In the past few weeks, two diabetes reports have been released: Diabetes Australia’s State of the Nation 2024 and The State of Diabetes Mellitus in Australia 2024, which is the long-awaited recommendations from the government’s committee into the Inquiry of Diabetes 2023, now pending an official response from the federal government.
This week is National Diabetes Week, and the campaign theme is ‘unite in the fight for tech’, focusing on access to insulin pumps and continuous glucose monitors (CGMs).
The committee’s report also highlights the benefits of these technological advancements, recognising their potential to enhance diabetes management.
However, other than a brief mention of telehealth, the report overlooks the broader role of digital health interventions. Similarly, the National Diabetes Week campaign fails to recognise the importance of digital health interventions playing a role in access to tech.
Benefits of diabetes technology
Chapter 5 of the Committee’s report highlights the advancements in diabetes-related technology. Insulin pumps and CGMs are at the forefront of these advancements, offering numerous benefits to people with diabetes.
These devices provide continuous feedback and make real-time adjustments, allowing for better glucose control, reduced frequency of hypoglycaemic events, and lessen the burden of managing diabetes manually, all of which improves the quality of life for those living with diabetes. These benefits are not limited to people taking insulin. There is increasing evidence on the benefits of CGMs for people living with type 2 diabetes not taking insulin and those living with prediabetes.
Insulin pumps and CGMs, while highly beneficial, are currently limited in their accessibility due to high costs and restrictive eligibility criteria. The cost of an insulin pump in Australia ranges between $6,000 and $10,000 every four years, and CGMs cost approximately $330 per month. These costs are prohibitive for many individuals.
National Diabetes Week is a call to the federal government to improve access to these technologies with subsidies provided by the National Diabetes Service Scheme (NDSS) or Pharmaceutical Benefits Scheme for all people living with all types of diabetes. With the Federal Government’s response pending, taking action on this would be a positive outcome.
Overlooked potential of digital health interventions
While a focus on access to these technologies is incredibly important, both reports and the current national campaign fall short of addressing the broader scope of tech – recognising the role of digital health interventions.
Amid national diabetes workforce shortages, digital health interventions can help bridge the gap in diabetes care. There are only 1600 certified diabetes educators, 7000 dietitians, 40,000 GPs and 1000 endocrinologists to meet the growing demand of diabetes cases. While developing a strategic plan to grow the future workforce will be important – with approximately four million people living with diabetes, prediabetes or undiagnosed diabetes – we need solutions now to help mitigate this growing epidemic.
Digital health interventions are not designed to replace care from healthcare professionals but to complement the care provided. People may see a healthcare provider 5-12 times per year for short 20-minute appointments.
To achieve the best outcomes, research has shown people need over 10 hours of ongoing education and support across 6-12 months. Digital health interventions can provide this ongoing self-management education and support all year round.
Other than a brief mention of telehealth, the omission of digital health interventions is a missed opportunity to recognise the value they have in providing the education and support people need, along with the impact they can have on improving health outcomes.
In Australia, there are limited digital programs available that are clinically-proven to be effective. For instance, the T2Diet program is currently Australia’s only scientifically-proven online nutrition program for people living with type 2 diabetes. But, as research continues, there will be more to come in future.
Missed opportunity for equitable access
Recognising the need to provide equitable access to scientifically-proven digitally-delivered programs will be essential for addressing the current diabetes crisis.
Through government support, these programs could be implemented into schemes such as the NDSS, with location or socioeconomic status being no boundary to accessible support.
For the government, supporting proven digital programs would be a cost-effective solution. The NDSS digital or face-to-face programs’ current delivery cost is $162 to $956 per person for short 2-6 hour programs, with no proven benefits for supporting clinical outcomes or sustainable health change.
The T2Diet program is $130 per person for the 16-week program or $230 for an entire year of support, with proven benefits for lowering blood sugar, supporting weight loss and reducing medication requirements. Yet, while the benefits of the T2Diet program are scientifically-validated, for some individuals, the cost may still be prohibitive.
The United Kingdom’s National Health Service has an Innovation Accelerator program that has successfully scaled multiple scientifically-proven digital health interventions across the national healthcare framework. Unfortunately, no such pathway currently exists in Australia.
Without digital health interventions mentioned in the committee’s report, the Federal Government lacks a directive to act upon. This gap suggests that Australia is still far from establishing an innovation pathway necessary for the timely implementation of impactful, scientifically-backed digital health programs.
Do you or a loved one suffer from diabetes? Have you tried any digital diabetes technology? Let us know in the comments section below.
