Meet others who are also managing diabetes
- Get guidance in your own language for easier learning

Program details:

- Available in Vietnamese or Arabic
- Four sessions, each lasting two hours
- Learn in a friendly small group
- Food and drinks provided

Who can attend?

- If you have type 2 diabetes, these sessions are for you
- If you’ve had diabetes for a while, this can help you get back on track

Topics discussed include:

- Knowing more about diabetes
- Physical activity
- Healthy eating
- managing diabetes
- Emotional health

How to join?

Pick up a brochure at your local participating pharmacy. Fill out the form on the back, tear it off, and give it to your pharmacist. A Bilingual Community Educator will contact you by phone or email with more information.

Participating pharmacies:

Arabic: Pharmacy 4 Less, 275 The Boulevarde, Fairfield Heights
Vietnamese: On’s Pharmacy, Shop 2, 76-80 John Street, Cabramatta

For more information on how South Western Sydney PHN support our community to manage their type 2 diabetes visit Diabetes | South Western Sydney PHN (swsphn.com.au)

Download a type 2 diabetes factsheet or audio file in your language at Health Resource Directory: Type 2 diabetes – Health Resource Directory

26 August 2024

Registrations are now open for the Western Sydney Diabetes Masterclass 2024 Series.

This is the sixth year of the series which targets GPs, pharmacists, diabetes educators, practice and community nurses, endocrinologists, dietitians, exercise physiologists, psychologists and podiatrists to equip them with the skills to better manage type 2 diabetes.

The Masterclass Series is a collaboration between Western Sydney, South Western Sydney, Nepean Blue Mountains and Hunter New England LHDs and PHNs; the Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU); National Association of Diabetes Centres (NADC); and the Agency of Clinical Innovation (ACI).

The series kicks off with a free full-day face-to-face event at the Parkroyal Hotel in Parramatta on Saturday, 14 September from 9am to 4pm. The highly anticipated event fills up quickly, with only 300 spots available on a first-come, first-served basis.

Keynote speaker will be Professor Stephen Twigg who will discuss diabetes and liver disease.

Other sessions will include subjects such as the benefit of exercise, living with stress, what every practitioner needs to know about nutrition, effective weight management in pregnancy and type 1 diabetes in general practice.

Following the face-to-face event, the Masterclass Series continues with weekly virtual sessions every Tuesday night from 17 September to 12 November at 7pm to 8.30pm.

The sessions are designed to keep you up-to-date with the latest in diabetes care and feature expert guest speakers, interactive case studies and panel discussions in subjects including unpacking medications, the future of treatment, improving diabetes care for Aboriginal people and curbing the numbers.

For enquiries email WSLHD-WSDiabetes@health.nsw.gov.au.

20 August 2024

GPs can support their patients by using the diabetes cycle of care.

The diabetes cycle of care is a checklist which outlines the various checks and reviews which should be undertaken to manage diabetes and reduce the risk of diabetes-related complications.

The annual cycle of care is recommended by the RACGP – Assessment of the patient with type 2 diabetes and has information about the recommended frequency of health checks.

A table outlining checks needed and how often those checks should be undertaken, is available on the SWSPHN website.

General practices are encouraged to put in place recall and reminder systems to ensure patients with diabetes complete their health checks on time to identify any health problems early.

You can identify which of your patients are overdue for elements of their annual cycle of care by generating a POLAR report and establishing patient recalls.

For assistance with pulling a POLAR report on your patients, please contact SWSPHN’s diabetes health coordinator, Alyssa Horgan, on 4632 3000 or email alyssa.horgan@swsphn.com.au

Your patients can access a diabetes annual cycle of care factsheet on the National Diabetes Services Scheme website.

30 July 2024

Do any of your patients diagnosed with type 2 diabetes mellitus struggle to get and eat nutritious foods?

Researchers are looking to recruit participants who have had type 2 diabetes mellitus for more than a year and who have had a recent HbA1c of more than 7.5 per cent to participate in a medically tailored meals study.

Participants will be randomly assigned to one of two groups. One group will receive 20 pre-prepared healthy meals over two weeks for six months and $250 in vouchers. The other group will receive $350 in vouchers.

GPs will be reimbursed $50 for every referred participant who is randomised into the study.

If you have patients who would be interested in participating, please contact Tobias Kongbrailatpam t.kongbrailatpam@westernsydney.edu.au or 4634 4593 for more information.

11 July 2024

With the right planning and preparation, women with diabetes can “absolutely” have a healthy pregnancy and a healthy baby.

This positive message from mother-of-two, Rachel Hicks (pictured), comes as National Diabetes Week, 14 to 21 July, focuses on improving access to the life-saving technology people with diabetes need to live well.

Mrs Hicks, from the Southern Highlands, who was diagnosed with type 1 diabetes when she was five years old, said access to an insulin pump and a continuous glucose monitor had been life-changing for her.

“Having diabetes as a child and a teenager, you get a lot of pressure to just fit in,” she said. “So, I was on manual injections for a very long time, and I was very against having an insulin pump for a long time as a kid.

“Encouragement from my team (at Macarthur Diabetes Service at Campbelltown Hospital) and being able to access an insulin pump through private health insurance, changed this when I was 17. I was told the pump would really help me get my diabetes in the most ideal space for my circumstances.”

For women with diabetes, understanding and managing the risks of unplanned pregnancies, undertaking pre-pregnancy planning and maintaining glycaemic control before and throughout pregnancy can significantly increase the chance of having a healthy baby.

Having high glucose levels during pregnancy, increases the chance the baby may not develop properly. It also can increase the risk of loss or stillbirth.

Mrs Hicks said when she decided to start a family, she’d been lucky enough to be among the first patients to access the Diabetes Contraception and Pre-pregnancy Program (DCAPP) when it was introduced at Campbelltown Hospital.

She said she had understood before becoming pregnant there would be challenges, and her diabetes may cause complications which could have long-term effects for her and her baby.

But, at the same time she knew she could be prepared.

“What really made a difference for me was my treating team, in addition to the introduction of DCAPP thanks to Professor David Simmons.” she said.

“It was really great to have the treating team in Campbelltown. They used language which was empowering and at every appointment they’d emphasise something that I’d done well.”

DCAPP has been designed to develop a more integrated approach to supporting women of childbearing age with type 1 and type 2 diabetes. Similar programs implemented elsewhere have reduced the rates of congenital malformations, miscarriage and stillbirths by up to 70 per cent.

South Western Sydney Primary Health Network is working in partnership with Western Sydney University and South Western Sydney Local Health District to implement the program in our region.

Mrs Hicks said it took a couple of years to get her diabetes in the space where she felt comfortable to be able to manage it and start trying for a baby.

Her pregnancy planning team included a diabetes educator, an endocrinologist and a GP, who worked collaboratively to improve her blood glucose management and put plans in place to prepare for extra low blood sugar levels, and ensure she had access to the most appropriate devices.

She said glucose monitors became more readily available around the time she was thinking about starting a family, with the introduction of a government subsidy.

“The glucose monitor removed a lot of the calculations and the decisions I’d have to make on a daily basis.

“Going through my first pregnancy there was so much more information to take on about what I needed to do for myself, for my baby, for my family during that time, so it was good to have a little bit of pressure relieved with access to a glucose monitor and getting more data on what was happening with my diabetes.

“My team helped me sign up for the glucose monitor subsidy and made sure I had all the tools I needed, even getting an updated ketones tester because I was still testing ketones manually.”

Mrs Hicks is also undertaking PhD research examining lived experiences of diabetes and pregnancy. She said in addition to tailored support like she had received, women with diabetes planning pregnancy could also benefit from the good peer support communities which existed and hearing about the experiences of others.

“As part of my research, I want to develop initiatives which are made by the community, for the community, to help improve pregnancy outcomes for people with diabetes. I also want to improve collaboration between those with lived experience of diabetes and pregnancy and healthcare professionals.”

If you have type 1 or type 2 diabetes and are thinking about having a baby, pre-pregnancy planning is vital. Speak to your GP about how you can prepare your body for a healthy pregnancy.

08 July 2024

Women with diabetes who have glucose levels outside target ranges and become pregnant are at increased risk of pregnancy related complications and poor birth outcomes.

Having support from a GP to plan and manage the pregnancies of women with diabetes can reduce complications for both the mother and baby.

South Western Sydney PHN (SWSPHN) is hosting a webinar during National Diabetes Week, 14 to 21 July, which emphasises the importance of having routine conversations with patients about managing their diabetes before becoming pregnant.

Head of the Campbelltown Hospital Endocrinology Department, Professor David Simmons, will present the Diabetes Contraception and Pre-pregnancy Program (DCAPP) webinar on Thursday, 18 July, from 7pm.

What is DCAPP?

DCAPP has been designed to develop a more integrated approach to supporting women of childbearing age with type 1 and type 2 diabetes.

SWSPHN is working in partnership with Western Sydney University and South Western Sydney Local Health District to implement the program in our region.

For women with pre-existing diabetes, understanding and managing the risks of unplanned pregnancies, undertaking pre-pregnancy planning and maintaining glycaemic level target ranges before and throughout pregnancy can significantly increase the likelihood of having a healthy baby.

Similar programs implemented elsewhere have reduced the rates of congenital malformations, miscarriage and stillbirths by up to 70 per cent.

DCAPP aims to open up early conversations between GPs and their patients about the seriousness and potential complications of becoming pregnant if the patients’ diabetes is not well-managed.

It provides GPs with guidance on managing these patients, including about referring patients with diabetes who are planning pregnancy to one of the diabetes pre-pregnancy clinics across our region. For patients who are not planning pregnancy, GPs are encouraged to discuss the importance of contraception with your patients with diabetes.

How are patients benefiting from DCAPP?

Mother of two, Rachel Hicks (pictured), was diagnosed with type 1 diabetes when she was five.

She said encouragement and support from her treating team at Macarthur Diabetes Service at Campbelltown Hospital, and Professor David Simmons introducing the Diabetes Contraception and Pre-pregnancy Program (DCAPP) at Campbelltown, made all the difference when she decided to start trying for a family.

Her team included a diabetes educator, an endocrinologist and a GP, who worked collaboratively to improve her blood glucose management and put plans in place to prepare for extra low blood sugar levels, and ensure she had access to the most appropriate devices like an insulin pump and a continuous glucose monitor.

“Going through my first pregnancy there was so much more information to take on about what I needed to do for myself, for my baby, for my family during that time. It was good to have a little bit of pressure relieved with access to a glucose monitor and getting more data on what was happening with my diabetes.”

How can diabetes care be more accessible?

Mrs Hicks is also undertaking PhD research examining lived experiences of diabetes and pregnancy, including working with DCAPP to look at peer support models.

She said her research had highlighted how there couldn’t be a one-size fits all approach to providing accessible care to, and engaging with vulnerable communities across South Western Sydney, including people from culturally linguistically and diverse (CALD) backgrounds.

“We’ve seen with diabetes programs delivered at Campbelltown Hospital for example, where our treating teams going out into the communities deliver some services in spaces which are more suitable and for those communities.

“And we saw hybrid models of care throughout the pandemic as well – a mixed delivery of services which has been beneficial, especially for women with diabetes who are concerned about how medicalised their pregnancy is going to be.

“If there’s any options for making care more accessible or equitable, like the option of the hybrid model of care, that would be most beneficial.”

Support for your practice

SWSPHN will run a POLAR report for interested practices in our region, to identify patients diagnosed with diabetes who are of childbearing age. The report will help develop a recall list, enabling you to engage those patients in discussions about pre-pregnancy planning and contraception. Our diabetes co-ordinator Alyssa Horgan is available to visit practices to assist in setting up a recall process.

For bookings or enquiries, contact Alyssa via email at alyssa.horgan@swsphn.com.au or phone 4632 3088.

Webinar details

The Diabetes Contraception and Pre-pregnancy Program webinar will:

educate GPs on potential maternal and neonatal outcomes if a woman’s diabetes is not controlled before pregnancy
which medications should be stopped, substituted or introduced before pregnancy
why they should refer patients to a diabetes pre-pregnancy planning clinic

It has been RACGP-approved for 1.5 Educational Activities hours.

Visit the SWSPHN website to register.

Additional resources

Download the flyer for ways to support your at-risk patients

Visit HealthPathways for pre-pregnancy planning for type 1 and type 2 diabetes pathways

Visit SWSPHN’s website to find diabetes resources for GPs

Visit Diabetes Australia for information about National Diabetes Week

24 June 2024

Western Sydney University’s accredited Diabetes Education course has a mid-year intake in July.

The Graduate Certificate in Person-centred Diabetes Care and Education is a clinically focused course which prepares students to support and educate people with diabetes to better self-manage their condition.

It’s designed for multidisciplinary clinicians including registered nurses, dietitians, podiatrists, exercise physiologists, pharmacists, physiotherapists, midwives, medical officers and other professionals working with people with diabetes.

The course is part-time with a duration of one year: July to November 2024 and March to June 2025. Students will also undertake a 40-hour clinical placement in a diabetes service.

A Post Graduate Open Day will take place on Sunday, 30 June 2024 at Western Sydney University South Parramatta Campus.

For enquiries email coursecoordinator.diabetes@westernsydney.edu.au.

Download the flyer

Download course information

21 June 2024

The diabetes annual cycle of care is a checklist designed to help keep diabetes under control to reduce the risk of diabetes-related complications.

If you have diabetes, your GP can help you manage your condition through a GP management plan which may allow you to receive a Medicare rebate when seeing some health professionals.

Steps you can take to reduce the risk of complications

As part of your daily diabetes management, you can undertake checks of your blood glucose levels (BGLs). Your GP will advise you what your BGL target is and how often you should test. The HbA1c test (also known as glycosylated haemoglobin) demonstrates an overall view of your blood glucose management average over the previous 10 to 12 weeks. Generally, 7 per cent or lower is ideal. This can be checked at least once a year, and up to four times a year.

It is also important your blood pressure is checked because high blood pressure can cause diabetes-related complications. For someone with diabetes, target blood pressure is less than 130/80. It should be checked regularly, at every doctors’ visit.

There is also an increased risk of damage to kidneys over time. A yearly urine microalbumin test can be used to detect early signs of kidney damage in people who are at risk of developing kidney disease.

Having high cholesterol (blood fats-lipids) can increase your risk of heart disease and stroke. It is best to have your lipids checked every 12 months.

Diabetes can cause complications to your eyes if left untreated. This damage can be prevented by keeping your BGL’s, HbA1c and blood pressure within target ranges. Have your eyes checked by an optometrist every one to two years or if you notice any change in your vision.

Your feet can also be affected by your diabetes. Make sure to look for changes every day, and see a podiatrist at least once a year.

Chart to help you manage your condition

	Check	How Often
	Foot assessment for high-risk feet	Every 1-3 months
	Foot assessment for moderate risk feet	Every 3-6 months
	Blood pressure	At least every 6 months
	Weight	At least every 6 months
	Waist circumference	At least every 6 months
	HbA1c	At least every 6-12 months
	Foot assessment for Very-low and low-risk feet	At least every year
	Kidney health	At least every year
	Blood fats	At least every year
	Healthy eating review	At least every year
	Physical activity review	At least every year
	Medication review	At least every year
	Smoking	At least every year
	Diabetes management	At least every year
	Eye examination	At least every two years
	Emotional health	As needed

You can find more information about other parts of the diabetes annual cycle of care at

Your diabetes annual cycle of care fact sheet | NDSS

04 June 2024

The Get Healthy Service can help your patients make lifestyle changes to improve their health.

The service, delivered by NSW Health, complements the care provided by a patient’s regular GP by offering free phone and online health coaching to patients over the age of 16.

You can refer your patients to the service to receive six or more confidential coaching calls with a university qualified health coach.

Coaches provide support to patients and will assist them to:

set and achieve health goals
eat well and keep active
reduce the amount of alcohol intake
reach and stay at a healthy weight
gain a healthy amount of weight in pregnancy
stay active during and after cancer treatment

Patients who complete the program have lost an average of 1.79kg, have reduced their waist circumference by 1.64cm and have reduced their BMI by 0.64kg/m2.

They were also more physically active and ate more fruit and vegetables each day.

You can refer your patients to this free service using the Get Healthy website.

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Topic: Diabetes