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This section delineates the possible courses of action or inaction that you believe could be taken.
Please provide the Minister with at least three potential courses of action; some of them may be unrealistic in your opinion but please pose them as options nonetheless.

What is being proposed: what are the options available to the government?
Why are you recommending these options?
What are the advantages and disadvantages of each? Ensure you consider any potential backlash from stakeholders/the public. 

After listing the advantages and disadvantages of the different options (above), you need to make a clear recommendation of one, or more, of these options, with a justification of this decision:

The issue statement sets out what has happened, is happening or will happen to trigger the need for the memo. It should not exceed three or four lines. It typically concludes with a question beginning with words such as: ‘What role can …’, ‘’Should … ‘; ‘How should the Department respond to ….’; ‘Who should take responsibility …’; ‘What action is required to …’; or ‘When should ….’

Statement of the problem

Type 2 Diabetes still remains to be an issue in Australia. The prevalence rate of diabetes seems to be rising yearly and more people are diagnosed with type 2 diabetes yearly, (Wright & Harwood 2012). This rise in diabetes affects the socio-economic status of the state. Therefore, there is a need to curb these rates. What can be done to reduce these prevalence rates, prevent and manage type 2 diabetes? Individuals should be encouraged to test for diabetes often in order to detect diabetes early and take the necessary precautions, (Morrison, Lowe & Collins 2010). Also, they should be provided with diabetes screening tools and advised on how to use them. Children should be taught on diabetes at an early age, shown a lifestyle that will prevent them from developing diabetes and kept from sources that may cause diabetes directly and indirectly such as inappropriate advertisements that may prompt them to result in unhealthy foods and snacks, (Lee et al 2013).

Diabetes is a chronic and dynamic condition, described by hoisted blood glucose levels. It is hard to assess the correct number of individuals with diabetes in Australia. The best gauge in light of the National Diabetes Services Scheme (NDSS), and the Australian Health Survey (National Health Survey, 2014– 2015), is that there are more than 1.2 million Australians with known diabetes, (Wang et al 2008). This is almost similar with the International Diabetes Federation ( IDF ) appraise which in 2017 there were 1.1 million individuals in the range of 20 and 79 years with diabetes in Australia. Prevalence of diabetes in Australia has dramatically multiplied in the course of past two decades and there is no sign this is abating, (Speight et al 2012). It is additionally evaluated that more than 2 million individuals are at high danger of getting diabetes. Among all individuals with diabetes, 85% have a type 2 diabetes, (Forbes, Coughlan & Cooper 2008).

It is hard to gauge the aggregate monetary value of diabetes and its social effect. Medicinal services which is owing to the cost of diabetes which is around $1.7B every fiscal year. Adding the direct and indirect expenses, the total diabetes cost may be though just an estimation as much as $14B annually, (Ling & Groop 2009). These miscellaneous expenses incorporate diminished profitability, nonappearance from work, early retirement and unexpected passing and, deprivation. Expenses are intensely packed specifically sub-sets of individuals with diabetes. Yearly immediate expenses for individuals with diabetes intricacies are more than twice as much as for those individuals without diabetes, (Rivas et al 2011).

Background

The Australian people who are aged or are old have a very high possibility of getting diabetes type two therefore are bound to practice very higher rates of handicap related to the malady. Individuals undergoing treatment for mental health disarranges, for example, sadness, nervousness and schizophrenia might also be at higher danger of diabetes, (Erlich et al 2008). Also, overweight individuals, individuals with prediabetes, and physically inactive individuals are more likely to get bound with diabetes type 2 disease. Australian Health Survey, 2013 showed that It is evaluated that, for each 100 individuals with type 2 diabetes especially in Australia, atleast more than 25 people might be living with diabetes which is undiscovered, (Diabetes 2010). People who have undiscovered diabetes type 2 are not informed about their situation and therefore they don’t have access to required vital care. They might therefore have complications of their diabetes.

According to (Catanzariti et al 2009), The risk factors associated with the rapid increase in the diabetes type 2 in countries like Australia can be prevented and gotten rid of. The main risk factors are lifestyle choices such as taking in too much sugars, being physically inactive, and hereditary factors such as overweight and/or obesity. Individuals who have prediabetes and are not diagnosed and people in geographically remote areas who have no access to healthcare are also at high risk of diabetes.

In reference to  (Cani et al 2008), Studies have shown that modification of the way of life has been more efficient in the process of reducing the diabetes rates in Australia as compared to pharmacological interventions. The Australian evaluative trial, Greater Green Triangle Diabetes Prevention Program proved that lifestyle changes by being more active and avoiding some foods greatly prevents diabetes. However, diabetes still remains an issue and a more vibrant program needs to be established to prevent and manage diabetes.

In order to reduce the prevalence rates due to type 2 diabetes, action needs to be taken. First is to identify the desired and specific goals that the strategies set are to meet, (Colagiuri et al 2010). Such goals include, preventing people from developing type 2 diabetes, creating vast awareness on diabetes type 2 in the whole of Australia, reduce the occurrence of complications related to diabetes such as cardiovascular diseases, manage the pre-existing impact of diabetes amongst all groups, and strengthen prevention and care of diabetes through further research.

Some of the considerations recommended are;

  1. Educational programs and social media campaigns on how to manage the risk factor of modification which is related to diabetes and education on self-management.
  2. Increase the availability and demand of healthy foods in the community. This can be done through a healthy- star rating method or increased taxes on unhealthy foods and decreased prices on much healthier foods. This can also be done through establishment of policies that govern the advertising code of conduct and regulating the audiences of some adverts that may encourage intake of unhealthy foods and drinks. This can be a viable factor to encourage healthy living but has some implications such as reduced revenues by some companies and thus affecting the economy.
  3. Identification of high risk individuals and consider effective interventions. This is a helpful factor but sometimes it can be hard to identify all high risk individuals and also there are high chances of selecting individuals who are not at risk. This can be costly and time wasteful.
  4. Promotion of awareness on type 2 diabetes and early detection of diabetes through dispatch of diabetes screening tools to high risk individuals.
  5. Use of technology for further research on diabetes and likely cure for diabetes. This can be effective but time consuming and costly. It is only viable for long-term solutions.
  6. Development of clinical policies and guidelines, programs to prevent diabetes related complications and pathways for local care.
  7. Peer support programs that are accessible to everyone. This can be done face to face or online. This however can be quite costly because a large workforce will be required to cover all areas including the geographically remote areas which may be hard to reach and there are likely cultural and linguistically barriers.
  8. Educations and social campaigns on monitoring of complications related to diabetes both to healthcare providers and general individuals.
  9. Ensure access to affordable medicines to manage diabetes and devices to detect and measure diabetes to all.
  10. Enhance schools and child care services to be diabetic free by provision of guidelines and policies to govern this child environment.
  11. Funding of research by government to be able to identify the cure for diabetes.

Pre-existing policies/activity

From the above considerations, some initiatives can be more effective and easier to implement and produce results in the short term. These have been identified and are the recommendations. First is the promotion and creation of awareness of type 2 diabetes, its causes and the likely ways to prevent it, (American Diabetes Association  2014). This can be done through a community approach and social media campaigns and training of healthcare providers to advice their patients on diabetes. Also, communities need to be educated on how their lifestyle can lead to development of diabetes and how to prevent this by being physically active and avoiding unhealthy diets, (Australia 2011).

Individuals should be encouraged to test for diabetes often in order to detect diabetes early and take the necessary precautions. Also, they should be provided with diabetes screening tools and advised on how to use them, (Begum 2011). Children should be taught on diabetes at an early age, shown a lifestyle that will prevent them from developing diabetes and kept from sources that may cause diabetes directly and indirectly such as inappropriate advertisements that may prompt them to result in unhealthy foods and snacks, (Cryer  2008).

Also, a community approach program should be developed in order to reach all individuals even those in remote areas and teach them on the implications of diabetes, (Colagiuri & Eigenmann 2009). Their healthcare providers should be given tools and resources to enhance their initiative of advising their patients and diagnosing them.

Social media platforms and campaigns can also provide a powerful tool for conveyance of the message about diabetes to the world and especially the young people who frequently use the internet. Use of technology for research can help in identifying the cure of diabetes in the long run.

References

Australia, D., 2011. National diabetes services scheme (NDSS). Diabetes Australia) Available at https://www. ndss. com. au/[Verified 19 December 2011].

American Diabetes Association, 2014. Diagnosis and classification of diabetes mellitus. Diabetes care, 37(Supplement 1), pp.S81-S90.

Begum, N., Donald, M., Ozolins, I.Z. and Dower, J., 2011. Hospital admissions, emergency department utilisation and patient activation for self-management among people with diabetes. Diabetes research and clinical practice, 93(2), pp.260-267.

Cryer, P.E., 2008. The barrier of hypoglycemia in diabetes. Diabetes, 57(12), pp.3169-3176.

Colagiuri, R. and Eigenmann, C.A., 2009. A national consensus on outcomes and indicators for diabetes patient education. Diabetic Medicine, 26(4), pp.442-446.

Colagiuri, S., Lee, C.M., Colagiuri, R., Magliano, D., Shaw, J.E., Zimmet, P.Z. and Caterson, I.D., 2010. The cost of overweight and obesity in Australia. Med J Aust, 192(5), pp.260-4.

Considerations

Cani, P.D., Rodrigo, B., Knauf, C., Waget, A., Neyrinck, A.M., Delzenne, N.M. and Burcelin, R., 2008. Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice. Diabetes.

Catanzariti, L., Faulks, K., Moon, L., Waters, A.M., Flack, J. and Craig, M.E., 2009. Australia’s national trends in the incidence of Type 1 diabetes in 0–14?year?olds, 2000–2006. Diabetic Medicine, 26(6), pp.596-601.

Diabetes, U.K., 2010. Diabetes in the UK 2010: key statistics on diabetes. London: Diabetes UK.

Erlich, H., Valdes, A.M., Noble, J., Carlson, J.A., Varney, M., Concannon, P., Mychaleckyj, J.C., Todd, J.A., Bonella, P., Fear, A.L. and Lavant, E., 2008. HLA DR-DQ haplotypes and genotypes and type 1 diabetes risk: analysis of the type 1 diabetes genetics consortium families. Diabetes.

Forbes, J.M., Coughlan, M.T. and Cooper, M.E., 2008. Oxidative stress as a major culprit in kidney disease in diabetes. Diabetes, 57(6), pp.1446-1454.

Ling, C. and Groop, L., 2009. Epigenetics: a molecular link between environmental factors and type 2 diabetes. Diabetes, 58(12), pp.2718-2725.

Lin, W., Huang, I.C., Wang, S.L., Yang, M.C. and Yaung, C.L., 2009. Continuity of diabetes care is associated with avoidable hospitalizations: evidence from Taiwan's National Health Insurance scheme. International Journal for Quality in Health Care, 22(1), pp.3-8.

Lee, C.M.Y., Colagiuri, R., Magliano, D.J., Cameron, A.J., Shaw, J., Zimmet, P. and Colagiuri, S., 2013. The cost of diabetes in adults in Australia. Diabetes research and clinical practice, 99(3), pp.385-390.

Morrison, M.K., Lowe, J.M. and Collins, C.E., 2010. Perceived risk of type 2 diabetes in Australian women with a recent history of gestational diabetes mellitus. Diabetic Medicine, 27(8), pp.882-886.

Rivas, M.A., Beaudoin, M., Gardet, A., Stevens, C., Sharma, Y., Zhang, C.K., Boucher, G., Ripke, S., Ellinghaus, D., Burtt, N. and Fennell, T., 2011. Deep resequencing of GWAS loci identifies independent rare variants associated with inflammatory bowel disease. Nature genetics, 43(11), p.1066.

Speight, J., Browne, J.L., Holmes-Truscott, E., Hendrieckx, C. and Pouwer, F., 2012. Diabetes MILES-Australia (Management and Impact for Long-term Empowerment and Success): methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults. BMC Public Health, 12(1), p.120.

Wang, Y., Beydoun, M.A., Liang, L., Caballero, B. and Kumanyika, S.K., 2008. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity, 16(10), pp.2323-2330.

Wright, J. and Harwood, V. eds., 2012. Biopolitics and the'obesity epidemic': governing bodies (Vol. 3). Routledge.

Youn, B.S., Klöting, N., Kratzsch, J., Lee, N., Park, J.W., Song, E.S., Ruschke, K., Oberbach, A., Fasshauer, M., Stumvoll, M. and Blüher, M., 2008. Serum vaspin concentrations in human obesity and type 2 diabetes. Diabetes, 57(2), pp.372-377

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