Jim Mann expands on comments he made last week about
the diabetes crisis hitting New Zealand and the Government's
failure to attend the World Diabetes Day forum in Dunedin.
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
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
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.