Diabetes is a chronic health condition marked by high levels of glucose (sugar) in the blood. It is caused by the inability to produce insulin (a hormone made by the pancreas to control blood glucose levels) or to use insulin effectively, or both. Diabetes is usually managed with help from a doctor and the Australian health system. Doctors and diabetes nurses formulate personalized Diabetes Care Plans that allow for five yearly visits with allied health professionals, such as a dietitian, diabetes educator or psychologist, with a Medicare rebate.
Diabetes is considered to be a disease rather than a disability and on its own, does not qualify for NDIS funding. However, if managing diabetes is difficult due to a disability, the NDIS may fund diabetes management supports. Diabetes management supports could offer a nurse to identify any disability related supports needed to follow a Diabetes Care Plan. Such support might include testing blood sugar levels, diet, exercise assistance and assistance with psychosocial support to facilitate higher functioning.
People with diabetes have been found to be twice as likely to have a disability than people without diabetes (39% compared with 17%) and almost 3 times as likely to have a severe or profound limitation (14% compared with 5%) than people without diabetes. Among working-age people with diabetes and disability, 40% said they were permanently unable to work compared with 20% of people with a disability. People with diabetes reported higher rates of high blood pressure, high cholesterol, heart disease, stroke, depression, vision loss and kidney related disorders than people without diabetes.
People with diabetes are 2 to 3 times more likely to have depression than people without diabetes. Only 25% to 50% of people with diabetes who have depression get diagnosed and treated. But treatment—therapy, medicine, or both—is usually very effective. And without treatment, depression often gets worse, not better”.
Prevalence
According to state-based registers in 2020, almost 1.3 million (1 in 20) Australians are living with diabetes and are registered with the linked National Diabetes Services Scheme (NDSS) and Australasian Paediatric Endocrine Group (APEG). This includes people with type 1 diabetes, type 2 diabetes and other diabetes. Almost 1 in 5 (19.4%) persons living in the lowest socioeconomic areas are 2.2 times as likely to be diagnosed with diabetes as those living in the highest socioeconomic areas. It contributed to around 17,500 deaths (10.8% of all deaths) when associated causes are included. Further, diabetes death rates were 5 times as high among Indigenous Australians as non-Indigenous Australians.
Diabetes Management Supports
The NDIS may fund a nurse to formualte a disability-related diabetes management plan. This may include funding for:
- an initial consultation
- a nurse to write the plan
- a nurse to review the plan and make any changes you need.
For some diabetes management supports, a registered nurse may be able to train and delegate key tasks to a support worker or enrolled nurse. This support worker would directly provide the support they are trained for. This is called ‘delegation and supervision of care.’ It allows a registered nurse to delegate nursing tasks to an appropriately trained person.
To access diabetes management supports, supporting evidence to show the support meets the NDIS funding criteria should be lodged (such as a Diabetes Care Plan from a GP). The evidence should show that the support is needed because of a disability, and how the support is likely to be effective and beneficial.
References
Australian Institute of Health and Welfare (2022) Diabetes: Australian facts, AIHW, Australian Government
https://www.aihw.gov.au/reports/diabetes/diabetes-disability-impairments-activity-limits/summary
https://ourguidelines.ndis.gov.au/supports-you-can-access-menu/diabetes-management-supports
