GP-centred care key to diabetes, but government must step up

4 minute read

Currently there are ‘neither carrots nor sticks’ to encourage the food industry to provide better choices to Australians.

Healthy eating, exercise and GP-centred care are central to diabetes prevention and management but focus must turn towards industry for a top-down approach for wider reach, a federal parliamentary inquiry into diabetes was told today. 

Professor Jason Wu, head of the nutrition science team at the George Insititute for Global Health, noted that while education around healthy eating and lifestyle was important, government policy’s focus on encouraging healthy eating and exercise had been “wholly insufficient”.  

“We need to implement policies that provide a strong incentive for food producers to increase the healthiness of their products to create an enabling environment that entices and make it easier for people to choose healthier foods, as well as invest in health promotion and education to influence consumer behaviour,” Professor Wu told the Standing Committee on Health’s Inquiry into Diabetes in Australia. 

According to Professor Wu, top-down policies that had proved effective internationally included implementation of a sugar tax, mandated targets for reducing salt content in foods and banning trans fats. 

Without strong incentives for industry, meeting targets for reducing obesity and managing diabetes would not be feasible, he added. 

Australia must shift the environment for consumers to facilitate better choices either through industry incentives or penalties, similar to the regulation of tobacco or alcohol. 

“Right now we have neither carrots nor sticks,” said Professor Wu. 

“Our food supply now is a critical driver of not just type two diabetes, but many other chronic diseases, so government does have a responsibility I think to shift the playing field.” 

Setting clear targets, such as percentage reductions in sodium content in foods over a threshold, were outlined by WHO last year as a feasible and effective method of improving health outcomes with minimal impact on consumers and industry, noted Professor Wu. 

“It’s a low agency intervention that can reach everybody because you’re shifting the entire food supply,” he added. 

According to Professor Wu, redirecting a proportion of healthcare spending to improving access to healthy foods may begin to tackle the diabetes at its core, particularly among Aboriginal and Torres Strait Islander communities who are disproportionally affected by obesity and diabetes, ultimately saving healthcare costs.  

Also presenting at today’s hearing, ACRRM President Dr Dan Halliday reiterated the disproportional incidence of diabetes in ATSI communities as well as the effects of poor access to primary care. 

“Rural generalists are in a unique position to assist in providing holistic care across both physical and mental health, involving providing care across illness spectrum, spanning across the community and public sector interface,” he said. 

Dr Halliday outlined the significant mental health impacts of diabetes that could be best addressed, especially in remote communities, by rural generalists. 

“Adults with diabetes have a significantly higher prevalence of medium, high or very high psychological distress than those without diabetes, 43.4% and 32.2% respectively,” he told the inquiry.” 

Policy and advocacy manager for Exercise and Sports Science Australia Judy Powell outlined the wealth of evidence of the benefits of exercise in both preventing and improving the progression of diabetes, suggesting that it should be standard practice to include exercise in the management plans of all patients with diabetes.  

But it’s the current Medicare funding system, which offers too few subsidised allied health professional sessions and a lack of GPs awareness of available services that are the major barriers to patient access. 

The group is working to educate GPs on prescribing exercise for patients, through their Exercise is Medicine program, which contributed to Continuing Professional Development points. 

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