Diabetes is a highly prevalent condition across the world, in both developed and developing nations. This disease affects significant portions of the population of all countries and its management is therefore very important to public health in general (1). Type 2 diabetes management is done in Australia and in the UK by many entities including the government entities in charge of healthcare, the pharmaceutical bodies that dedicate their efforts to research and development of drugs that are used to manage diabetes, charity organisations that help with funding the war against diabetes and carry out public education, and the individual patients and their family who have to deal with the administration of treatments such as insulin on a daily basis in order to control the disease (2). The management if type two diabetes therefore involves many entities and its success relies on the efficient and comprehensive engagement of all the stakeholders in the management effort.
In Australia, a study carried out over the spun of two years by the health survey body indicated that about four percent of the general population of the country had diabetes, with over 85 percent of them having type two diabetes (3). Other studies have shown that over 7 percent of the population of Australia lives with type two diabetes while close to half of those with diabetes being unaware of their condition (2). This indicates that efforts in the management of diabetes have to be stepped up and streamlined further by the federal government of Australia as well as all other levels of government in order to increase awareness. Diabetes is best managed in cases where it is discovered early, and the percentage of the population that is unaware of the respective conditions is at a higher risk of developing complications or loss of lives to diabetes (4). In response to these studies, the government of Australia has boosted funding for diabetes research and management in the recent years, starting with over 12 million dollars for the Diabetes MEDs Check program (3). Organizations such as the pharmaceutical guild have also started programs such as the field training of patients and medical practitioners in the management of diabetes.
In the UK, there are close to 3 million people living with diabetes, and it is estimated that close to 1 million more people Have the disease but are unaware of their condition (5). Additionally, research has indicated that 5 million people are at a high risk of developing diabetes due to issues like lifestyle choices, genetic predisposition, and eating habits. The prevalence of diabetes has been found to be almost thrice as high as that of all the forms of cancer combined in the UK, and a vast majority of the cases of diabetes in the country are type 2. The National Health Service in the UK has estimated that over 10 percent of all its funding is dedicated to the management of diabetes, and other related condition, which shows that diabetes is generally costly to manage (6). The funds dedicated to diabetes management in the UK have been estimated to be about 9 billion pounds, and the UK government has been consistent in providing the funds and in aiding the fight against diabetes over the years (5). The role of private entities such as charities is less in the UK than it is in Australia because of the differences in the health care system of the two countries.
Figure 1 Comparison between diabetes prevalence and cancer prevalence in the UK over the period between 2006 and 2010 (7)
Aims and Objectives
The aim of this report is to study the management of diabetes in developed countries using Australian and the United Kingdom as case studies, in order to identify ways in which the management can be streamlined, so as to reduce cases where death and complications may arise as a result of inefficient management.
Another aim of the report is to contrast the management of type two diabetes in the UK and in Australia in order to establish a correlation between various management strategies and a reduction in fatality of diabetes related conditions in community pharmacies.
The paper also aims to identify which type 2 diabetes management strategies are the most economical in terms of yielding the best results for the lowest cost for community pharmacies.
Search strategy
A qualitative approach is used in this research process. The research strategy involves reviewing various articles and studies that have been done on the topic of management of diabetes in the two countries. This involves the comparison of findings of other peer reviewed articles, and drawing of new observations from the same (8). It also involves looking at data from health institutions in both countries, from both the government health department and from private health care providers in order to gain a clear and empirical understanding of the state of type two diabetes management in the UK and in Australia.
Activities involved in the Management of Diabetes in Patients in the UK and in Australia
There are certain activities that must be carried out in order to properly manage type 2 diabetes in a patient. The basic activities are similar in both the UK and in Australia since the nature of the disease is the same irrespective of the geographical location of the patient (9). The standards of monitoring and management of diabetes are almost the same in all developed countries because the equipment involved in the measurement of the physiological parameters is readily available in these countries.
Measurement of vital indicators of type 2 diabetes
The activities involved in the management of diabetes include basic processes such as the measurement of blood sugar or glucose levels, the measurement of blood pressure and the measurement of blood cholesterol or fat levels (10). These measurements need to be done as frequently as possible so that patients have knowledge of their prevailing conditions as well as historical data upon which to base the progression of their improvement or deterioration. In both the UK and in Australia, these services are available in all healthcare facilities. Additionally, there are kits available for the measurement of blood sugar and blood pressure, which the patients can purchase at a low cost and use at home as regularly as they want to (9). The use of kits requires a bit of training, and it is provided by doctors and outreach programs in both countries.
Monitoring of diabetes related complications
The most common complications that may come about as a result of type 2 diabetes include the deterioration of vision, loss of nerve function in the limbs and reduced blood circulation in the peripherals, and the failure of one’s kidneys (11). These conditions have to be monitored in all cases so that specialized medication is provided to reduce their progression or to prevent their occurrence altogether. In both the UK and Australia, hospitals across the country are equipped with specialized equipment and trained personnel who offer frequent check-up services to patients (11, 12). Both government and private hospitals have services that are tailor-made to curtail these conditions. In the UK, people with diabetes are offered an annual eye check-up in order to prevent the occurrence of retinopathy (12). A similar program exists in Australia, where the patients opt for eye checks at a frequency of their own choosing, although the cost of the check-up is subsidized by the Diabetes MEDs Check program. Diabetes patients are also offered frequent foot checks in both the UK and in Australia, and they are often referred to specialized podiatrists in case they have developed further complications or they are in need of further observation or treatment (13). The governments of both countries along with other private entities have in the past few decades carried out campaigns to create awareness on this particular outcome of type two diabetes since if it goes unchecked; it could lead a patient to lose a limb (11). Monitoring of the renal function is one of the most important things in the management of type two diabetes. In both the UK and in Australia, diabetes patients are offered biannual tests to monitor their kidneys because kidney failure is one of the leading causes of death among the diabetes patients across the world (13). In both countries, the tests include a urine test to find out if there are proteins present in the urine, which is usually an indicator of advanced complications. There is also a blood test issued, which is an indicator of the functioning of the patient’s kidneys.
Medical advice and emotional support for patients
In both the UK and in Australia, there are programs put in place to offer medical advice and counselling to the diabetes patients and to the members of their families. The provision of medical advice is important to both those people living with diabetes, and to the general population, especially those at high risk of developing diabetes (14). Medical advice teaching the patients and their amateur caregivers on the proper way to administer medication, the proper dosage and frequency for patients who take insulin, and the proper dietary choices that the patients need to make. Free advice is offered by the Australian pharmaceutical society as well as other entities, both public and private in Australia (15). There is also plenty of sound advice readily available in web sites and trough other forms of media in Australia. In the UK, there are similar awareness and training programs all over the country from the government, charitable organisations, and even online sources.
The people living with diabetes often require counselling, therapy or emotional support. Most hospitals in both the UK and Australia have organized support groups for people with diabetes so as to ensure that individuals are able to share their experiences, which come in handy in the management of type two diabetes (14). In the UK, the National Health Service covers therapy sessions for diabetes patients to help them cope with the stress that comes with managing diabetes. Australian doctors can also prescribe therapy for diabetes patients who they consider to be in need of psychological support (15).
It is therefore evident that both the UK and Australia have in place adequate programs, both from the government and from private entities, which are geared at helping the general population detect whether or not they have diabetes, prevent the occurrence of diabetes in high risk individuals, manage diabetes to prevent the occurrence of serious complications, and treat the complications is they occur (13).
Diabetes management in community pharmacy in UK and Australia
Basic services provided at community pharmacies for type 2 diabetes patients
The establishment of community pharmacies in the UK and in Australia has led to great improvements in the provision of medicine among members of the community in the respective countries (16). Community pharmacy is particularly good for the supply of the type 2 diabetes medication since its reach in the community is deep, and therefore it tends to give access to more people than other healthcare facilities such as hospitals. Community pharmacy programs are available across all the Australian states, and they are facilitated by government programs such as Meds Check (17). Diabetes patients often require frequent and continuous medication, and the presence of community pharmacies make it easy for them to gain access to prescriptions and other medical therapies.