This year’s World Diabetes Day, on 14 November, has adopted a long overdue and particularly important theme: Early Action on Diabetes.
With millions of Australians already at risk, isn’t it time we put as much effort into preventing Type 2 diabetes as we do into treating it?
The International Diabetes Federation is encouraging governments, healthcare professionals and communities worldwide to recognise diabetes risk factors, improve early diagnosis and take action to reduce the likelihood of developing Type 2 diabetes.
It’s an important message. But here in Australia, it raises an uncomfortable question.
If we know so much about preventing or delaying Type 2 diabetes, why are we still so focused on managing it once it develops?
The Australian diabetes picture isn’t encouraging
According to the Australian Institute of Health and Welfare (AIHW), approximately 1.3 million Australian adults were living with diabetes in 2022–24. Diabetes contributed to 11% of all deaths in 2024 and accounted for approximately $4.4 billion in healthcare expenditure during 2023–24.
And that’s before considering the personal cost to individuals and families.
Diabetes increases the risk of cardiovascular disease, kidney damage, vision problems and nerve damage. These complications can significantly affect quality of life, independence and long-term wellbeing.
Yet there’s another figure that deserves just as much attention.
Around two million Australians are estimated to have prediabetes, a condition where blood glucose levels are higher than normal but haven’t reached the threshold for Type 2 diabetes.
That’s two million opportunities for earlier intervention.
Prediabetes: the warning sign we’re overlooking
One of the biggest challenges with prediabetes is that most people feel perfectly well.
There may be no obvious symptoms, no dramatic changes in energy levels and nothing particularly alarming about everyday health.
Behind the scenes, however, the body’s ability to regulate blood glucose may already be changing.
Insulin resistance often plays a major role. When cells become less responsive to insulin, the pancreas works harder to maintain healthy blood glucose levels.
Over time, this additional demand can contribute to deteriorating glucose regulation.
The encouraging news? Prediabetes doesn’t automatically mean Type 2 diabetes is inevitable.
Research consistently demonstrates that changes to nutrition, physical activity and other lifestyle factors can significantly reduce the risk of progression. One of the most effective forms of exercise for managing blood glucose levels has been shown to be resistance training to increase muscle mass.
But people need to know they’re at risk before they can take meaningful action.
Food as Medicine: more than simply avoiding sugar
When people hear the words diabetes prevention, the advice often sounds remarkably familiar.
Eat less sugar. Lose weight. Exercise more.
While this advice is a good start, there’s more to the whole story.
Type 2 diabetes is a complex metabolic condition influenced by genetics, body composition, dietary patterns, physical activity, sleep and other health factors.
One particularly important area is dietary fibre.
Unlike refined carbohydrates, fibre-rich whole foods can help moderate the rise in blood glucose following meals, support digestive health and contribute to feelings of fullness.
Certain fibres are also fermented by beneficial gut bacteria, producing short-chain fatty acids that are being investigated for their roles in metabolic health and inflammation.
This is where the Food-as-Medicine philosophy becomes especially relevant.
Rather than simply removing foods from the diet, we should be encouraging people to improve the nutritional quality and diversity of what they eat.
Vegetables, legumes, whole grains, nuts, seeds and other naturally fibre-rich foods offer multiple benefits that go well beyond blood glucose management and offer improvement in ALL aspects of health.
Bottom line is there’s no single magic ingredient or supplement that replaces a healthy dietary pattern.
Prevention shouldn’t be a privilege
We also need to acknowledge that healthy living isn’t equally accessible to everyone.
Food affordability, working hours, geographic isolation, access to healthcare and opportunities for physical activity all influence people’s ability to make healthier choices.
Telling someone to eat better is relatively easy. Ensuring they have access to affordable nutritious food, preventive health services and practical ongoing support is considerably more challenging.
Australian research shows that diabetes disproportionately affects people living in socioeconomically disadvantaged and remote communities, along with Aboriginal and Torres Strait Islander populations.
Prevention must be more than another message about personal responsibility.
Are we investing enough in prevention?
Australia has made important advances in diabetes treatment, technology and management. Medications, monitoring devices and specialist services provide essential support to people already living with diabetes. They deserve continued investment.
But prevention deserves the same commitment.
Imagine the potential benefits of making diabetes risk assessments, nutrition education and practical lifestyle support more accessible through general practice, pharmacies, workplaces and community organisations.
Imagine identifying insulin resistance and prediabetes years before a diagnosis, then helping people make sustainable changes rather than simply advising them to return for another blood test.
We shouldn’t underestimate the value of relatively small, consistent improvements in everyday habits. And we shouldn’t wait until someone becomes a patient before offering meaningful support.
A different conversation for World Diabetes Day
World Diabetes Day is an opportunity to recognise people living with all forms of diabetes, including Type 1 diabetes, which cannot currently be prevented through lifestyle changes.
It’s also an opportunity to rethink our approach to Type 2 diabetes.
Early screening, better education and greater access to preventive support could change the health trajectory of many Australians.
Not every case can be prevented, and prevention will never eliminate the need for effective medical treatment. But we can certainly do better at recognising risk and responding earlier.
World Diabetes Day shouldn’t simply remind us how many Australians are living with diabetes.
It should challenge us to ask how many future diagnoses we could prevent or delay.
