Diabetes is now an epidemic in Australia. The illness affects people of diverse ages, backgrounds, and cultures. Mary Kotsopoulos, from Heidelberg Heights in Melbourne, is one of the 1.2 million Australians living with Type 2 diabetes, and one of the 310,000 that now requires insulin.
Mary, who is now 65 years old, managed her condition well for 10–15 years; however, after being diagnosed with another serious health problem last year, she required a medication that spiked her glucose levels. As a result, she now requires insulin as well as glucose-lowering medications and hourly blood checks—even during sleep—to prevent complications, including coma.
“I was scared to go to sleep at night because my levels were going down so low. I was told by the medical professionals that I need to keep it in check because when you’re asleep, you don’t know what is happening; I couldn’t feel it, and it can lead to a coma,” she said.
Type 1 and Type 2 diabetes
There are two forms of diabetes: Type 1 and Type 2. In essence, blood glucose levels rise due to the pancreas not producing enough insulin or the body’s cells becoming resistant to insulin. Those with Type 1 diabetes are typically diagnosed before age 30, but diagnosis is possible at any age, and they rely on daily insulin and regular glucose monitoring. They represent about 10 per cent of all diabetes cases in Australia.
Type 2 diabetes, which accounts for 85–90 per cent of all cases, tends to develop in adults over 45 years old, though it increasingly affects younger individuals. Risk factors include family history and certain ethnic backgrounds. According to Diabetes Australia, around 10.7 per cent (51,900) of Aboriginal and Torres Strait Islander people live with Type 2 diabetes, and prevalence increases with remoteness and socioeconomic disadvantage.
However, Type 2 diabetes can also lead to reliance on insulin and constant monitoring like Type 1 diabetes, if not managed, or due to factors such as another illness or ageing. If that occurs, life can become even more arduous for insulin-dependent Type 2 diabetes sufferers. Mary spoke to Neos Kosmos about her daily life and how she managed to find a way to keep her diabetes in check. She gained peace of mind when she began using the revolutionary Continuous Glucose Monitor (CGM), which provides real-time feedback on glucose levels and alerts users of potential danger.
“I tried it for two weeks, and I thought, I can’t be without it. It’s a godsend,” she said.
Mary now advocates for greater access to CGM and lobbies for more government subsidies to assist those who need it but may not have the financial capacity to access what has become essential technology for those with insulin-dependent Type 2 diabetes. She spends over $200 a month—$3,000 a year—to use the CGM as someone with Type 2 diabetes. Some Australians with diabetes have better access to this technology, but gaps persist, particularly for people with insulin-dependent Type 2 diabetes. The Commonwealth government does provide financial support for CGM devices for those with Type 1 diabetes, which leaves many, like Mary, exposed to the implications of the disease.
New report calls for greater access to subsidised CGM to address a growing epidemic
A report published in July by the National Inquiry into Diabetes urges that subsidised CGM access be expanded for Australians with insulin-dependent Type 2 diabetes and others who have glucose control difficulties. The report highlights the considerable burden of Type 2 diabetes on the healthcare system, impacting fields from obstetrics to geriatrics, and states that CGM technology is essential to help “delay the onset of complications.”
An estimated 1.1 million hospitalisations were associated with Type 2 diabetes in 2021–22, according to the Australian Institute of Health and Welfare (AIHW). Australia’s peak diabetes organisation, Diabetes Australia, has now joined the call for better access to CGM devices through a petition. The Australian Diabetes Educators Association CEO, Susan Davidson, has also endorsed their call.
Beyond the immediate safety it provides Mary, her CGM has taught her more about which foods impact her glucose levels, helping her make better dietary choices.
“I’ve learned so much by having it [CGM] on all the time. It’s interesting to note different times of the day, different foods, what they do to you, and how much they spike your sugars, or how much your sugar levels go down.”
Mary has appealed to the National Diabetes Service Scheme (NDSS) for subsidised CGM access, accompanied by a letter from her endocrinologist explaining the CGM’s essential role in her care. Unfortunately, her request was denied.
“The government really needs to pull their finger out,” Mary says. She adds that while the recent report is “promising,” “sustained advocacy is necessary” to bring about change.