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Issue

Vol 134 No 1529: 5 February 2021

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Issue Summary

Article
SUMMARY

The clinical workforce caring for emerging adults with diabetes in New Zealand is under resourced

Diabetes is one of the most common disorders in emerging adults (15–25 years of age) and affects approximately 2,300 New Zealanders in this age group. Emerging adulthood is typically the hardest age group in which to achieve good glycaemic control (control of glucose levels), due to the high prevalence of psychosocial stressors and increased insulin resistance of puberty. Consequently, international guidelines recommend emerging adults with diabetes receive care from a dedicated multidisciplinary team consisting of an endocrinologist (specialist diabetes physician), diabetes nurse specialist, dietitian, psychologist and social worker or youth worker. Our survey of all 20 district health boards (DHBs) show that the clinical workforce caring for emerging adults with diabetes in New Zealand is significantly under resourced, with only twelve DHBs having a dedicated multidisciplinary team, only eight DHBs having dedicated dietitian staff, three DHBs having dedicated psychology staff and four DHBs having a dedicated social worker or youth worker/health navigator. Median staffing-to-patient ratios were at least three-fold less than international recommendations, more than ten-fold and thirty-fold less for dietitians and psychologists, respectively, and approximately half that of staff caring for children with diabetes in New Zealand. Despite the increasing prevalence of type 2 diabetes in emerging adults, no DHB had an intervention programme for type 2 diabetes in this age group.

Article
SUMMARY

The clinical workforce caring for emerging adults with diabetes in New Zealand is under resourced

Diabetes is one of the most common disorders in emerging adults (15–25 years of age) and affects approximately 2,300 New Zealanders in this age group. Emerging adulthood is typically the hardest age group in which to achieve good glycaemic control (control of glucose levels), due to the high prevalence of psychosocial stressors and increased insulin resistance of puberty. Consequently, international guidelines recommend emerging adults with diabetes receive care from a dedicated multidisciplinary team consisting of an endocrinologist (specialist diabetes physician), diabetes nurse specialist, dietitian, psychologist and social worker or youth worker. Our survey of all 20 district health boards (DHBs) show that the clinical workforce caring for emerging adults with diabetes in New Zealand is significantly under resourced, with only twelve DHBs having a dedicated multidisciplinary team, only eight DHBs having dedicated dietitian staff, three DHBs having dedicated psychology staff and four DHBs having a dedicated social worker or youth worker/health navigator. Median staffing-to-patient ratios were at least three-fold less than international recommendations, more than ten-fold and thirty-fold less for dietitians and psychologists, respectively, and approximately half that of staff caring for children with diabetes in New Zealand. Despite the increasing prevalence of type 2 diabetes in emerging adults, no DHB had an intervention programme for type 2 diabetes in this age group.

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