Type 2 diabetes mellitus (T2DM) is one of the most common long term conditions affecting NZ adults, with a prevalence of around 7%. Prediabetes is a precursor stage to T2DM with up to 70% eventually progressing on to T2DM. A further 26% of adult New Zealanders have prediabetes. The prevalence of both T2DM and prediabetes is rapidly increasing in NZ. Māori, Pacific and Indian people have particularly high rates of T2DM with rates up to three times higher than European New Zealanders. Diabetes is associated with multiple long-term complications, higher mortality and substantial healthcare costs. We use the Virtual Diabetes Register, to identify risk factors for poor outcomes among people with diabetes. We are also evaluating interventions to reduce the burden of diabetes in our community, including work aiming to reduce lower limb complications of diabetes and a major trial investigating the usefulness of a self-management intervention, which shifts the focus from clinical management in the surgery or clinic, to prevention and management in the hands of the people living with these conditions.
Ko te mate huka momo 2 nei (T2DM) tētahi o ngā tino māuiui tūroa ki waenga i te hunga pakeke o Aotearoa, kei te āhua 7% te tokomaha e pāngia ana. Ko te tōmuatanga mate huka, he tapuwae tōmua ki te mate huka, arā ko tōna 70% ka pāngia e te tōmuatanga ka tae atu ki te mate huka momo 2 nei. Tērā anō ko tōna 26% o ngā tāngata pakeke o Aotearoa kei te pāngia e te tōmuatanga mate huka. Kei te tere te nui haere o te pānga atu o te mate huka me te tōmuatanga mate huka ki ngā iwi o Aotearoa. He nui tonu ngā tatauranga mō te mate huka a Ngāi Māori, ki ngā iwi o te Moana-nui-a-Kiwa, ki Ngāti Īnia hoki, arā kei te toru tāima te nui ake i ngā tatauranga o te iwi Pākehā. Kei te whai hononga te mate huka ki ētahi māuiuitanga tūroa, ki ngā tatauranga mate nui ake, ki ngā utu nui hoki mō te whakawhiwhi ratonga hauora. Ka whakamahi mātau i te Rēhita Mate Huka Mariko ki te tautohu i ngā whakamōrearea mō ngā huanga kino e rangona ana e te hunga mate huka. Kei te arotake hoki mātau i ētahi kaupapa hei whakamāmā i ngā taimahatanga o te mate huka ki tō tātau hapori, tae atu ki ngā mahi hei whakaiti i te pānga atu o te mate huka ki ngā waewae o te tangata me tētahi rangahau nui e titiro ana ki te whai hua o tētahi kaupapa whakahaere whaiaro māna ka huri te aro i ngā mahi whakahaere i te whare haumanu ki ngā mahi whakahaere a te tangata e pāngia ana e te mate huka.
Projects
- BetaMe Study
- Epidemiology and prevention of diabetic foot lower-limb amputation
Key publications
Gurney, J., Stanley, J., York, S., Sarfati, D. Regional variation in the risk of lower-limb amputation among patients with diabetes in New Zealand. ANZ Journal of Surgery, Accepted and In-Press, doi: 10.1111/ans.15079
Gurney, J., Stanley, J., York, S., Sarfati, D. (2018). Lower-limb amputation in New Zealand: temporal changes and the role of diabetes mellitus. New Zealand Medical Journal, 131 (1484).
Sarfati D, McLeod M, Stanley J, Signal V, Stairmand J, Krebs J, Dowell A, Leung W, Davies C, Grainger R. (2018). BetaMe: Impact of a comprehensive digital health programme on HbA1c and weight at 12 months for people with diabetes and pre-diabetes: study protocol for a randomised controlled trial. Trials, 19(1), p161.
Gurney J, Stanley J, Rumball-Smith J, York S, Sarfati D. Post-operative death following lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetes Care 2018;41:1204–1211 | https://doi.org/10.2337/dc17-2557
Sarfati D, McLeod M, Stanley J, Signal V, Stairmand J, Krebs J, Dowell A, Leung W, Davies C, Grainger R. BetaMe: Impact of a comprehensive digital health programme on HbA1c and weight at 12 months for people with diabetes and pre-diabetes: study protocol for a randomised controlled trial. Trials 2018; 19: 161 https://doi.org/10.1186/s13063-018-2528-4
Gurney J, Stanley J, York S, Rosenbaum D, Sarfati D. Risk of lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetologia 2017; https://doi.org/10.1007/s00125-017-4488-8.
Gurney, JK, Kersting U, Rosenbuam D, Dissanayake A, York S, Grech R, Ng A, Milne B, Stanley J, Sarfati D. Pedobarography as a clinical tool in the management of diabetic feet in New Zealand: a feasibility study. Journal of Foot and Ankle Research 2017; 10(11):24.
Gurney, J.K., Marshall, P.W.M., Rosenbaum, D., Kersting, U.G. (2013). Test-retest reliability of dynamic plantar loading and foot geometry measures in diabetics with peripheral neuropathy. Gait and Posture, 37 (1), p135-137.
Gurney, J.K., Kuch, C., Rosenbaum, D., Kersting, U.G. (2012). The Māori foot exhibits differences in plantar loading and midfoot morphology to the Caucasian foot. Gait and Posture, 36, p157-159.