It’s a shocking statistic. More than 300 Australians, or one person every five minutes, develops diabetes every day.

Think about that: one person every five minutes.

And the number of diagnoses is multiplying daily. Currently, almost 1.9 million Australians have diabetes and close to 120,000 Australians have developed diabetes in the past year.

Diabetes is the seventh most common cause of death by disease in Australia, with a total annual cost impact estimated at $17.6 billion (inflation adjusted).

It is not only the diabetes affected who suffer: There is little end-to-end support for Type 1 or Type 2 sufferers and no mental health support available for sufferers or parents of children with diabetes.

So, as we reflect on National Diabetes Week (July 9-15), serious discussions about cause, prevention, solutions, and funding for research must continue.

Was this the most important National Diabetes Week ever? 

This year, Diabetes Australia delivered a call to arms against Australia’s biggest health crisis.

In fact, National Diabetes Week 2023 kick-started the biggest conversation about the impact of diabetes this country has seen.

The focus of this year’s event was to create a conversation to drive change, and to create hope for the future. 

It featured online conversations about the impact of diabetes in Australia, featuring real people with all types of diabetes sharing their hope for the future and the change they want to see. 

It also launched the Great Debate series, co-hosted by Diabetes Australia’s Group CEO Justine Cain and Dr Norman Swan AM, featuring people living with diabetes and diabetes experts, discussing the big topics relevant to the future of diabetes in Australia. 

Each night a different topic was discussed and debated:

Monday 10 July: Timely and affordable access: Who cares? 

Tuesday 11 July: Brain drain: Is diabetes research in Australia in crisis? 

Wednesday 12 July: Australia’s obesity crisis: Is there a magic pill? 

Thursday 13 July: Type 2 diabetes remission: Hype, hope or happening? 

Friday 14 July: Keeping pace with treatments and tech: Is Australia falling behind? 

While it is impossible to administer overnight solutions to any of the issues raised in these debates, it highlighted the real problems that need to be addressed in the short and long-term to stem the tide.

For instance, while Australia has one of the world’s best health systems, access to care can be limited. Regular health checks to help manage diabetes and reduce the impact of diabetes-related complications are too few. But how do we make access to care easier?

You can watch that debate and the solutions it throws up here.

When discussing remission, the panel noted it is possible for some people living with type 2 diabetes to reduce their average glucose level and sustain that reduction for a prolonged period (at least three months) without the need for glucose lowering medication.

Technological advancement and Australia’s ability to keep pace was also discussed. Is Australia keeping pace with breakthroughs in diabetes medicines and technology? The discussion was generally positive around technological revolution, however there are issues around access, cost and knowledge of what equipment works best for certain types of diabetes. You can watch that discussion here.

Where Myopharm’s concerns lie is in research funding and it is in this area that significant adjustments need to be made.

Research is not in crisis, it's in a death spiral

In the 'Diabetes research in Crisis' debate we heard that only 5% of government funding is available for research and that sadly researchers spend a third of their lives applying for grants.

For companies such as Myopharm, the lack of government support means a greater reliance on philanthropic funding. 

And this isn’t easy to find.

Diabetes Australia notes: “Australia has world-class researchers but investment in diabetes research is falling, even as the number of people living with all types of diabetes continues to increase. How do we support and sustain a thriving diabetes research community to help Australia make measurable progress towards reducing the impact of the diabetes epidemic?”

This year the Albanese government rolled out the Cardiovascular Health Mission, a $220 million research fund that supports a large program of work to improve heart health and reduce stroke in Australia.

Last year, the Heart Foundation congratulated the Federal Government on $33.6 million in funding to the heart health of Australians.

As for cancer, the Australian Government is investing $893.5 million in services that will improve the health outcomes and survival rates of Australians from a range of life-threatening cancers, by building state-of-the-art cancer treatment centres and ensuring Australians catch up on testing, screening, and treatment of cancers.

The government is two years into a 10-year plan to tackle diabetes, but funding details are sketchy.

The Australian National Diabetes Strategy 2021–2030 (the Strategy):

• considers current approaches to diabetes services and care;
• considers the role of governments and the diabetes sector;
• ensures current efforts and investments align with identified needs;
• maximises the efficient use of health care resources and
• articulates a vision for preventing, detecting and managing diabetes.

Meanwhile, Diabetes Australia, a not-for-profit organisation supported financially by the community is dishing out many of the funding grants. It has offered the following grants for 2024: two $150,000 Millennium Awards: one for type 1 diabetes and one for type 2 diabetes. One $150,000 Charles Campbell Coghlan OAM Emerging Researcher Award for an early to mid-career researcher. 15 General Grants, up to $60,000 per grant.

Over the last four years:

• 2023 - 32 General Grants of up to $70,000 each were awarded by Diabetes Australia.
• 2022 - 50 General Grants of up to $70,000 each were awarded.
• 2021 - 51 General Grants of up to $60,000 each were awarded.
• 2020 - 50 General Grants of up to $60,000 each were awarded.

It seems Diabetes Australia is carrying the load; but funding is minimal compared with government funding for Cardiac and Cancer. 

When you consider diabetes comorbidities have surpassed both cardiovascular and cancer, there is something askew here.

High indigenous numbers

Also concerning is the number of indigenous citizens with diabetes. We need to look carefully at our indigenous population as to why numbers are so high, and we need to better understand the challenges.

Indigenous Australians and Torres Strait Islanders have over 50% diabetes, the highest incidence in the world. 

The Australian Diabetes Educators Association (ADEA) Research Grant Program is designed for researchers, academics and student researchers from Australian universities and research institutes who are working with credentialled diabetes educators and people with diabetes on research projects that aim to improve diabetes care, management, and education.

Grants of up to $60,000 are being offered for a maximum of 12 months.

In 2019, the Government said it would invest $6 million over two years to fund the Aboriginal and Torres Strait Islander Diabetic Foot Complication Project.

The Project aims to reduce illness and death because of diabetes foot-related complications and amputations.

In October last year, indigenous health research was given a major boost with the Australian Government committing over $11.2 million for medical researchers to tackle health disparities and develop solutions for First Nations Australians.

However, this is for overall health. Diabetes treatment and management funding is still lacking.

Addressing the stigma

An important topic in trying to deduce why diabetes is overlooked for funding, is the related stigma.

Diabetes UK suggests “Diabetes stigma can take lots of different forms. It may involve being subjected to a throwaway comment, encountering myths and misconceptions about what diabetes is and what causes it, or it could be negative behaviour towards those living with the condition.”

Obesity is also a factor.

Diabetes is linked with obesity and therefore seen as a self-inflicted problem.

The Australian Bureau of Statistics' National Health Survey from 2017–18 revealed that 67 per cent of Australian adults were overweight or obese (12.5 million people), an increase from 63.4 per cent since 2014-15

In 2023, about 14 million Australians are living with overweight or obesity - that's 2 in every 3 adults, and 1 in 4 children.

Funding needs to go into combating the stigma. That would certainly make it easier for the likes of Myopharm, which is currently licensing Omni - D®, a Food for Special Medical Purpose pre-meal drink that has proven medical benefits for people with type 2 diabetes. 

Myopharm is looking to be a major player in the fight against obesity and diabetes, but like many in the space, while it is in the right area of research, it must find extra philanthropic support and utilise R&D rebates to do its good work.

Hope on the horizon 

A new Parliamentary Inquiry has been instigated to help address gaps in knowledge about diabetes, as well as improve policy.

The Australian Government’s Inquiry into Diabetes in Australia focuses on the priorities needed to better support people living with or at risk of diabetes.

Dr Gary Deed, Chair of RACGP Specific Interests Diabetes told newsGP the new Diabetes In Australia inquiry is “a timely reminder that diabetes remains a major public health crisis”.

The inquiry will consider the impacts of diabetes on the health system and economy, the disease’s causes and risk factors and will also consider recent advances in its prevention, diagnosis, and management.

The links between diabetes and obesity will also come under scrutiny along with current Federal Government policy.

Deed said educating GPs about diabetes is a priority and funding to support the use of guidelines in clinical care is “desperately needed”.

“The RACGP has many great resources, including in diabetes,’ he said. “However, to embed these into the workflow of each GP requires nationally coordinated support.”

“Diabetes has a timeline that starts before the diagnosis is established right to the end-of-life care that may be needed,” Deed told newsGP.
 
“All through these journeys GPs and their care teams are part of the essential support network that people turn to [for] help and health.
 
“Hopefully this review will seek to discover some of the key times in the journey of the person with diabetes, where GPs need extra support to step up care and coordination.”

Hopefully, the inquiry leads to more funding for diabetes researchers and biotech companies looking to minimise the impact of the disease on the community at large.