Lawrence Kingi, a podiatrist at Counties Manukau DHB, works on a dialysis ward to help prevent diabetic-related amputations. Photo / Jason Oxenham
Lawrence Kingi, a podiatrist at Counties Manukau DHB, works on a dialysis ward to help prevent diabetic-related amputations. Photo / Jason Oxenham
Better drugs to control diabetes and avoid complications including heart attacks and kidney failure would be funded if white people were suffering like Māori and Pacific, Māori Party co-leader John Tamihere says.
Tamihere made his comments at the South Auckland Diabetes Summit, where a world-renowned expert said the lack of funded modern diabetes drugs was a "national scandal".
The virtual summit was organised by the Diabetes Foundation Aotearoa, which estimates nearly 800 people - mostly Pacific and Māori - die needlessly every year because New Zealand doesn't fund modern drugs that are available across the OECD, including in Australia.
Pharmac in January asked pharmaceutical companies to lodge proposals to supply modern diabetes medicines, and a funding announcement is expected soon. However, it's not clear how many patients would have access.
The summit began with a presentation from Professor David Simmons, an international diabetes expert who has delved into 25 years of GP clinic data, covering 56,000 South Auckland diabetics.
It showed control of blood glucose levels - crucial to avoid complications including eyesight loss and heart and renal failure - in type 2 diabetes patients hasn't improved for 10 years.
Māori Party co-leader John Tamihere. Photo / Brett Phibbs
Simmons said modern drugs "available all over the developed world" better controlled diabetes without side-effects New Zealand patients currently encounter. For example, instead of causing weight gain they can aid weight loss.
Funding the drugs - extended release Metformin XR, SGLT-2 inhibitors and GLP-receptor agonists - was only one part of a broader suite of changes needed, Simmons said, but was vital and a bargain, given the expensive hospitalisations and early death that would be prevented.
"South Auckland is a diabetes hotspot, with substantial excess morbidity, mortality and sorrow - you all know this - due to diabetes," said Simmons, Professor of Medicine at the Western Sydney University Macarthur Clinical School.
"We can turn it around. Primary care has managed blood pressure and cholesterol well, but glucose control - the harbinger of death and damage - needs access to evidence-based tools currently unavailable to them.
"We need the resources for these new medications. I have to say that the lack of access to these two medications, something [funded] across the whole of the OECD, I think it's a national scandal.
Preliminary data from his South Auckland analysis showed a tenfold increase over 25 years in the numbers of diabetics hospitalised for cardiovascular disease. The same trend was seen for end-stage renal failure.
The data showed Māori and Pacific suffered much higher rates of diabetes complications requiring hospital care, after adjustment for variables including deprivation and obesity and smoking status.
"End-stage kidney hospitalisation, if you are 50 years old, it is five to tenfold [higher] among Māori and Pacific people. These are really high rates, and ... particularly in the last 10 years, there's been no change."
Dr Matire Harwood, from Papakura Marae Health Centre, chaired a political discussion featuring Tamihere, National list MP and Māngere candidate Agnes Loheni, Green Party candidate for Manurewa, Lourdes Vano, and Mote Pahulu, from the New Conservatives.
Tamihere, standing in Tamaki Makaurau, was blunt in his assessment of why better diabetes drugs aren't funded.
"If white folk were in the same difficulty that we have, I can assure you that [the drugs] will all have been funded."
There was good work going on in the community but it wasn't being supported, he said. Most funding went to non-Māori and Pacific organisations and people.
Loheni, National's associate health spokesperson, said the party was soon to release its health policies, which would have a focus on prevention and reducing inequities.
"National will be putting more money into Pharmac, in a sustainable manner ... I can't give some numbers, but this will be of benefit to diabetic patients."
National list MP and associate health spokesperson Agnes Loheni. Photo / Michael Craig
Vano said healthcare needed to be accessible for everyone and a very early stage in illness. Pahulu said the New Conservatives would take GST off fresh fruit and vegetables.
Labour wasn't represented.
Dr John Baker, chairman of the Diabetes Foundation, said the three medicines New Zealand diabetics currently got were recommended for third world countries by the American Diabetes Association & the European Association for the Study of Diabetes.
He estimates 491 deaths each year could be prevented by the use of SGLT-2 and 286 deaths by the use of GLP-agonist drugs. A further 99 dialysis cases could be avoided by using SGLT-2.
Funding the drugs would cost about $59 million a year, he estimates - and Pharmac negotiations would reduce that further. All type 2 diabetics must have open access to the new classes of medicines, he said.
More than a quarter of a million New Zealanders have diabetes, and another 100,000 are thought to be undiagnosed. About 90 per cent have type 2, the sort mostly brought on by lifestyle and linked to obesity.
Diabetes happens when the pancreas stops making enough insulin, or insulin can't be properly used. Without insulin, glucose (sugar) from food cannot get from the bloodstream into cells to produce energy.
Over the long term, too much glucose in the blood ravages nerves, organs and tissue, risking heart attack, stroke, kidney failure and blindness.
