Hon Judi Moylan

GRIEVANCE DEBATE- World Diabetes Day

Mrs MOYLAN (Pearce) (20:58): I welcome the opportunity to use this grievance debate to talk about World Diabetes Day, which happened last week when the parliament was not sitting. We had an excellent lunch, which had been arranged by Diabetes Australia, at the Lodge. Mr Matheson was a gracious host and spoke compellingly about the challenge of diabetes in Australia today. World Diabetes Day came after a report called Diabetes: the silent pandemic and its impact on Australia was launched in Parliament House. That report is a research paper written by a very well-known Melbourne institute, the Baker IDI Heart and Diabetes Institute, in partnership with Diabetes Australia and the Juvenile Diabetes Research Foundation. World Diabetes Day was marked across the globe on 14 November. The day is a reminder that diabetes is one of the most important healthcare challenges that governments around the world will face this century. At the European Diabetes Leadership Forum at Copenhagen earlier this year, former UN secretary-general Kofi Annan—a man who has seen many of the worlds conflicts, pandemics and crises—chillingly reminded his audience that diabetes kills more people worldwide annually than HIV-AIDS, tuberculosis and malaria combined. Even more sobering is the fact that Australia is on the front line. One study has found that if the rise in diabetes continues, up to 17 per cent of Australians will have diabetes by 2025. In fact, I believe that this is referred to in the study I mentioned. Unbelievably, we are on track to beat that prediction.

The message is clear that the government needs to act, but it needs to act in concert with all Australians. Every one of us has a responsibility for our own health. It is not just a government responsibility but government needs to lead the way. I am pleased to see the member for Hindmarsh in the chamber tonight, because he has been a long-term advocate for a comprehensive plan to combat diabetes in this country. He has been a long-term member of the Parliamentary Diabetes Support Group. We thank him, as the chair of Standing Committee on Health and Ageing, for his work to highlight the need to manage diabetes better than we have done.

Before this century reaches its half term, the global affliction of diabetes will have wrought incalculable harm to the quality of life of individuals, with consequences for the social fabric and the productivity of all nations. For richer nations the consequences will be drastic, but for poorer nations they will be catastrophic. All over the globe diabetes is an insidious blight to income, productivity, and life expectancy. The World Health Organization estimates that 347 million people worldwide have diabetes, and that without intervention the number will double by 2030. There are currently 2.9 million deaths each year directly caused by diabetes.

The global challenge of diabetes in the 21st century was the trigger for the United Nations resolution passed unanimously in 2006, which declared 14 November World Diabetes Day. But with diabetes rates growing worldwide, six years after the resolution there is little room for self-congratulation. It should serve to stiffen our resolve as a community to do better. Diabetes must be a national health priority, with an emphasis on prevention, diagnosis, treatment and research.

We continue to be confronted by escalating health costs and fiscal constraints—exacerbated by the deadly political inertia of a hung parliament, frankly. Amid all this we need to retrieve the crucial mantra that nothing succeeds like prevention. Prevention is both the best medicine and the best politics. And it is also the cheapest.

Undiagnosed, untreated or inadequately treated diabetes can lead to death preceded by multiple health conditions. It is a major cause of limb amputation, blindness, cardiovascular disease and kidney disease. Locally, it is estimated that 1.7 million Australians out of a population of 23 million have diabetes, with 280 new cases being diagnosed every single day. Over two million people have pre-diabetes, which is a condition where the blood sugar level is irregular, placing an individual at high risk of developing type 2 diabetes. Without diagnosis and appropriate intervention, more than 30 per cent of people with pre-diabetes go on to develop type 2 diabetes within 10 years.

The stark reality of the prevalence and cost of diabetes in Australia was outlined, as I said, earlier this year in a research paper by Baker IDI, Diabetes: the silent pandemic, and its impact on Australia. It projects a diabetic population of three million over the age of 25 by 2025. Type 2 diabetes was once called late-onset diabetes, as it mostly affected people over the age of 60. Yet today, children, particularly in the Indigenous and Pacific Island populations are being regularly diagnosed with the condition and being condemned to a future of complex and expensive care. I had the privilege of speaking with the Speaker of the Tongan parliament at dinner this evening and I know from my regular visits to New Zealand, where I have been invited to speak, that the Pacific Islanders have a particular challenge ahead of them, as so many people in the Pacific have diabetes. It is a huge challenge. He was telling me this evening that many of them cannot get access to kidney dialysis; they have to go offshore to have that treatment.

The Organisation for Economic Cooperation and Development has warned that obesity is a major contributor to the diabetes pandemic. In the Betterlife Index of the last 20 years, Australia is identified as having one of the fastest growing obesity rates on the planet. It reveals that about 60 per cent of Australians are now overweight or obese. Baker IDI estimates that the total annual cost for Australians with type 2 diabetes is up to $6.57 billion per annum. This figure includes healthcare costs, the cost of carers and Commonwealth government subsidies.

The latest statistics in the Australian Institute of Health and Welfare overview of kidney transplant and dialysis in Australia show that the rate of new cases of end-stage kidney disease, ESKD, has increased by 80 per cent and is largely diabetes related. Indeed over the preceding 18 years kidney replacement therapy for ESKD almost tripled as did the number of people on kidney dialysis. There is a wealth of grim documentation pointing to the catastrophic cost of failing to diagnose early. The peak body Diabetes Australia estimates that there will be a 12-fold differential in the cost of managing advanced diabetes compared with early diagnosis and intervention.

A message that I have long promoted is that governments need not be afraid of the cost of diagnosing and treating diabetes; they need to be afraid of not diagnosing it and not treating it and then having to treat a number of complex conditions that result from not diagnosing and not treating diabetes. The dilemma for government therefore is whether to invest in prevention and relatively inexpensive treatment modalities, or continue to withdraw programs with an inevitable budgetary explosion affecting current and future generations.

Tragically, Australia today is without a coherent strategy for managing diabetes and has been without a national diabetes action plan since 2007. So tonight I would like to urge all my colleagues, particularly those who have long been involved with the parliamentary diabetes support group, to urge government to make a statement, to take leadership and to declare diabetes a national health priority.

This week we have the opportunity to speak to young people in this parliament at the Kids in the House event. They will tell their stories about what it is like to be a child living with diabetes and how that impacts on the quality of life. The other mission for us is to make sure that we do remember these children by ensuring that a cure for diabetes is forthcoming.


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