Strategy to home in on diabetes

By MARTIN JOHNSTON, health reporter


Thousands more people with diabetes and its precursors are expected to be picked up by doctors and nurses using guidelines issued yesterday.

Type 2 diabetes costs the health system $170 million a year, and this is predicted to top $1 billion by 2021. About 115,000 New Zealanders have been diagnosed with the disease, which is linked to obesity.

The same number are thought to have the disease without knowing it. A further 60,000 are expected to develop diabetes by 2021, in an epidemic being made worse by the increasing rate of obesity.

The New Zealand Guidelines Group yesterday published updated guidelines on the management of diabetes and stroke patients and the assessment and management of cardiovascular disease (mainly heart disease and stroke).

Diabetes New Zealand has welcomed the guidelines, even though the Government has not moved on the group's longstanding call for a comprehensive diabetes screening programme and national register.

The guidelines, for GPs and nurses, were an important step in managing an expensive and often preventable disease, said Diabetes NZ president Russell Finnerty.

The cardiovascular guideline's recommendation to include blood-sugar testing when checking cardiovascular disease risks was a form of screening, he said.

The project manager for the cardiovascular guideline, GP Dr Robert Cook, said the test of patients' blood-glucose levels after fasting would pick up many more people with undiagnosed diabetes and those with an increased risk of developing the disease.

The onset of diabetes could be prevented by changing diet and increasing physical activity.

The diabetes guideline recommends that sufferers have their cardiovascular disease risk checked annually - most people with diabetes die of cardiovascular disease.

It also urges regular screening for kidney, eye and feet problems, common complications of diabetes.

Health Ministry chief clinical adviser Dr Sandy Dawson said just over half the people known to have diabetes took up the state-funded free diabetes medical check last year. This year's target is 65 per cent.

Graphic: Type 2 diabetes