The National Association of Diabetes Centres [NADC], who conducted this initiative, is a national collective of over 60 Diabetes Centres brought together by a common desire to see improvement in the standard of diabetes care in Australia.
The NADC was established as a joint initiative by the Australian Diabetes Society and the Australian Diabetes Educators’ Association after considering the outcomes of the Diabetes Control and Complications Trial (DCCT). The DCCT found that maintenance of good glycaemic control significantly reduces diabetes related complications in individuals with Type 1 diabetes, and recognised the role of multidisciplinary teams in the provision of specialist care for those people requiring intensive treatment. Subsequently the United Kingdom Prospective Diabetes Study (UKPDS) showed that maintenance of good glycaemic and blood pressure control, through a team approach, in people with Type 2 diabetes, reduced the long term complications of the disease.
As a consequence, the NADC was created to establish and promote effective health care practice and ultimately achieve better outcomes for people with diabetes. In particular, key strategies were identified including the development of standards of care and quality review initiatives, information provision, and training and support for health professionals in specialist multidisciplinary settings.
What is a Diabetes Centre?A Diabetes Centre is a specialist unit made up of a team of health professionals dedicated to the care of individuals with diabetes. The key functions of a Diabetes Centre are:
- patient education;
- medical treatment and clinical care of people with diabetes;
- providing training in diabetes care to other health professionals;
- providing a support and advisory service to people with diabetes and their non-specialist health professionals; and
- research into medical, scientific, social and behavioural aspects of diabetes.
Diabetes Centres are an important component of the range of health care services available to people with diabetes. Whilst Diabetes Centres vary in their make up most will have on site:
- endocrinologists who provide specialist medical management, treatment and advice to people with diabetes;
- diabetes nurse educators who provide individual and group patient education, counseling and support services, and specialise in the clinical and nursing care of people with diabetes;
- dietitians whose job is to assess the individuals nutritional needs and provide advice and an appropriately tailored eating plan to suit the person’s physical needs and help promote good health and good diabetes control; and
- podiatrists who specialise in assessing and treating diabetic foot problems as well as providing foot care education to individuals and groups.
Who will access a Diabetes Centre?Most patients are referred to Diabetes Centres by General Practitioners in order that their patients receive specialist assessment and treatment. Given this role, it is important to recognise that it is most likely that people attending Diabetes Centres will be those whose diabetes is less likely to be managed well. In considering the outcomes of this data collection, it is important to remember that whilst Diabetes Centres will provide assessment and treatment, ongoing responsibility for management of most people remains with the individual and their general practitioner.
Therefore, patients with diabetes referred to specialist diabetes services including Diabetes Centres and specialist endocrinologists in private practice [who are the subject of this report], are likely to be those with newly diagnosed disease requiring education, and those with uncontrolled diabetes or complications of the disease requiring specialist assessment and management. As such the latter patients, in particular, likely represent those individuals with more complex or complicated diabetes.