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Bin Laden has nothing on killer diabetes
Stevenson's Country, May 4, 2005
By Philippa Stevenson
Terrified of terrorism? Afraid of headlining diseases like Aids and Sars?
To rank your fears in the order that they are likely to occur you'd be better scared stiff of the next thing you put in your mouth and the time spent on the couch. Especially if you are a Maori, a Pacific Islander or Asian.
Diabetes - especially the most prevalent type 2 diabetes, which is related to poor diet and lack of exercise - has reached epidemic proportions. It is the world's second biggest killer disease behind cancer.
The World Health Organisation estimated that in 2000 177 million people had diabetes and that within 30 years there would be more than 350 million sufferers. That includes in New Zealand where it is one of our most pressing health problems.
A decade ago, research findings that first raised the alarm found that one in three older Maori could expect to get diabetes, and one in eight people of European descent. Of Maori who get diabetes, one in 20 - a fifth - die each year. That is seven times the death rate of the general population.
Most diabetics die from chronic conditions associated with the disease like heart attack, stroke and kidney failure. They also have limbs amputated and go blind.
When it comes to the fear factor Osama bin Laden should have nothing on diabetes.
But like terrorism, prevention is the best cure. One of the most ambitious preventative strategies got underway this week in the Waikato. It is targeting the region's entire Maori population aged over 28 years - 32,000 people.
The project designed and run by diabetes specialist, Professor David Simmons of Auckland University's Waikato Clinical School, hopes to recruit 15,000 people to determine the most effective way to stop them developing diabetes.
The 2½ years of research, which, if successful, will reduce new cases of diabetes in that population by 35 per cent and immediately become a nationwide preventative programme has global as well as local significance.
When I suggested the world was watching him Simmons laughed but only half-heartedly. It sounds presumptuous but it's true.
"It's quite uncomfortable. We need the support but we'd rather hide and get on with it," he said.
After six months of preparation they began getting on with it yesterday. Today and every weekday for the next seven months the Te Wai o Rona - Diabetes Prevention Strategy team will try to screen 120 people a day for diabetes. The first three days are being spent at Turangawaewae Marae in Ngaruawahia, then the team will move onto other marae and community halls to which people are being invited through their iwi, community groups and GPs.
Half of around 15,000 people identified without the disease will have intensive personal coaching and community support to improve their nutrition and increase activity.
Simmons will not give details of the intervention because individuals or agencies prematurely adopting and promoting the practices he is advocating run the risk of ruining the research before it is completed.
The other half of those in the trial will receive the standard advice given to people at risk of diabetes.
Besides the personal toll, diabetes costs New Zealand between $600 million and $1 billion each year. Simmons believes his prevention strategy will cost an economical $200 per person per year.
"It is ambitious research but to show it works we've got to have big numbers. We want to prevent the low risk people becoming high risk as well as stop those at high risk developing diabetes. You need big numbers for that because it is phenomenally hard to change people's lifestyle."
He anticipates up to a thousand people will find out they have diabetes as a result of the initial screening.
Thirty-two organisations are involved. They range from Eggs Inc and Rivermill Bakery, which are helping to provide free breakfasts for those being screened, and Task Force Green workers, who have been trained to take people's measurements, to the Waikato and Lakes District Health Boards, Auckland University, AUT, and Wintec.
Also on board are dieticians, PhD students, Sport Waikato, private laboratories, diabetes groups, Maori health providers and Tu Wharetoa, Waikato Tainui, Raukawa, Hauraki and Maniapoto iwi.
By June, Simmons hopes that his proposed International Diabetes Translational Research Institute will be established in Hamilton to be home to the prevention strategy and other research projects.
The not-so catchy name arises from his desire for the new institute to translate scientific knowledge about diabetes into practical, affordable, sustainable health care.
Some countries, including Pacific nations like Fiji, cannot afford the burgeoning cost of diabetes. Our own kidney medical services are being swamped.
The statistics tell why.
Last year, the Health Ministry estimated that another 8000 New Zealanders joined the 115,000 people already living with diabetes.
Each year, 500 people with diabetes have a lower limb amputation, 70 become blind, and more than 170 start renal dialysis. About 1600 die.
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