May

20

2021

Research could revolutionise type 2 diabetes treatment

Healthy North Coast is one of 5 Primary Health Networks (PHNs) participating in the DiRECT-Australia study, with 5 general practices from the Ballina/Byron, Clarence Valley, Coffs Harbour and Richmond Valley regions involved in the project. 

Diabetes Australia NSW & ACT have released this media release.

New research could revolutionise the way type 2 diabetes is treated in Australia, potentially helping millions of Australians, now and in the future, avoid diabetes complications and severe illness.

The DiRECT-Australia study, being undertaken by Diabetes NSW & ACT, five Primary Health Networks (PHNs), and the University of Sydney, is trialling whether a structured weight management and lifestyle program can trigger remission of type 2 diabetes.

With more than 1.2 million Australians diagnosed with the condition and a further 500,000 who have developed type 2 diabetes but are not yet aware of it, the results of this study could change the quality of life for patients and save the health system billions of dollars.

Watch the 7NEWS report on the DiRECT-Aus study: 

The research is replicating the UK DiRECT study in Australia to determine if the remission results can be achieved here.

In the UK study’s results, published in the Lancet:

  • 46% of participants in the intervention group achieved type 2 diabetes remission.
  • Of those in remission after one year, 70% stayed in remission.
  • Remission is closely linked to weight loss: two-thirds of those who lost 10 kilos or more and 86% of those who lost 15 kilos or more achieved remission.
  • ·Weight management program also resulted in better quality of life and reduced need for diabetes medications compared to standard care.

One of the research leads, endocrinologist Tania Markovic, is a clinical associate professor at the Boden Collaboration and Sydney Medical School, University of Sydney, and Senior Staff Specialist in the Department of Endocrinology, Royal Prince Alfred Hospital, Sydney.

Assoc Prof Markovic says the UK research debunks the belief that type 2 is an inevitably progressive condition.

“The results from the UK indicate that type 2 diabetes can be halted and people can achieve remission after diagnosis,” Assoc Prof Markovic said.

“It’s important that we understand we’re talking about remission, not a cure. If people regain weight, type 2 will resume. This study has the potential to give diabetes patients different outcomes than we’ve achieved with traditional treatments, such as medications, in the past.”

As well as resulting in remission for many participants, the UK program led to fewer diabetes medications across the whole intervention group.

Remission of type 2 diabetes means blood glucose levels are in the normal range without diabetes medication. In clinical terms, this means an HbA1c (a blood test that shows your average glucose levels over two to three months) of 6.5% or 48 mmol/mol, or lower, while not taking diabetes medications for at least the previous two months.

Assoc Prof Markovic said complications from diabetes include heart and kidney disease, stroke, blindness, amputations, and depression.

Diabetes NSW & ACT’s DiRECT-Aus Project Lead, Kate Gudorf, said research participants receive meal replacement shakes and bars, education and regular appointments with a dietitian.

“The dietitian helps people move through the diet phases, starting with meal replacements and later moving to a healthy, calorie-controlled diet,” Kate said.

“It’s not easy to lose weight and keep it off so we offer support throughout the program, including individual and group meetings with a dietitian.

“The meetings cover a range of topics to help participants make lifestyle changes, such as improving food choices and increasing physical activity. These meetings are designed to support people to change behaviour and maintain weight loss.”

Sydney North Health Network Primary Care Advancement General Manager, Deb Pallavicini, said the PHNs’ investment in the DiRECT research could help people with type 2 diabetes slow or prevent long-term complications.

It could also save the Australian health system billions of dollars by avoiding acute intervention and hospitalisations in the long term.

“As a result of the DiRECT study in the UK, type 2 diabetes remission programs are now becoming widely available there,” Ms Pallavicini said.

“Sydney North PHN has become involved in this research as we think Australia could achieve similar outcomes to the UK, which would allow this intervention to be widely used in Australia, too.”

Visit Primary Care Impact for more information about the project: 
DiRECT-Aus Diabetes Remission Replication Project

Visit HealthPathways for localised information on diabetes.

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Our regional partners

  • Local Health District partners in our footprint: Mid North Coast Local Health District (MNCLHD) & Northern New South Wales Local Health District (NNSWLHD)
  • Aboriginal Medical Services (AMS)
  • The Royal Australian College of General Practitioners (RACGP)
  • Australian College of Rural and Remote Medicine (ACRRM)
  • Rural Doctors Network (RDN)
  • Rural Clinical Schools & Regional Training Hubs
  • General Practitioners
  • Registrars and International Medical Graduates
  • North Coast Allied Health Association (NCAHA)
  • Local Councils
    Pharmaceutical Society of Australia (PSA)
  • Universities including: Charles Sturt University (CSU), University of New South Wales (UNSW), Southern Cross University (SCU)

Aged Care Disaster Management Planning

Strategic Priority Area: One team

North Coast is identified as the region most likely to be impacted by climate change in Australia and also forecasted greatest growth in those 65+.

Healthy North Coast takes a lead role in ensuring the older population and the sector that supports them are prepared for, can respond to and recover from disasters and other emergencies.

We have led eight regional disaster management capacity building workshops, bringing together SES, community organisations and the aged care sector.

We have also developed disaster preparedness tip sheets for both residential and community aged care providers.

Voluntary Assisted Dying

Strategic Priority Area: One team

In May 2022, the NSW Parliament passed the Voluntary Assisted Dying Act 2022. Effective from Tuesday, 28 November 2023, eligible people have the choice to access voluntary assisted dying. 

Healthy North Coast has developed a webpage for both health professionals and consumers, with links to available information and resources.

Living with Dementia resources

Strategic Priority Area: No one is left behind

Healthy North Coast has worked with people living with dementia, their families and local service providers to develop an information booklet that will help them connect with local and national supports along their journey.

Highly regarded by a range of professional supporting those on or starting the dementia journey, the booklet includes commonly asked questions for people to ask their GP and/or specialist.

“It’s a fantastic resource and I give it to everyone on their first diagnosis. Its easy to read, so well planned and thought through and has lots of really useful information, tailored to the region.
I also find it very helpful when educating clinical staff.”

−Geropsychiatric Nurse Practitioner, Mid North Coast.

The resource is available in digital and printed copies, with more than 5,000 distributed across the region. An e-version is available to clinicians via the Dementia and Cognitive Impairment HealthPathway.

Deteriorating Resident Triage Tool

Strategic Priority Area: One team

Empowering aged care teams to deliver safer, more consistent care.

The Deteriorating Resident Triage Tool (DRRT) supports aged care staff to confidently recognise and respond to signs of resident deterioration. It enables timely, evidence-based decisions, strengthens communication with health services, and promotes early intervention and effective care planning, helping residents receive the right care, at the right time, in the right place. By doing so, it reduces unnecessary Emergency Department presentations and improves resident outcomes.

Developed in collaboration with a specialist geriatrician and informed by input from Residential Aged Care Managers, NSW Ambulance, GPs, and clinical experts across the Mid and North Coast Local Health Districts, the DRRT is practical, relevant, and aligned with contemporary best practice.

Aligned with the Strengthened Quality Standards:

  • Standard 1 – The Person: Respects resident preferences and Advance Care Directives.
  • Standard 2 – The Organisation: Strengthens governance and clinical oversight.
  • Standard 5 – Clinical Care: Supports early recognition and escalation of clinical deterioration.

North Coast care finders program

Strategic Priority Area: No one is left behind

Care finders is a free service to assist older adults connect to aged care services and supports. Care finders support older people who experience significant barriers to accessing services, and walk alongside their clients at their own pace, to understand their individual situation and support them to work through the steps to address their needs. Care finders assist people with access to other supports in the community. They can provide connections both with accessing services for the first time, and with changing or finding new services and supports if their needs change.

Care finders can:

  • Provide information about local aged care services
  • Help to set up an assessment with My Aged Care to access support, and
  • Find services that are targeted and available to help.

The care finder program has been extended to June 2029 and is provided by the following organisations. Each (Lismore, Coffs Harbour, Clarence Valley, Richmond Valley, Port Macquarie-Hastings, Kempsey, Nambucca and Bellingen) and Footprints (Kyogle, Tweed, Byron and Ballina).

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Psychological services in residential aged care homes

Strategic Priority Area: Improving Lives Now

Healthy North Coast commissions two service providers to deliver psychological therapies and supports for older people with, or at risk of developing, a mental illness and who are living in residential aged care homes (RACHs).

The aim of the program is to both provide direct support to residents and their families and carers, as well as upskill the RACH workforce to respond to the needs of residents presenting with mental health concerns.

Healthy Towns. Healthy Communities.

Strategic Priority Area: Securing a Healthier Future

Connection and a sense of belonging are protective factors for both individual and community health and wellbeing. Evidence highlights that the social determinants of health play a critical role in addressing many of our regions health challenges.

That’s why Healthy North Coast has long been committed to supporting communities to strengthen and to build social health. Our initiatives, including contemporary ‘Social Prescribing’, help people to connect to activities, supports and each other, and assist communities to integrate services and bridge gaps.

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Telehealth in Residential Aged Care

Strategic Priority Area: Improving Lives Now

The Royal Commission into Aged Care Quality and Safety identified several critical areas affecting aged care residents and our health system. Key challenges include:

  • Limited access to general practitioners (GPs) and allied health professionals in aged care facilities.
  • Difficulties accessing out-of-hours services

Telehealth offers valuable opportunities to enhance support for residents living in aged care homes. Funded by the Commonwealth Department of Health and Aged Care, this initiative provides telehealth equipment and staff training as part of the response to the Royal Commission’s findings.

By improving access to primary care clinicians, specialist services, and other service providers through telehealth, we can significantly enhance health outcomes for residents, reducing unnecessary hospital transfers and emergency department visits.

The selection of telehealth equipment was guided by our Healthy Ageing Strategy (HAS), a comprehensive digital discovery questionnaire, and consultation workshops with various stakeholders. These efforts included interviews with residents to understand their attitudes toward telehealth, ensuring the initiative meets their needs and preferences.

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Greater Choice at Home Palliative Care Program

Strategic Priority Area: Improving Lives Now

Aims to provide people who have life limiting conditions the opportunity to exercise choice and receive high quality care at home, harnessing improved and better coordinated supports and services that meet their individual needs.

Program objectives:

  • Improve access to palliative care at home and support end-of-life care systems and services (in primary health care and community care)
  • To enable the right care at the right time and in the right place (to reduce unnecessary hospitalisation)
  • Generate and use data to support continuous improvement of services across sectors
  • Use available technologies to support flexible and responsive palliative care at home, including in the after-hours.

These objectives will contribute to achieving the following intended overarching outcomes of:

  • Improved capacity and responsiveness of services to meet local needs and priorities
  • Improved patient access to quality palliative care services in the home
  • Improved coordination of care for patients across health care providers and integration of palliative care services in their region.

Education & training funding elibility

Funding is open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.

Workforce Locum support and R&R funding criteria

  • Available to primary care services in disaster impacted communities within the Healthy North Coast footprint.
  • Available to support short-term workforce coverage, allowing clinicians to rest and recover.
  • Workforce-support funding in total is capped for each site, over a 12-month period:
    • $10k for GPs and/or
    • $5K for nursing and/or
    • $5k administration support and/or
    • $5K allied/pharmacy and other.
  • Funding is not to be used to fill gaps in staffing that have not been able to recruit to and not to replace existing staff.
  • Healthy North Coast will assess requirements and approve available funding directly with the service requesting support.
  • Priority will be given to sites that have immediate, short-term workforce support needs.
  • Requests will be reviewed and supported on a case-by-case basis.
  • Program funding administered via RCTI Agreement (Recipient Created Tax Invoice) to be paid monthly, or on completion of the placement (whichever comes first).
  • Practices will be required to complete a request for payment form monthly, or on completion of the placement (whichever occurs first).

Wellbeing Flexible Funding Criteria & Eligibility

  • Open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.
  • Activity must be purposeful, with the aim of increasing the wellbeing of your team.
  • Requests will be assessed on a case-by-case basis, with funding allocated based on team size.*
  • Following approval by Healthy North Coast, funding will be administered via RCTI Agreement (Recipient Created Tax Invoice) upon providing proof of expenses.
  • Funding cannot be used for the purchase of alcohol, or any other goods or services where the vendor cannot quote their Australian Business Number.
  • Planned activities must occur prior to 30th June 2024.
  • Funding will not be available for retrospective activities.
*Team Size
(Total staff and contractors)
Funding Available
Small (1-5)$500-$1500
Medium (6-20)$1500-$4000
Large (>20)$4000-$5000

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