Behavioural innovation is key to improving the health of one million Australians living with type 2 diabetes

Few would disagree with Speight1 that greater attention to behavioural aspects of type 2 diabetes (T2D) is key to dealing with the current T2D epidemic in Australia and its serious complications.2 One of the greatest drivers of the current T2D epidemic is an unhealthy personal lifestyle behaviour. A key recommendation from the 2009 Preventative Health Task Force was to provide the community with a health enhancing environment,3 which was also emphasised in the National Diabetes Strategy (NDS) 2016–2020.4

Regarding Speight’s comments on the NDS — “reality or rhetoric?”— the strategy was released by the federal government in November 2015;4 it was the result of 18 months of work by the NDS Advisory Group (NDSAG), which comprised national and international diabetes experts. It involved extensive face-to-face community consultation and written submissions.

In her article, Speight also wrote: “An encouraging feature [of the NDS] is that behavioural and psychological aspects of diabetes are acknowledged. It is disappointing, however, that the language is vague and somewhat passive”. The NDS is a cautiously edited version of the comprehensive, considered advice the NDSAG submitted to the federal Minister for Health.5 Substantial NDSAG advice — including rationale and key recommendations — was omitted.

The NDSAG defended that their recommendations should be available to providers of submissions and those who attended the face-to-face consultations. The Minister agreed that the NDSAG advice document be made publicly available in the website of the Department of Health.5

Finally, Speight wrote that “there is no implementation plan or allocation of dollars”. The role of the NDSAG was solely to provide advice to inform the strategy’s development. An implementation group has now been established, which consists of state-based officials and a person with significant diabetes expertise, and will report in late 2016. Whether behavioural innovation will receive any attention or funding is unknown.

The NDSAG produced a comprehensive integrated plan5 to manage diabetes, which is an expensive and escalating public health problem. Twenty years ago, the Minister for Health, Michael Wooldridge, launched an attack on diabetes, which he saw as a big threat. Successive governments have failed to maintain the momentum generated then. The current implementation process may mean that the overall plan to deal with diabetes and its complications is fragmented and delayed, so reasonably, Speight enquires “National Diabetes Strategy: reality or rhetoric?” We hope it is the former.