Govt must wake up on diabetes

Jim Mann.

A recent article published in the Otago Daily Times referred to criticisms I made on World Diabetes Day (November 14) of Government inaction over a looming diabetes crisis. Here I provide additional context, as other comments reported in the article suggest I may not understand government process and that I am overreacting with regard to action required for the treatment and prevention of this condition.

One of the major events of World Diabetes Day was a forum at Forsyth Barr Stadium in Dunedin in which approaches to the management of the diabetes crisis were discussed. An important objective of this forum was to again draw attention to the epidemic nature of diabetes in New Zealand and, in particular, to information not previously available on the alarming prevalence of pre-diabetes.

Given that diabetes is now one of the most important health issues facing this country, it is important to hear how the Government proposes tackling the problem and how other political parties view its approach. All political parties, the local DHB, Pharmac and the president of Diabetes New Zealand were invited to attend. Unfortunately, the only politician to attend was Maryann Street, Labour's health spokeswoman.

A Government perspective was essential to the diabetes discussion given there has been no public opportunity to debate the issues, that care for people with diabetes is known to be patchy throughout the country (excellent in some areas, questionable in others) and that, although screening for diabetes is being encouraged in some groups, there is no consistent approach to the management of pre-diabetes.

The latter issue is particularly concerning given the overwhelming evidence that risk of progression to diabetes from pre-diabetes can be radically reduced by lifestyle measures (dietary modification in particular, but also physical activity).

We needed to hear and understand why the focus of future diabetes programmes will be on good nutrition during pregnancy and early life - other programmes will be suspended in order to fund this new approach.

While good nutrition for mothers to be and their children in early life is important, there is no convincing evidence that this practice will reduce the risk of diabetes and other chronic disease in later life. Furthermore, such an approach ignores the crisis which exists in the entire current population of New Zealand.

The reasons given for the failure of a Government representative to attend the World Diabetes Day forum were that government business could not be disrupted and that there were activities around Prince Charles' visit that took precedence. One could argue that the health of half the New Zealand population deserved a higher priority.

The suggestion that I might not understand the process of government is risible given that I have worked closely with both National- and Labour-led governments (politicians and officials) on issues relevant to diabetes, heart disease and nutrition for the past quarter of a century. For some reason, the current Government seems unwilling to engage with health professionals like me. Rather than follow the suggestion of Michael Woodhouse MP that I should "calm down", I would venture to suggest that with regard to diabetes, the Government should wake up before a potential health disaster becomes a reality.

• Prof Jim Mann is director of the Edgar National Centre for Diabetes and Obesity Research and professor of medicine and human nutrition at the University of Otago.