After an ambush by 2020 Australian of the Year Dr James Muecke at the AMA national conference in Adelaide, Dr Michael Wright had a measured response.
The RACGP has responded to surprising criticism from former Australian of the Year Dr James Muecke over potential conflicts of interest among authors of its type 2 diabetes handbook.
Dr Muecke, an ophthalmologist and vehement advocate against ultra-processed foods and the influence of Seventh Day Adventist beliefs about plant-based diets through its company Sanitarium, did not spare the college during his keynote speech at the AMA’s national conference in Adelaide on Friday.
“The Royal Australian College of General Practitioners’ leadership team is riddled with conflicted doctors,” he said.
He went on to claim that most of the authors of Management of Type 2 Diabetes: A handbook for general practice had financial ties to the pharmaceutical industry, a conflict of interest which, he said “have not been disclosed anywhere”.
RACGP president Dr Michael Wright responded quickly, telling TMR:
“The RACGP has clear processes to identify and manage potential conflicts of interest,” he said.
“I’d be happy to speak with Dr Muecke to understand his specific concerns.”
Dr Muecke’s criticism of the T2D handbook included a complaint about the lack of mentions of “therapeutic carbohydrate reduction using real food”.
“There’s no mention of therapeutic carbohydrate reduction using real food – the third and arguably most powerful option, despite the fact it’s now been endorsed by Diabetes Australia and the Australian Diabetes Society as best practice,” he told the conference.
“Within the body of the handbook, there are a few brief mentions of therapeutic carbohydrate reduction, but amounting to roughly half of one page and much of it dismissive of the approach.
“This contrasts to 20 pages dedicated to the pharmaceutical management of type 2 diabetes.”
Dr Wright pointed out that the handbook had been extensively reviewed by individual experts and relevant organisations.
“This extensive and independent review process mean its recommendations and clinical guidance reflect the high-quality evidence for clinical management of type 2 diabetes in general practice,” he told TMR.
“This includes review by experts and relevant organisations including the Australasian Metabolic Health Society, the chief medical officer of Diabetes Australia, Dietitians Australia, the Royal Australian and New Zealand College of Ophthalmologists, and members of the RACGP Expert Committee – Quality Care, in addition to members of the RACGP Specific Interests – Diabetes group.
“In addition to this extensive independent expert review, the development process for this and other guidelines includes tracking and managing any conflicts of interest or perceived conflicts of interest.
“All members of the Handbook’s working groups are required to adhere to the RACGP Conflicts of Interest Guidance, and required to disclose any potential conflicts or sources of bias, which are carefully managed throughout the guideline’s preparation.
“The Diabetes Handbook aims to provide GPs with a range of evidence-based options and highlights the importance of a comprehensive approach to managing type 2 diabetes.
“We recognise the importance of involving diverse perspectives and experts, and consult widely in guideline development. Guidelines must reflect the expert consensus and strong evidence.
“The Diabetes Handbook’s recommendations highlight low-calorie diets among other possible approaches for achieving remission as this reflects the evidence and expert consensus at the time of publication.
“The growing interest in therapeutic carbohydrate reduction was recognised in the Handbook and we are committed to regularly reviewing emerging evidence,” said Dr Wright.
Dr Muecke maintained that conflicts of interest between Big Food, Big Soda, Big Pharma, religious groups such as the Seventh Day Adventists and a lack of “government accountability, oversight and action”, were major drivers of the current chronic disease crisis in Australia.
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“Our politicians currently enable a policy environment which allows conflicted scientists and health practitioners onto advisory panels and working groups, government health bodies for their policy and guideline documents, on to patient advisory groups for their physician statements, and on to professional medical associations and their various committees,” he said.
“Politicians also currently enable the policy environment which allows the predatory marketing and sale tactics of the food and beverage industries at every turn, a policy environment that allows industry and their business allies to prey on children, the vulnerable and the addicted.”
Dr Muecke did not let the AMA off the hook either, saying its current campaign for a tax on sugary beverages, Sickly Sweet, was not appropriate.
“The AMA needs to move away from the public awareness strategies such as their Sickly Sweet campaign, [and instead provide] Australians with more information so they can make better choices,” he said.
The Sickly Sweet campaign “diverts attention away from the pro-industry policy environment”, he said.
“It shifts accountability from laws favouring industry to the willpower of everyday people, the victims of these harmful policies.
“Strategies such as these don’t impact population health. They undermine support for policy change and they reduce political will for meaningful action.
“Here in Australia, our children are projected to be the first generation to live sicker and shorter lives than their parents because of metabolic dysfunction.
“It’s not about becoming a nanny state, because the disturbing reality prevails, the nanny is killing us.”
The AMA national conference was held in Adelaide on Friday 1 August and Saturday 2 August 2025.
