Last week, I had the opportunity to attend the Australasian Diabetes Congress in Perth. The event was a treasure trove of information and insights into the current state and future of diabetes management in Australia.
Here are some of my key takeaways:
- Australia has one of the highest rates of type 1 diabetes globally…
with approximately 3,000 new diagnoses each year. This alarming statistic highlights the importance of continued research and innovation in diabetes care. - Growth in Insulin Pump Use
The use of insulin pumps has seen significant growth since 2011, increasing from 10,500 users to a projected 30,670 by 2025. This growth highlights the increasing reliance on technology to manage diabetes effectively. - Understanding “Time in Range”
A crucial metric discussed was “time in range,” which measures the percentage of time a person’s blood glucose levels are within the target range. It’s important to note that this metric is for hyperglycaemia, not hypoglycaemia. Interestingly, achieving 70% time in range does not revert cardiovascular disease (CVD) risk to that of a non-diabetic person. - Equity in Access to Technology
There was a strong emphasis on the need for equitable access to continuous glucose monitoring (CGM) and other technologies across Australia. Achieving more stringent targets in diabetes management requires that everyone has access to these life-changing tools. - “The eye sees what the mind knows,”
One of the practical sessions focused on quickly assessing CGM data by distinguishing between “structure” and “behaviour.” While structure is fixed, the key is to look for behavioural patterns, especially when using insulin pumps. As the saying goes, “The eye sees what the mind knows,” so it’s crucial to know what to look for. - Life Expectancy Impact
A sobering statistic shared was that men diagnosed with type 1 diabetes before the age of 10 loose an average of 14.2 years of life, while women lose 17.7 years. This highlights the urgent need for advancements in diabetes care and management. - Hope for a Cure
There were promising discussions on how to ‘arrest’ type 1 diabetes and the hope for a future cure. This is an area of intense research and optimism. - Screening and Unmet Needs
The question of whether we should screen for type 1 diabetes was raised, along with the unmet needs in diabetes care, such as addressing obesity and direct organ protection. - MODY Management
Research into managing different types of Maturity Onset Diabetes of the Young (MODY) was also presented, offering new insights into this less common form of diabetes. - Lung Function in Type 2 Diabetes
One of the talks I attended discussed how lung function can be compromised in people with type 2 diabetes, indicating that the lung is another organ affected by this condition. - Inhaled Insulins
Finally, there was a review of the current status of inhaled insulins, providing an update on this innovative method of insulin delivery.
I also attended a workshop focused on carbohydrates. Here are some of the key points discussed:
- Inaccuracy in Counting Carbohydrates:
Counting carbohydrates is often inaccurate, hard to assess, and mentally taxing. Calculations are typically based on ratios that do not perfectly reflect the impact of macronutrients on blood glucose levels. - Glycaemic Response:
The more carbohydrates consumed, the more unpredictable the glycaemic response, making it difficult to dose insulin properly. Despite advancements in technology, only 13% of adults are reaching target glycaemia. - Lowering Carbohydrate Intake:
Reducing carbohydrate intake may help minimize insulin dosing errors and improve glycaemic variability.
Research on Remote Access to Trials
I also attended a discussion on the challenges faced by people living remotely in accessing research trials. These individuals often lack opportunities, with type 2 diabetes not being a priority due to health service limitations and the tyranny of distance.
MAFLD and Type 2 Diabetes
The preferred nomenclature for NAFLD is now MAFLD (Metabolic Associated Fatty Liver Disease). Approximately 55% of people with type 2 diabetes have MAFLD, and type 2 diabetes is a predictor for worse outcomes. International and local guidelines recommend screening for liver fibrosis in patients with type 2 diabetes, with Fib-4 being recommended as a risk stratification tool.
How can we help?
As a Credentialed Diabetes Educator (CDE), Nutritionist and Nurse Pracitioner, I can assist people with Type 1 and 2 Diabetes. If you are looking for more advice and assistance, reach out for a free call today.