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Setting the benchmark for diabetes prevention and management


Morgan Liotta


16/07/2020 1:05:25 PM

The RACGP’s updated resource provides comprehensive guidance for primary care teams and outlines emerging challenges in the field of diabetes.

Cover image of the Diabetes Handbook
The updated Diabetes Handbook is a GP-focused reference guide, says Chair Dr Gary Deed.

In collaboration with Diabetes Australia, the RACGP has launched the updated Management of type 2 diabetes: A handbook for general practice (Diabetes Handbook) to coincide with National Diabetes Week.
 
Based on the most up-to-date data, an estimated 1.2 million Australians (4.9% of the total population) had diabetes in 2017–18. This estimate includes people with type 1 and 2 diabetes, and type unknown, but excludes gestational diabetes.
 
An estimated 2.3% ($2.7 billion) of total disease expenditure in the Australian health system was attributed to diabetes in 2015–16.
 
Dr Gary Deed, Chair of the RACGP Specific Interests Diabetes network and clinical editor of the Diabetes Handbook, says the updated resource is an important primary care tool.
 
It provides GPs and other health professionals with the latest information on diabetes issues and due to the ever-changing nature of the condition, regular updates are necessary.
 
‘Diabetes as a chronic disease presents a challenge to many GPs due to a plethora of changing treatment options,’ he told newsGP.
 
‘It is increasingly difficult to stay abreast of these changes and, through the work of fellow GPs who reviewed the evidence, this updated handbook provides a quick GP-focused reference guide.’
 
Based on emergent clinical evidence, significant updates have been made to the handbook, Dr Deed said, including addressing major clinical issues related to type 2 diabetes, with a focus on a broad review of the international evidence to provide recommendations that could be applied in clinical practice.
 
‘Updates include managing risks and other impacts of diabetes, with new recommendations regarding cessation of sodium glucose co-transporter 2 [SGLT2] inhibitors in people with type 2 diabetes who are undergoing surgery and endoscopic procedures,’ he said.
 
‘Managing cardiovascular risk [has also been updated], with new recommendations for the use of SGLT2 inhibitors in people with type 2 diabetes associated with cardiovascular disease and suboptimal glucose control.’
 
These recommendations support the significance of early detection, treatment and ongoing management of the condition to improve health outcomes, Dr Deed said.
 
In addition to updated recommendations, the handbook features a number of completely new topics, including:

  • early-onset of type 2 diabetes – including referrals for children and young adults to an endocrinologist
  • mental health and type 2 diabetes – how to best support people experiencing psychological distress related to living with diabetes
  • management of type 2 diabetes in older people and residential aged care facilities – including the importance of developing individualised care plans
  • the use of technology in managing type 2 diabetes – including smart phone apps, wearable technology, insulin pumps and continuous glucose monitoring
  • diabetes management advice for people fasting during Ramadan.
Diabetes Australia CEO Professor Greg Johnson described the new section on the mental health burden of type 2 diabetes as a key focus area. It is also part of the National Diabetes Week 2020 campaign – Heads up on diabetes – highlighting the mental and emotional health challenges of living with diabetes.
 
‘Around half of all people living with diabetes have experienced mental health challenges in the past year related to their diabetes. It is a relentless condition – day in, day out, 365 days a year,’ Professor Johnson said.
 
‘Over one-third of people with diabetes feel burned out … so it is essential that GPs are able to recognise and support these people who might be struggling with the burden of diabetes management.’
 
Diabetes Australia estimates that people with the disease face up to 180 diabetes-related decisions every day. 
 
RACGP President Dr Harry Nespolon said the release of the updated Diabetes Handbook is a reminder of the central role GPs play in identifying those most at risk, as well as management of the condition.
 
‘People with diabetes need to carefully monitor their condition and should consult with their GP regularly, particularly if any health problems emerge,’ he said.
 
‘It is also vital that anyone with diabetes symptoms, including fatigue, urinating often and heightened thirst, consults their GP right away, as this may be a sign of undiagnosed diabetes.
 
‘We need to reverse this trend and it is particularly important that people with diabetes take care of themselves and heed expert medical advice from their GP.’
 
Dr Nespolon said the handbook provides practical, evidence-based guidance and recommendations for GPs ‘doing all they can’ to support people with diabetes.
 
It is also a timely reminder for all Australians living with diabetes to look after their health and wellbeing.
 
‘Unfortunately, the COVID-19 pandemic has resulted in many people delaying or avoiding a trip to the GP,’ he said.
 
‘A June 2020 survey of more than 700 people found 32% of respondents had delayed or avoided a visit to a GP in the last three months.’  
 
Dr Deed said GPs can be confident in managing diabetes with the help of the updated resource.
 
‘The handbook is to be used as a reference source for the whole primary care team focusing on patient care,’ he said.
 
‘It is a result of passionate team work … to produce a resource that compliments the other clinical resources the RACGP provides for general practice, and an example of colleagues working to support each other in the busy landscape of general practice.’
 
Management of type 2 diabetes: A handbook for general practice is available on the RACGP website.
 
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chronic disease management diabetes mental health preventive health



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