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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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.

The booklet includes commonly asked questions for people to ask their GP and/or specialist.

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 Pilot

Strategic Priority Area: One team

The Deteriorating Resident Response Tool (DRRT) has been developed to guide RN’s in Residential Aged Care homes (RACHs) to better understand, anticipate and make clinical decisions responding to the deteriorating health of residents.

The objective of the DRRT is to give RACH staff clear information to triage and provide appropriate care for a range of residents’ health conditions, and, in turn, prevent unnecessary presentations to ED.

The tool has been designed together with a specialist geriatrician, consulting with stakeholders such as Residential Aged Care Managers, NSW Ambulance, GPs, and experts from Mid and North Coast LHDs.

The pilot commences in March with four participating RACHs. Evaluation measures will include effectiveness in building RN confidence and reported reduction in unnecessary hospitalisations. Findings will inform a future planned, region-wide implementation.

North Coast Care Finders Program

Strategic Priority Area: No one is left behind

The Care Finders program is a free region-wide service to support vulnerable older people who have no-one else to help them, to learn about, apply for and set up support services.

Care finders can help people understand what aged care services are available, set up an assessment, and find and choose services. They also help people with access to other supports in the community, both accessing services for the first time and changing or finding new services and supports.

On the North Coast, Healthy North Coast has commissioned four organisations to provide this important service: EACH, Carexcell, Lifetime Connect and Footprints.

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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.

Social prescribing (Healthy Me Healthy Community)

Strategic Priority Area: Securing a Healthier Future

Delivered by Feros Care, the Healthy Me, Healthy Community program aims to build individual and community connections to reduce loneliness and improve wellbeing in Port Macquarie.

The program helps people to connect with community, activities, supports and services that address their broader social determinants of health, as an alternative or supplement to a clinical approach.

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Digital Health in Residential Aged Care

Strategic Priority Area: Improving Lives Now

Timely access to primary health care professionals, whether through face-to-face consultation or telehealth, is recognised as an issue for many Residential Aged Care Homes (RACHs), that in some cases can lead to potentially preventable hospitalisations. RACHs require adequate telehealth facilities to support access to virtual consultations for their residents.

Project goals

  • Assist participating RACHs to have appropriate telehealth facilities and equipment to enable their residents to virtually consult when needed with their primary health care professionals, specialists and other clinicians. 
  • Provide training to participating RACH staff to support them to have the capabilities to assist their residents in accessing virtual consultation services.
  • Encourage increased use of My Health Record by RACHs, to improve the availability and secure transfer of resident’s health care information between RACHs, primary care and acute care settings.
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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